Failure of fear extinction in insomnia: An evolutionary perspective

Lampros Perogamvros; Anna Castelnovo; David Samson; Thien Thanh Dang-Vu

doi:10.1016/j.smrv.2020.101277

Failure of fear extinction in insomnia: An evolutionary perspective

Sleep Med Rev. 2020 Jun:51:101277. doi: 10.1016/j.smrv.2020.101277. Epub 2020 Feb 13.

Authors

Lampros Perogamvros¹, Anna Castelnovo², David Samson³, Thien Thanh Dang-Vu⁴

Affiliations

¹ Division of Pulmonology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland. Electronic address: lampros.perogamvros@unige.ch.
² Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland; Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland.
³ Department of Anthropology, University of Toronto, Mississauga, Canada.
⁴ Department of Health, Kinesiology and Applied Physiology, Perform Center and Center for Studies in Behavioral Neurobiology (CSBN), Concordia University, Montreal, Canada; Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal (CRIUGM), CIUSSS Centre-Sud-de-l'île-de-Montréal, Montreal, Canada.

PMID: 32143023
DOI: 10.1016/j.smrv.2020.101277

Abstract

The pathophysiology of insomnia remains poorly understood, yet emerging cross-disciplinary approaches integrating natural history, observational studies in traditional populations, gene-phenotype expression and experiments are opening up new avenues to investigate the evolutionary origins of sleep disorders, with the potential to inform innovations in treatment. Previous authors have supported that acute insomnia is a normal biopsychosocial response to a perceived or real threat and may thus represent an adaptive response to stress. We further extend this hypothesis by claiming that insomnia reflects a fear-related evolutionary survival mechanism, which becomes persistent in some vulnerable individuals due to failure of the fear extinction function. Possible treatments targeting fear extinction are proposed, such as pharmacotherapy and emotion-based cognitive behavioral therapy.

Keywords: Evolution; Fear extinction; Hyperarousal; Insomnia.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Biological Evolution*
Cognitive Behavioral Therapy*
Fear / physiology*
Humans
Sleep Initiation and Maintenance Disorders / psychology*

Grants and funding

MOP 142191/CIHR/Canada