Insomnia is a condition that disrupts your ability to fall and stay asleep. Around 70 million¹ Americans have some type of sleep disorder, insomnia being the most common of them.
People who live with insomnia suffer from a reduced quality of life. They feel sleepy during the day, have trouble concentrating, and may eventually develop other health disorders, such as diabetes, hypertension, and obesity.
The main causes of insomnia include stress, mental health disorders, pain, medication, and poor sleeping habits. However, in some cases, it may be genetic.
Are genes responsible for your insomnia? Let’s take a closer look.
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According to the Diagnostic and Statistical Manual of Mental Disorders – 5² (a handbook that medical professionals use to assess and diagnose mental disorders), insomnia is a condition that causes:
Difficulty falling asleep
Difficulty maintaining sleep
Non-restorative sleep (when you don’t feel rested or refreshed after sleeping)
Early morning awakening with inability to go back to sleep
To be classified as insomnia, symptoms should appear at least three times a week for a minimum of 90 days and cause clinically significant distress. Clinically significant distress means that you struggle with everyday activities, such as doing chores, socializing, or working.
Acute insomnia is a sleep disorder that causes brief sleeping difficulty. Also called short-term insomnia, it’s triggered by a stressful or traumatic life event. This condition lasts for less than three months, with symptoms fading over time. As soon as the person starts dealing with the underlying event, insomnia gradually goes away.
When short-term insomnia doesn’t fade, it turns into a chronic condition. A doctor may suggest that you have chronic insomnia if you have sleeping problems at least three times a week for over three months.
Both acute and chronic insomnia are more common in women than in men.
Today, there are no specific laboratory or imaging tests that can diagnose insomnia. The only way to do it is to review your sleep history. The doctor will ask you questions about your sleeping habits and may ask you to keep a diary.
In most cases, chronic insomnia is caused by underlying medical or psychological conditions. Battling insomnia usually involves treating these secondary issues. If your doctor can’t find any conditions that may be causing your insomnia, the reason could be genetic.
Currently, scientists are looking closer at the possible genetic causes of insomnia. Figuring out whether this condition has genetic roots could help develop effective prevention and management methods.
Genome-wide association studies (GWAS) allow scientists to identify specific genes that may be responsible for a certain disease. This method looks at the entire set of DNA from a large group of participants and searches for specific variations.
GWAS can help single out which DNA variations occur more frequently in people with a specific disease. That helps pinpoint which genes may be responsible.
The largest GWAS³ related to insomnia was published in 2019. It discovered that 956 genes have a link to this condition. Overall, scientists concluded that, similar to other neuropsychiatric disorders, insomnia isn’t a result of one simple variation.
It may be caused by hundreds of small genes.
In 2018, scientists from the University of California San Diego and the VA San Diego Healthcare system conducted GWAS⁴ to determine the genetic cause of insomnia.
They took DNA samples from over 33,000 soldiers and studied them to identify the possible genetic cause of insomnia. Overall, the study confirmed that genes might be partially responsible for chronic insomnia. It linked insomnia to certain variants on chromosome 7. Scientists also found a genetic link between insomnia and diabetes.
In 2016, a major German GWAS⁵ also tried to link insomnia to genetics. These scientists found variations in CSNK2A1. This gene is involved in the regulation of the circadian rhythm, a natural process that regulates your sleep-wake cycle.
In 2011, a smaller South Korean GWAS⁶ also demonstrated a possible genetic origin of insomnia. Scientists identified variations in ROR1 and PLCB1 genes, which are involved in bipolar disorder and schizophrenia, respectively.
A twin study allows scientists to understand whether the origins of a certain disease are genetic or environmental. When it comes to insomnia, such studies may demonstrate whether the problem lies in your genes or comes from environmental influences (e.g., lifestyle, habits, sleep hygiene).
In 2015, scientists from Virginia Commonwealth University conducted a twin study⁷ to identify the genetic causes of insomnia in adults. They found that genetic factors can be responsible for this disorder.
Scientists also concluded that while genetics can contribute to insomnia, environmental factors still play a major role in developing the condition. Additionally, they demonstrated that genetics influence insomnia symptoms in women more frequently than they do in men.
In 2017, a Nature Genetics GWAS³ looked at a large group of people who experienced daytime sleepiness, which is one of the insomnia symptoms. The study analyzed data from over 450,000 people, 104,786 of whom suffered from frequent daytime sleepiness.
The study found 57 gene sites that may be associated with self-reported daytime sleepiness. These associations weren’t affected by common risk factors, such as lifestyle choices, caffeine, depression, or stress.
Fatal familial insomnia (FFI)⁸ is a rare genetic brain disorder. It affects the part of the brain responsible for controlling the sleep-wake cycle. Besides the inability to sleep normally, the common symptoms of this disorder are:
High blood pressure
Problems with thermoregulation (body temperature control)
Symptoms of this condition worsen over time and usually lead to serious physical and mental problems. To diagnose FFI, doctors perform clinical exams, sleep studies, and imaging studies.
In the majority of cases, FFI occurs in people who have a specific variant in the PRNP gene, which is inherited. Genetic testing can confirm the diagnosis.
