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Insomnia, sleep quality, pain, and somatic symptoms: Sex differences and shared genetic components

Zhang, Jihuia; Lam, Siu-Pinga; Li, S. X.a; Tang, N. L.b; Yu, M. W.M.a; Li, A. M.c; Wing, Yun-Kwoka,*

doi: 10.1016/j.pain.2011.12.003
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TOC summary A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population.

This study investigated the sex differences, and the shared genetic and environmental factors underlying the associations of sleep disturbances (insomnia and sleep quality) with pain and somatic symptoms in both adolescents and middle-aged adults. We recruited 259 adolescents (69 with current insomnia) and their parents (256 middle-aged adults, 78 with current insomnia). Insomnia severity and sleep quality were measured by the Insomnia Severity Inventory (ISI) and Pittsburgh Sleep Quality Index (PSQI), respectively. Pain and somatic symptoms were measured by the Somatic Symptom Inventory and Visual Analogue Scale for overall pain. Subjects with insomnia scored higher on all measures of pain and somatic symptoms than non-insomnia patients, in both adolescents and adults (P < .001). Both pain and somatic measures were associated with ISI and PSQI scores after controlling for age, sex, depressive and anxiety symptoms. There was an interaction effect between insomnia and female sex on pain and somatic symptoms (P < .05), especially in adults. Pain and somatic symptoms ran in family with moderate heritability (range h2 = 0.15–0.42). The phenotypic associations of ISI and PSQI with pain and somatic measures were both contributed by genetic (range pG = 0.41–0.96) and environmental (range pE = 0.27–0.40) factors with a major genetic contribution. In summary, insomnia and poor sleep quality are closely associated with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population. A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms.

aDepartment of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China

bDepartment of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China

cDepartment of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China

*Corresponding author. Address: Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China. Tel.: +852 26367748; fax: +852 26475321.

E-mail: ykwing@cuhk.edu.hk

Submitted April 26, 2011; revised November 5, 2011; accepted December 6, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.
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