Association between apolipoprotein E epsilon4 and sleep-disordered breathing in adults

JAMA. 2001 Jun 13;285(22):2888-90. doi: 10.1001/jama.285.22.2888.


Context: Apolipoprotein E epsilon4(ApoE epsilon4) 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 epsilon4 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 epsilon4, 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 epsilon4 (6.5 [0.6] vs 4.8 [0.3]; P =.01). These effects increased with the number of ApoE epsilon4 alleles carried.

Conclusions: A significant portion of sleep-disordered breathing is associated with ApoE epsilon4 in the general population.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Apolipoprotein E4
  • Apolipoproteins E / genetics*
  • Female
  • Genotype
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Polymorphism, Restriction Fragment Length
  • Polysomnography
  • Regression Analysis
  • Sleep Apnea Syndromes / genetics*
  • Sleep Apnea Syndromes / physiopathology


  • Apolipoprotein E4
  • Apolipoproteins E