Bad sleep can be in your DNA, but you can often do something about it

A question that clients regularly ask me is: is my poor sleep innate?

Scientists at Radboudumc have recently discovered that specific genes—the so-called FOXP genes—play a direct role in how well you sleep. Children with a mutation in the FOXP1-gen were found to sleep consistently worse.

FOXP1 helps regulate other genes, especially during development. When it doesn’t function properly, it can affect how the brain and other organs form. The chance that your poor sleep is caused by a mutation in your FOXP1 gene is extremely small. In the Netherlands, only about fifty patients are known.

Is poor sleep innate?

What triggered me about this research is that it touches on a question clients often ask me: is my poor sleep something I was born with? The short answer is that predisposition can play a role. Some people are more sensitive to sleep problems than others. They react more strongly to stress or have a biological clock that naturally runs a bit differently.

But if you think you sleep poorly because your father or mother did too and that it’s simply “in your DNA,” some nuance is needed. Predisposition explains why you may be more vulnerable. It doesn’t necessarily explain why you’re sleeping poorly now or why it isn’t improving.

The 3-P model

Sleep scientist Arthur Spielman described in the 1980s how insomnia develops and persists. His 3-P model distinguishes three layers:

1. Predisposing factors – the biological sensitivity you were born with. You can’t change this.

2. Precipitating factors – stressful event(s) that triggered the problem, such as a period of overload, a divorce, an ill family member, or financial problems.

3. Perpetuating factors – the thoughts and habits that keep the sleep problem going, even after the stress has passed. This is the key layer.

   
   

I recognized myself in all three. Predisposition: yes. Trigger: also yes. But what kept me sleeping poorly for five years was the third P—the way I thought about sleep and everything I did to try to force it. The growing fear of not being able to sleep. A fear I still occasionally feel—the body has a good memory—but one that no longer keeps me awake.

Where the leverage lies

Cognitieve Gedragstherapie voor Insomnie (CBT-I) focuses on the third P. Not on your genes. Not on past stressful events, but on what is still maintaining the sleep problem now. The beliefs that keep you awake at night (“If I don’t sleep now, I won’t get through tomorrow”). The habits that undermine sleep pressure (“I’ll just go to bed early, maybe I’ll fall asleep sooner”). The strained relationship with your bed, which is no longer a restful place.

CBT-I works for 70 to 80% of people with chronic insomnia. Not by forcing sleep, but by removing the obstacles. Ask yourself: what do I do every day to try to fall asleep? And does it help? Those who notice that all these efforts mainly create stress are the ones for whom CBT-I makes the biggest difference.