Philpott 1

Lindsay Philpott
Cosmin Ritivoiu
English 102
4 May 2015
Insomnia and Heritability

Insomnia is a common problem among Americans today, with about 30% of Americans
struggling with it (Insomnia Statistics). While studying this topic is still in its early stages,
research has shown that many factors can contribute to insomnia. From medical problems such
as back pain, arthritis, asthma, and allergies; to depression and anxiety, insomnia is now
becoming an epidemic (National Sleep Foundation, What Causes Insomnia?). Centers for
Disease Control Prevention entitled one of their web articles Insufficient Sleep is a Public
Health Epidemic (Centers for Disease Control Prevention). As researchers continue to study out
different causes of this growing problem, they have come to the conclusion as studies suggest
that insomnia can be attributed to hereditary and genetic factors.
As stated in the first paragraph, 30% of Americans struggle with insomnia. Of that 30%,
about 30-35% struggle briefly with insomnia, 15-20% have what is called short-term insomnia
disorder, and about 10% have the chronic insomnia disorder (Sleep Education). Many factors
have been shown to contribute to insomnia. The 30% who briefly struggle with insomnia, may
find it is from medical conditions, such as back pain, arthritis, or allergies, while those who
suffer from short-

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term insomnia, may find their problems more challenging, such as depression or anxiety and
stress. But, there are 10% who suffer insomnia for long periods of time. This paper will attempt
to determine whether these 10% may suffer insomnia because of genetics or heritability.
Many have thought that insomnia is a symptom of another disorder; and indeed, it is a
symptom of depression and anxiety. However, studies have shown that insomnia can act
independent of these (Heritability of Insomnia Symptoms). And because insomnia can act by
itself as a medical problem, further research was needed to study what other factors could
contribute to this, i.e., genetics or heritability.
One study examined insomnia and genetics and its relation by itself and in conjunction
with depression and anxiety (Heritability of Insomnia Symptoms). Researchers studied 8-16
year old twins. There were 1412 twin pairs that contributed to the study, 46.3% of them male,
and 53.7% female. The researchers interviewed the participants, as well as their parents. The
results were as follows.
First, it was noted that the symptoms of insomnia were similar, and in the same range
between males (at 18.3%) and females (at 20.5%). The researchers also found that the overall
heritability of insomnia symptoms based on combined youth and parental reports is moderate,
with genetic factors accounting for about 37% of the variance (Heritability of Insomnia
Symptoms, 2011). The heritability of overanxious disorder was 30% for males and 46% for
females, and the heritability for depression was 11% for males and 19% for females. The
researchers also found that there was not as much evidence for genetic factors relating to
insomnia, as there were environmental factors. They concluded that there may be substantial

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overlap between the genetics of insomnia with that for depression and anxiety, although it was
not clear whether genetics was the main factor.
Another study looked specifically at the family history to see how it relates to insomnia.
The objective of the researchers for the study was to look at the rates of family history of
insomnia in a population-based sample composed of self-defined good sleepers and individuals
with insomnia and compare individuals with and without family history of insomnia on several
characteristics presumably associated with insomnia (Family History of Insomnia). The study is
described in the next few paragraphs.
There were 953 adults with a mean age averaged at 43.9 years. The researchers method
of study was to ask these individuals by use of a questionnaire and a survey of their past and
present history of sleep. The participants were categorized as good sleepers, individuals with
insomnia symptoms, or individuals with an insomnia syndrome (Family History of Insomnia).
They found that 39.7% of the participants had what were called first-degree relatives that had
past or current sleep issues. First-degree relatives were those who were parents or siblings of the
participant. Also, insomnia was the most common sleep disorder among first-degree relatives.
The researchers also found that those participants who did report insomnia were also more likely
to report a family history of insomnia.
This study was intended to examine further the relationship between a family
history of insomnia and the presence of insomnia in a population-based sample.
The findings indicate that individuals with either past or current insomnia are
more likely to report a positive family history of insomnia than are individuals
without any history of insomnia. Despite some methodologic [sic] limitations,

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these findings add to the limited available evidence suggesting that both a past
history of insomnia, as well as a positive family history, may predispose to the
development of persistent insomnia. (Family History of Insomnia)
Although more studies are needed to really determine if insomnia is linked to family history, the
researchers found that this study did provide additional evidence about the potential role of both
family and personal history of insomnia as predisposing factors to insomnia (Family History of
Insomnia), which means it could possibly be heritable.
One study though, had some results that suggested that insomnia could be moderately
heritable. This study was a twin study, in which the researchers used twins to see if the same
problem was in the family and if it was heritable. The participants they used for this study were
739 complete monozygotic twin pairs (52%) and 672 complete dizygotic twin pairs (48%).
They were initially enrolled and were followed up at three additional time points (waves). Mode
ages at each wave were 8, 10, 14, and 15 y (ages ranged from 8-18 y) (The Heritability of
Insomnia). There were a total of 4 waves.
For each wave they had a large number of participants, but all those who completed all
four waves totaled 325 in number. Table 1 (page 11) shows the Prevalence of child/adolescent
reported insomnia symptoms (The Heritability of Insomnia). It shows the rates of insomnia of
males and females, also showing that females have a higher chance of having insomnia. The
researchers also found that younger children were more likely than older children to experience
insomnia symptoms at the same wave. They found that there were age differences in those who
experienced middle insomnia in wave 1, an age difference of middle insomnia and any

