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Featured Article: Sleep quality varies as a function of 5-HTTLPR genotype and stress
neuroscienceCME Journal Club
Premiere Date: Monday, February 11, 2008 | Thomas Roth, PhD Chief, Division Head Sleep Disorders and Research Center Henry Ford Hospital Detroit, MI |
 | Andrew D. Krystal, MD, MS (Faculty) Professor of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham, NC |
As the knowledge base within the neurosciences expands exponentially, it becomes a challenge to keep pace and to know
where to focus precious time in search of the most clinically relevant literature.
neuroscienceCME Journal Club was designed for clinicians who have made this commitment to staying current. Are you
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improvements.
February 2008: Brummett BH, Krystal AD, et al. Sleep quality varies as a function of 5-HTTLPR genotype and stress. Psychosom Med 2007;69(7):621-624.
View Abstract
Synopsis:
There are very limited data on the genetics of disorders of initiation and maintenance of sleep (DIMS). The subgroup of individuals with essentially lifelong insomnia are of interest in this regard, however such individuals are rare, greatly limiting the possibility for population genetic research. A much larger group of individuals appears to be particularly vulnerable to experiencing sleep disturbance in response to stressors. This vulnerability appears to have trait-like stability in individuals across different stressors and over time such as might be seen with a genetic predisposition. The current study explored the genetics of developing sleep disturbance associated with the stress of being the primary caregiver for a spouse or parent with dementia. We evaluated whether variations in one specific gene that codes for the serotonin (5HT) transporter might be associated with the vulnerability to developing disturbed sleep in caregivers or might be linked to sleep quality in general. We studied this particular gene because it contains a polymorphism (s allele) that is common in the population that is associated with reduced 5HT reuptake activity which would be expected to increase 5HT binding and thereby disturb sleep. We compared self-rated sleep (subjects completed a single Pittsburgh Sleep Quality Index) in 142 caregivers and 146 controls as a function of 5HT transporter gene polymorphism. We found that genotype was unrelated to sleep. However, there was a significant polymorphism by caretaker interaction (p < .009) such that greater sleep disturbance (significant effects were observed in the sleep onset latency and nocturnal sleep disturbance subscales) was reported by caregivers with the s allele polymorphism compared with controls and compared with caregivers without the s allele. These findings provide preliminary evidence that the s allele polymorphism of the 5HT transporter gene may play a role in moderating sleep disturbance in response to chronic stress.
CME Outfitters, LLC, gratefully acknowledges an independent educational grant from Cephalon, Inc., in support of this complimentary 30-minute activity.
CE credit will not be offered for this activity.
Andrew D. Krystal, MD
Dr. Andrew Krystal is currently Associate Professor with tenure in the Department of
Psychiatry at Duke University Medical Center. There he directs the Sleep Research Laboratory, the Insomnia Clinic, the Quantitative EEG Laboratory, and the Therapeutic Brain Stimulation Research Program. He attended the Massachusetts Institute of Technology where he completed Bachelor's and Master's Degrees in Biomedical Engineering. He earned his doctorate in medicine from Duke University in 1987. He subsequently completed psychiatry residency training at Duke along with fellowships in Clinical Neurophysiology and Clinical Research Methodology. He is Board Certified in Psychiatry, Sleep Medicine, and Clinical Neurophysiology. His primary areas of clinical work are in sleep disorders, EEG, and mood disorders. His primary research is related to the pathophysiology and treatment of sleep disorders and mood disorders.
