Academic Editor: Alessandro Poggi
Importance: Statins have been linked to an increased risk for insomnia,
but the literature is controversial. Moreover, it is unknown, if the potential
effects are directly related to the inhibition of the statin target HMGCR, the
subsequently lowered cholesterol levels, or other off-target effects of statins.
Aims: To investigate the association of statin treatment and genetic
proxies of cholesterol lowering drugs with the risk for insomnia and chronotype
in a large population-based cohort. Methods: A cross-sectional cohort
study based on baseline data collected between 2006–2010 in UK biobank cohort
was conducted. European participants without any history of
psychiatric/neurological disorders or of stroke and with available genetic data
as well as information on statin use were included in the present study.
Self-reported measures of insomnia and chronotype were analysed (a) in statin
users versus control subjects, (b) subjects carrying single nucleotide
polymorphisms (SNPs) in the HMGCR gene, which are associated with
reduced enzymatic function and lower cholesterol levels (rs17238484 and rs12916)
and (c) subjects carrying a SNP in the PCSK9 gene (rs1159147), which
leads to lower cholesterol levels independent of HMGCR. The main analysis were
performed using multivariable regression models. Statin treatment and SNPs in
HMGCR and PCSK9 genes were used as exposures and main outcomes
were insomnia and chronotype. Results: A total of 206,801participants
(mean [SD] age, 57.5 [7.9] years; 56% women; 20% statin users) were included in
the present study. Statin users had an increased risk of insomnia compared to
controls (odds ratio [95% CI], 1.07 [1.03 to 1.11]; p = 1.42