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insomnia symptoms in wave 2, and age differences between middle insomnia between those
in wave 3.
In their discussion of the study, the researchers said they found four important findings.
First, they found that the
prevalence of clinically significant insomnia was relatively high compared to
expected figures for adulthood in middle/late childhood, but significantly
decreased to levels in line with adults by adolescence. Similarly, individual
insomnia symptoms (initial insomnia, middle insomnia, and early morning
awakening) significantly decreased across waves. (The Heritability of Insomnia)
The researchers considered that the possible reason for this greater proportion of insomnia
symptoms in younger children in comparison with adolescents could be attributed to the sleep
habits of the younger children, in regard to their poor sleep hygiene and inappropriate
associations of the bedroom environment with wakefulness (i.e., children often use their
bedrooms for play) (The Heritability of Insomnia). They also thought it may have something to
do with when the children would be put to bed by their parents, thinking that when they went to
bed they may have not been tired or their circadian rhythm was not synced with that time.
The second factor the researchers found was that there were associations between
clinically significant insomnia between adjacent waves, suggesting that within childhood and
adolescence, insomnia persists, but that continuity of symptoms across time within childhood

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and adolescence is minimal (The Heritability of Insomnia). The third factor gets into more of
the genetic issue:
Genetic factors contributed to ratings of clinically significant insomnia at all
waves, from 33%, 38%, 14%, and 24% in waves 1, 2, 3, and 4, respectively. The
genetic estimates are in line with estimates we would expect in adults in our
sample at wave 1 and wave 2; yet are somewhat lower in our sample at later
waves. This highlights the greater importance of the nonshared [sic] environment
during adolescence in comparison with that in younger children, in whom a host
of environmental and social changes are likely to take place, which may
consequently interfere with sleep. Interestingly, our results highlight the
contribution of nonadditive [sic] genetic effects at waves 1, 2, and 4, providing us
with insight into the possible genetic mechanisms at play. However, the greater
within-pair correlations in MZ twins compared with those of DZ twins could
suggest an alternative explanation. Such a pattern of results could suggest the
presence of sibling interaction, where one twins behavior affects that of the cotwin, rather than nonadditive [sic] genetic effects. (The Heritability of Insomnia).
This is noteworthy, because it seems to say that in waves 1, 2, and 4 there were more significant
evidences for genes playing a factor to insomnia. Yet, at wave three, the genetic factor is pretty
low, so it concludes with that sibling interaction could play a part in that situation.
The fourth also dealt with genetic factors. The study indicated that genetic factors
influencing insomnia at wave 1 contribute to the maintenance of insomnia through adolescence.
This is consistent with a study demonstrating that the stability of sleep difficulties from age 8 to

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10 y was to the result of shared genetic effects (The Heritability of Insomnia). There were some
genetic effects at wave 2, but not at waves 3 and 4; although, in waves 2 and 4, they had the
same genetic factors that could contribute to insomnia.
Although the study had some limitations, the researchers did conclude that childhood
insomnia was indeed more prevalent. Also, they found that clinically significant insomnia was
heritable across all waves, while the other ratings of insomnia were not necessarily heritable
(The Heritability of Insomnia).
While the last study was twin study, another study looked at the role genes played in
insomnia. They also wanted to see what genes could be related to insomnia. For starters, they had
to define the phenotype of interestor they had to define what the insomnia phenotype was
(The Role of Genes in the Insomnia Phenotype). Without taking the time to go through what the
researchers did to come to the conclusion about a phenotype, they came to a conclusion that the
Beta EEG power would be an ideal phenotype for genetic studies of insomnia. Beta EEG is
supposed to be connected with the increase of cortical processing, saying that insomnia could be
something between wakefulness and sleep that people will just think is wakefulness.
Then the researchers needed to see if the insomnia phenotypes were heritable.
In family history studies, family members of individuals affected with the
condition of interest are compared to family members of unaffected individuals. If
genetic factors contribute to the condition, the family members of affected
individuals will be more likely to also report the condition than those of
unaffected individuals given that they have shared genes. The greater the degree

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of genetic similarity between individuals the more they should be alike on
phenotypic measures. (The Role of Genes in the Insomnia Phenotype)
The researchers noticed that parents who struggled with insomnia, or at least not sleeping well at
night, reported having children that also had trouble sleeping at night. They found that
childhood onset insomnia was more likely the results of genetic heritability.
The researchers also found the possibility through the study of insomnia phenotypes that
there could be familial aggregation. This could be through the environment and genes combined.
In summary, family and twin studies demonstrate that insomnia phenotypes tend
to aggregate in families, with a greater degree of genetic similarity correlating
with greater phenotypic similarity. With few exceptions, heritability estimates in
adults were consistently in the range of .25 to .45, regardless of the exact question
or phenotype used. (The Role of Genes in the Insomnia Phenotype).
The study concluded by saying that insomnia was moderately heritable (The Role of Genes in
the Insomnia Phenotype). One third of the variance in symptoms traced to factors that were
genetics. Future studies include finding what genes are actually involved in the insomnia
phenotype.
In contrast with the article on finding potential genes, another article determined to
answer the question of whether insomnia was heritable (Genetics of Insomnia). This article
looked at the two main groups that researchers study to answer this question: twin studies and
family history studies. This paper has looked at some of those twin studies, in which they have
concluded that insomnia can be moderately inheritable.

