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
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  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
Conclusions A significant portion of sleep-disordered breathing is associated with ApoE ∊4 in the general population.