Genomics may cut sleep ills

Human genes are remarkably similar to those of other animals, including mice, zebra fish, fruit flies and even worms.

And it is studying those genes in those animals — all popularly used in medical research — that scientists and doctors believe will lead to targeted, patient-specific treatments of sleep disorders like obstructive sleep apnea.

"I believe this vision of personalized medicine is a major opportunity" for understanding and treating sleep disorders, said Dr. Allan I. Pack, professor of medicine and director of the Center for Sleep and Respiratory Neurobiology, and chief of the Division of Sleep Medicine, at the University of Pennsylvania.

Genetics offers new technology and approaches that are powerful, he said Monday to a packed ballroom at the Salt Palace, where he delivered the keynote speech at a conference of more than 5,500 sleep experts. Sleep 2006, a joint meeting of the American Academy of Sleep Medicine and The Sleep Research Society, is the largest gathering of sleep experts — including doctors, technologists, researchers and others — in the world.

It's not simply learning to screen for or diagnose disorders, Pack said. Such research will take experts "from managing disease to managing risk," including not only efficacy of therapy, but side effects. Those who understand an individual's genetics when it comes to a specific disorder will be better equipped to predict outcomes and what medications or other interventions an individual might respond to.

Genomics is already being used in cancer. Pack predicts it will soon be a valuable tool in sleep medicine areas like his own specialty, obstructive sleep apnea.

Sleep apnea is dangerous. The condition, marked by interruptions in breathing during sleep, is a risk for a variety of different outcomes, including hypertension, sleepiness and insulin resistance. Many prominent experts believe it can lead to development of atherosclerosis, as well. It shortens lives.

The question, he said, is "Can we tell who is most likely to develop these by their genotype?"

Research has shown a genetic role in the variation in sleep drive in mice. It's not yet proven what role genes play in such a drive in humans. But the research is ongoing, revealing information about a molecular basis for sleep drive and a recovery process that occurs during sleep. Even the worm C. elegans has a distinct sleep-like state. Wakefulness, it's believed, is the result of a molecular process in the brain. And the findings don't just apply to apnea, but to other sleep-related disorders such as restless leg, parasomnia, narcolepsy and insomnia, Pack said.