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According to this article, there have only been 6 family history studies performed
(Genetics of Insomnia). In those family history studies, the researchers interviewed parents who
slept poorly as children, and looked at how they fell asleep and how well they slept. The
researchers noticed a correlation between the parents, and their 3-year old children who had the
same problems with sleeping. The small body of family history studies of insomnia is in
agreement with the twin studies in demonstrating a modest degree of genetic influences
although saying that more research is still needed (Genetics of Insomnia).
The second part of the article looked at specific genes that could be a cause of insomnia.
The researchers looked at genes such as serotonin, dopamine, aminobutyric acid, adenosine,
hypocretin/orexin, and others.
Our understanding of the genetics of insomnia, while primitive, points in several
directions for future research. This area is ripe for studies that could shed light on
the processes of both normal and pathologic sleep. The end result could be
improved identification of individuals at risk and the development of novel
treatments for insomnia. (Genetics of Insomnia)
However, as they concluded, more in-depth study and research is needed to determine which
gene, or genes, actually contributes to insomnia.
From looking at the different studies in this paper, there are several conclusions that can
be made. The first that can be considered is that insomnia or sleep issues can be attributed to
environmental issues. These can be something from stress at work, anxiety over family
problems, or even anxiety disorders in general. This type of insomnia is called short-term
insomnia, in which about 15-20% of Americans struggle with (Sleep Education).

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The second conclusion is that those who suffer from insomnia just briefly, deal with it
mainly because of different medical problems, like aches and pains. About 30-35% of the
American population deal with this type of insomnia (Sleep Education). This is the largest
percentage group.
The third conclusion to notice is the 10% of Americans who deal with chronic insomnia
(Sleep Education). It only makes sense that this would be the only group in which chronic
insomnia is heritable. Because almost all of the studies shown in this paper concluded that
insomnia is at least moderately heritable. It seemed that the 10% group has shown that their
insomnia is possibly heritable.
Insomnia is definitely a problem for many Americans. Each night, literally thousands of
people lay awake because they cannot sleep. This lack of sleep can be accounted for many
accidents, memory problems, and much more. Obviously, as mentioned already, environmental
factors definitely play a role. Yet for those who deal with it more seriously, researchers have
needed to take a second look; and although a lot more research is needed, from the research
shown here and in other places, this paper can come to the conclusion that insomnia is at least
moderately heritable.

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Table 1 for the Longitudinal Twin Study:

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Works Cited
"Insomnia Statistics - Prepare to Be Surprised." Better-Sleep-Better-Life.com. N.p., n.d. Web. 18
Mar. 2015. <http://www.better-sleep-better-life.com/insomnia-statistics.html>.
"What Causes Insomnia?" - Insomnia. N.p., n.d. Web. 17 Mar. 2015. <http://sleepfoundation.org/
insomnia/content/what-causes-insomnia>.
"Insufficient Sleep Is a Public Health Epidemic." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 13 Jan. 2014. Web. 24 Feb. 2015. <http://
www.cdc.gov/features/dssleep/>.
"Insomnia Awareness Day Facts and Stats." Insomnia Awareness Day Facts and Stats. N.p., n.d.
Web. 18 Mar. 2015. <http://www.sleepeducation.com/news/2014/03/10/insomniaawareness-day-facts-and-stats>.
Gehrman, Philip R., Lisa J. Meltzer, Melisa Moore, Allan I. Pack, Michael L. Perlis, Lindon J.
Eaves, and Judy L. Silberg. "Heritability of Insomnia Symptoms in Youth and Their
Relationship to Depression and Anxiety." Sleep. Associated Professional Sleep Societies,
LLC, n.d. Web. 18 Mar. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208840/
>.
Beaulieu-Bonneau, Simon, Mlanie LeBlanc, Chantal Mrette, Yves Dauvilliers, and Charles M.
Morin. "Family History of Insomnia in a Population-Based Sample." Sleep. Associated
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The Heritability of Insomnia Progression during Childhood/Adolescence: Results from a
Longitudinal Twin Study (n.d.): n. pag. Web. 27 March 2015.

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Gehrman, Philip R., Cory Pfeiffenberger, and Enda Byrne. "The Role of Genes in the Insomnia
Phenotype." Sleep Medicine Clinics. U.S. National Library of Medicine, n.d. Web. 23
Apr. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780427/>.
Gehrman, Philip R., Enda Byrne, Nathan Gillespie, and Nicholas G. Martin. "Genetics of
Insomnia." Sleep Medicine Clinics 6.2 (2011): 191-202. Web. 15 April 2015.