Why Sleep Is Important for Health (2014)

Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective.
Annu Rev Psychol. 2014 Jul 21.
Irwin MR.

Sleep has a critical role in promoting health.
Research over the past decade has documented that sleep disturbance has a powerful influence on the risk of infectious disease, the occurrence and progression of several major medical illnesses including cardiovascular disease and cancer, and the incidence of depression.
Increasingly, the field has focused on identifying the biological mechanisms underlying these effects.

This review highlights the impact of sleep on adaptive and innate immunity, with consideration of the dynamics of sleep disturbance, sleep restriction, and insomnia on (a) antiviral immune responses with consequences for vaccine responses and infectious disease risk and (b) proinflammatory immune responses with implications for cardiovascular disease, cancer, and depression.

This review also discusses the neuroendocrine and autonomic neural underpinnings linking sleep disturbance and immunity and the reciprocal links between sleep and inflammatory biology. Finally, interventions are discussed as effective strategies to improve sleep, and potential opportunities are identified to promote sleep health for therapeutic control of chronic infectious, inflammatory, and neuropsychiatric diseases.

GWAS explains only a small proportion of the total heritability

By exploiting allied phenotypic data, it is possible to examine the genetic contribution to such aspects of disease biology (including prognosis) by comparing the genetic profiles of patients with contrasting clinical phenotypes—a so-called ‘within-cases’ analysis.

Prognosis in autoimmune and infectious disease: new insights from genetics
Clinical & Translational Immunology (2014) 3, e15
James C Lee, et al.

Keywords: autoimmunity; FOXO3; genetics; infection; prognosis

despite the apparent success, GWAS results have only explained a relatively small proportion of the total heritability of each disease.[3]
Work is now underway to try to identify the ‘missing heritability’ through a variety of complementary methods, including:

  • whole-genome sequencing (to identify rare variants that may have larger effect sizes) and
  • studies to examine interactions between a given gene and other genes (epistasis) and
  • between genes and the environment.


Genomic medicine (Sci Transl Med. 2013)

Genomic medicine: a decade of successes, challenges, and opportunities.
Sci Transl Med. 2013 Jun 12;5(189):189sr4.
McCarthy JJ1, McLeod HL, Ginsburg GS.

In most cases, genomic medicine tools remain in the realm of research, but some tools are crossing over into clinical application
next-generation sequencing in cancer pharmacogenomics, in the diagnosis of rare disorders, and in the tracking of infectious disease outbreaks.
the role of the host microbiome, … the repurposing of drugs.
challenges include the difficulty in establishing clinical validity and utility of tests, … addressing the ethical aspects of genomics for patients and society.
fundamental shifts in how we define disease

Data from the 1000 Genomes Project have confirmed previous estimates of the population frequency of germline [common] variants to be about 1 in every 1000 of the 3.2 billion nucleotide positions, giving rise to about 3 million [common] variants in the human genome (6).

the ~1% of the genome that codes for genes
The challenge lies in figuring out the meaning of variants that occur in the vast remaining noncoding regions of the genome, the so-called dark matter, whose function is largely unknown.