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Mendelian Randomization Research Examining the Effects of Insomnia on Herpes Zoster and Postherpetic Neuralgia
Xueying Yang1, Xuan Li1, Jingrun Lin1
1Department of Anesthesiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China, sysu.edu.cn.
Background:
Insomnia is closely linked to herpes zoster (HZ) and postherpetic neuralgia (PHN); nonetheless, the causal relationship has not been sufficiently clarified. This research employs the Mendelian randomization (MR) method to investigate the causal relationship between insomnia and HZ, as well as PHN.
Methods:
Summary statistics from publicly available GWASs were utilized for four sleep traits (insomnia, sleep duration, habitual short sleep [< 7 h/day], and habitual long sleep [≥ 9 h/day]), HZ, PHN, and common risk factors (smoking, alcohol use, obesity, hypertension, and diabetes [Type 1 and Type 2]). Bidirectional univariable two-sample MR was conducted to assess causal associations between insomnia and HZ/PHN. Multivariable MR (MVMR) was performed to determine whether insomnia exerted an independent causal effect on HZ after adjusting for these risk factors.
Results:
This study identified a positive causal effect of insomnia on HZ risk via inverse variance weighted (IVW) (OR = 1.97, 95% confidence interval [CI]: 1.13-3.45, p = 0.017, P-FDR = 0.034). Longer sleep duration showed a suggestive inverse association with HZ, with each additional hour associated with 34% lower odds (IVW: OR = 0.66, 95% CI: 0.43-1.00, p = 0.048; P-FDR = 0.096). Neither habitual short sleep (IVW: OR = 1.17, p = 0.206) nor habitual long sleep (IVW: OR = 1.11, p = 0.446) was causally associated with HZ. No causal relationships were observed between any sleep trait and PHN, nor evidence for reverse causation. In MVMR, insomnia remained associated with HZ after adjusting for diabetes via IVW (OR = 2.36, 95% CI: 1.12-4.93, p = 0.023), but this association disappeared after further adjustment for smoking, alcohol use, obesity, and hypertension.
Conclusion:
Genetically determined insomnia was causally associated with increased HZ risk, independent of diabetes but probably confounded by smoking, alcohol use, obesity, and hypertension, while longer sleep duration showed a suggestive protective effect.
