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Chronic insomnia in the setting of MTHFR polymorphism
Vidhi Kapoor1,2, Nathaniel F Watson2,3, Lonnele Ball4
1Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, Washington.
Abstract:
We present a patient with chronic insomnia resistant to traditional pharmacologic (eg, sedative-hypnotics) and nonpharmacologic (eg, cognitive behavioral therapy for insomnia) therapy. A finding of elevated serum homocysteine triggered a whole-genome sequencing analysis which revealed a homozygous methylenetetrahydrofolate reductase (MTHFR) gene polymorphism (C677T/C677T; dbSNP rs1801133). Interventions targeting her polymorphism-dependent loss of function successfully resolved her insomnia. This case demonstrates a genomic approach for insomnia whereby successful treatment was focused on optimizing the patient's metabolome, which was altered as a result of a missense single-nucleotide polymorphism.
Citation:
Kapoor V, Watson NF, Ball L. Chronic insomnia in the setting of MTHFR polymorphism. J Clin Sleep Med. 2022;18(4):1215-1218.
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