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Association Between Apolipoprotein E  4 and Sleep-Disordered Breathing in Adults
Hiroshi Kadotani, MD,PhD;
Tomiko Kadotani, MD;
Terry Young, PhD;
Paul E. Peppard, PhD;
Laurel Finn, MS;
Ian M. Colrain, PhD;
Greer M. Murphy, Jr, MD,PhD;
Emmanuel Mignot, MD,PhD
JAMA. 2001;285:2888-2890.
Context Apolipoprotein E  4 (ApoE 4) is a well-known risk factor for Alzheimer disease and cardiovascular disease. Sleep-disordered breathing occurs in Alzheimer disease patients and increases risks for cardiovascular disease. Complex interactions among sleep, brain pathology, and cardiovascular disease may occur in ApoE 4 carriers.
Objective To study whether genetic variation at the level of ApoE is associated with sleep-disordered breathing or sleep abnormalities in the general population.
Design, Setting, and Participants Ongoing longitudinal cohort study of sleep disorders at a US university beginning in 1989, providing a population-based probability sample of 791 middle-aged adults (mean [SD] age, 49 [8] years; range, 32-68 years).
Main Outcome Measure Nocturnal polysomnography to evaluate apnea-hypopnea index.
Results The probability of moderate-to-severe sleep-disordered breathing (apnea-hypopnea index  15%) was significantly higher in participants with 4, independent of age, sex, body mass index, and ethnicity (12.0% vs 7.0%; P = .003). Mean (SEM) apnea-hypopnea index was also significantly higher in participants with ApoE 4 (6.5 [0.6] vs 4.8 [0.3]; P = .01). These effects increased with the number of ApoE 4 alleles carried.
Conclusions A significant portion of sleep-disordered breathing is associated with ApoE 4 in the general population.
Author Affiliations: Center for Narcolepsy (Drs H. Kadotani, T. Kadotani, and Mignot), and Department of Psychiatry and Behavioral Sciences (Drs H. Kadotani, T. Kadotani, Murphy, and Mignot), Stanford University School of Medicine, Stanford, Calif; Department of Pediatrics, Kobe University School of Medicine, Kobe, Japan (Dr T. Kadotani); Department of Preventive Medicine, University of Wisconsin, Madison (Drs Young and Peppard, and Ms Finn); Stanford University Sleep Disorders Clinic, Palo Alto, Calif (Dr Colrain); and Veterans Affairs Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Palo Alto, Calif (Dr Murphy).
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JAMA. 2001;286(12):1447-1448.
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