Thomas Roth, PhD
Dr. Roth is a Clinical Professor in the Department of Psychiatry at the University of Michigan College of Medicine, Ann Arbor, and Director of the Sleep Disorders and Research Center at Henry Ford Hospital, Detroit, Michigan. He received his PhD from the University of Cincinnati, Cincinnati, Ohio. He is currently Chairman of the World Health Organization (WHO) worldwide project on sleep and health and has served on several WHO national and international committees. Formerly, Dr. Roth served as Chair of the National Institutes of Health's National Center of Sleep Disorders Research. He is a past president of the American Academy of Sleep Medicine, the National Sleep Foundation, and the Sleep Research Society. He has also chaired committees of the Association of Professional Sleep Societies, the American Academy of Sleep Medicine, and the World Federation of Sleep Research Society. Dr. Roth's research has included sleep loss, sleep fragmentation, sleep pathologies, and the effects of pharmacologic agents on sleep-wake function.
Disclosure Declaration
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Dr. Krystal has disclosed that he receives grants/research support from Astellas Pharma Inc., Cephalon, Inc., Evotec Inc., GlaxoSmithKline, Merck & Co., Inc., National Institute of Health, Neurocrine Biosciences, Inc., Neurogen Corporation, Neuronetics Inc., Pfizer Inc., Respironics Inc., Sanofi-aventis, Sepracor Inc., Somaxon Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., and Transcept Pharmaceuticals, Inc. He serves as a consultant to Actelion Pharmaceuticals Ltd, Arena Pharmaceuticals, Inc., Astellas Pharma Inc., Axiom Pharmaceuticals, Inc., AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company, Cephalon, Inc., Eli Lilly and Company, GlaxoSmithKline, Jazz Pharmaceuticals, Inc., Johnson & Johnson Pharmaceutical Research & Development, L.L.C., King Pharmaceuticals, Inc., Merck & Co., Inc., Neurocrine Biosciences, Inc., Neurogen Corporation, Novartis Pharmaceuticals Corporation, Organon Pharmaceuticals USA, Inc., Pfizer Inc., Research Triangle Institute, Respironics Inc., Roche Labs, Sanofi-aventis, Sepracor Inc., Somaxon Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., and Transcept Pharmaceuticals, Inc. He is on the speakers bureau of the Sleep Medicine Education Institute.
Dr. Roth has disclosed that he receives grants from Cephalon, Inc., GlaxoSmithKline, Neurocrine Biosciences, Inc., Pfizer Inc., sanofi-aventis, Schering-Plough Corporation, Sepracor Inc., Somaxon Pharmaceuticals, Inc., Syrex, Takeda Pharmaceuticals North America, Inc., TransOral Pharmaceuticals, Inc., Wyeth Pharmaceuticals, and Xenoport, Inc. He serves as a consultant to Abbott Laboratories, Acadia Pharmaceuticals, Inc., Acoglix, Actelion, Alkermes, Inc., ALZA Corporation, Ancil, Arena Pharmaceuticals, AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company, Cephalon, Inc., Cypress Bioscience, Inc., DOV Pharmaceutical Inc., Elan Pharmaceuticals, Inc., Eli Lilly and Company, Evotec Inc., Forest Pharmaceuticals, Inc., GlaxoSmithKline, Hypnion Inc., H. Lundbeck A/S, Hoffmann-La Roche Inc., Johnson & Johnson, King Pharmaceuticals, Inc., McNeil, MediciNova, Inc., Merck & Co., Inc., Neurim Pharmaceuticals, Neurocrine Biosciences, Inc., Neurogen Corporation, Novartis Pharmaceuticals Corporation, Orexo AB, Organon Pharmaceuticals USA, Inc., Orginer, Prestwick Pharmaceuticals, Inc., Proctor & Gamble, Pfizer Inc., Purdue Pharma LP, Resteva, Sanofi-aventis, Schering-Plough Corporation, Sepracor Inc., Servier, Shire Pharmaceuticals, Somaxon Pharmaceuticals, Inc., Syrex, Takeda North America Pharmaceuticals, Inc., TransOral Pharmaceuticals, Inc., VANDA Pharmaceuticals, VivoMetrics, Wyeth Pharmaceuticals, XenoPort, Inc., and Yamanouchi Pharma America, Inc. He is on the speakers bureaus of sanofi-aventis and Takeda Pharmaceuticals North America, Inc.
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