The PRNP gene is responsible for regulating the production of the human prion protein. When this gene is altered, the prion protein becomes abnormal and dangerous. As these proteins build up in the thalamus (the part of the brain responsible for the sleep-wake cycle), nerve cells begin dying and cause a variety of negative consequences.
Currently, there is no cure for FFI. However, doctors can prescribe therapy to manage the symptoms and improve the patient’s quality of life as much as possible.
Yes and no. Over the years, scientists have discovered various proofs that genes may be responsible for insomnia. However, further research needs to be done to find a clear answer to this question.
So far, it seems that the combination of generic, personal, and environmental factors contributes to chronic insomnia.
The main goal of insomnia-related genetic research is to understand the origins of this condition and come up with new management and prevention strategies.
For example, if scientists discover that a certain gene influences the success of insomnia treatment, it could be possible to design individual treatment plans to improve the chances of their successful outcome.
In the future, it may be possible to practice early intervention and alter the risk genes or use gene therapy to replace defective genes.
If the doctor believes that the cause of your insomnia is your genes, you could choose to undergo genetic testing. Generally, unless you have FFI, doctors don’t perform genetic testing in a clinical setting.
Once your doctor offers a diagnosis, you can participate in a research study or find consumer companies that conduct DNA testing. Keep in mind that even if genetic testing reveals that you do have gene variations responsible for insomnia, the course of treatment for your condition will not change.
Scientists are still far away from implementing genetic data into insomnia prevention and treatment tactics.
If you are diagnosed with chronic insomnia and genetic factors are responsible, the doctor can still work out an effective treatment plan.
Current research shows that genes may only be partially responsible for your insomnia. This means that you could still have underlying problems that contribute to your sleep issues.
Any course of treatment for insomnia begins with finding the secondary problems and treating them.
According to studies⁹, when compared to medications, CBT-I is an effective way to treat insomnia. It also has longer-lasting results. The American College of Physicians¹⁰ officially endorses CBT-I as the best treatment for chronic insomnia and recommends it as the first line of treatment.
CBT-I includes a variety of techniques that a medical professional may recommend depending on the intensity of your condition and other personal factors.
Sleep education — patients learn about healthy sleeping and lifestyle habits that can contribute to improving their sleep
Sleep hygiene — patients find out how to improve sleep hygiene (e.g., regular sleep schedule, proper room temperature, comfortable bedding)
Stimulus control — patients learn which steps to take to eliminate the anxiety they feel about insomnia (worrying could cause their sleep problems)
Relaxation techniques — these techniques can help a person with insomnia calm their mind and body
Sleep restriction — making sure that the person uses the bed for sleeping only
Biofeedback — this method allows recording biological signs (heart rate, muscle tension) to figure out which patterns affect sleep quality
For CBT-I to be successful, it’s important to find a qualified CBT-I specialist. Your primary care physician can recommend one in your area.
While studies show that CBT-I can be more beneficial for insomnia patients than medication, your doctor may still prescribe certain drugs to help you sleep.
Some of these medications include the following:
These psychoactive drugs can help you fall and stay asleep. However, doctors don’t recommend them as part of a long-term treatment since they have the potential for abuse and dependence. FDA classifies them as schedule IV controlled substances.
These drugs have a lower abuse and dependence potential than BZD. However, their effect isn’t as dramatic either. Nonbenzodiazepines can reduce sleep latency (the time it takes to fall asleep).
Melatonin is a hormone that your brain produces when it’s dark. It makes you feel sleepy. Melatonin agonist activates melatonin receptors to help you fall asleep.
Doxepin¹¹ is a tricyclic antidepressant that slows the activity in your brain to help you fall asleep. However, it may cause a variety of side effects, including nausea and dizziness.
These drugs can relax your body and help you fall asleep. Some people also take them to ease restlessness during the day. However, doctors rarely prescribe them for insomnia due to negative side effects.
Depending on your needs and medical history, your doctor may prescribe a combination of different drugs. However, the majority of them can’t be used for a long time due to side effects, gradual loss of efficacy, and dependence potential.
Even if your insomnia is genetic, it’s possible to manage the symptoms and help you get more sleep. If you don’t address the problem, it could lead to serious complications, including:
Mental health issues
High blood pressure
If you are experiencing insomnia symptoms, contact your doctor as soon as possible. Whether your condition is acute or chronic, a medical professional can help you manage it.
Is insomnia genetic? Research shows that genes may be partially responsible for chronic insomnia. More studies need to be done to single out the exact gene variation that could be causing the condition.
Even if your condition has genetic roots, you can still manage it with cognitive behavioral therapy, medication, and lifestyle changes. Contact your doctor to design a personalized treatment plan.
About our program | Center for Disease Control and Prevention
Diagnostic and statistical manual of mental disorders (DSM-5-TR) | American Psychiatric Association
Disease at a glance | Genetic and Rare Diseases Information Center
Behavioral therapy works best for insomnia | American Psychiatric Association
PRNP prion protein [ Homo sapiens (human) ] | National Library of Medicine
Treatments for insomnia | Sleep Foundation
Insomnia | Johns Hopkins Medicine
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