REM sleep is reduced in late middle-aged and older APOE4 allele carriers

Claire André; Marie-Ève Martineau-Dussault; Andrée-Ann Baril; Nicola Andrea Marchi; Véronique Daneault; Dominique Lorrain; Carol Hudon; Célyne H Bastien; Dominique Petit; Cynthia Thompson; Judes Poirier; Jacques Montplaisir; Nadia Gosselin; Julie Carrier

doi:10.1093/sleep/zsae094

REM sleep is reduced in late middle-aged and older APOE4 allele carriers

Sleep. 2024 Apr 18:zsae094. doi: 10.1093/sleep/zsae094. Online ahead of print.

Authors

Claire André^{1

2}, Marie-Ève Martineau-Dussault^{1

2}, Andrée-Ann Baril^{1

3}, Nicola Andrea Marchi^{1

2

4

5}, Véronique Daneault^{1

2}, Dominique Lorrain^{6

7}, Carol Hudon^{8

9}, Célyne H Bastien^{8

9}, Dominique Petit^{1

10}, Cynthia Thompson¹, Judes Poirier^{11

12}, Jacques Montplaisir^{1

10}, Nadia Gosselin^{1

2}, Julie Carrier^{1

2}

Affiliations

¹ Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada.
² Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada.
³ Department of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.
⁴ Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Vaud, Switzerland.
⁵ Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Vaud, Switzerland.
⁶ Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada.
⁷ Department of Psychology, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
⁸ CERVO Brain Research Centre, Québec City, QC G1E 1T2, Canada.
⁹ School of Psychology, Université Laval, Québec City, QC G1V 0A6, Canada.
¹⁰ Department of Psychiatry, Université de Montréal, Montréal, QC H3T 1J4, Canada.
¹¹ Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada.
¹² Douglas Mental Health University Institute, CIUSSS de l'Ouest-de-l'Ile-de-Montréal, Verdun, QC H4H 1R3, Canada.

PMID: 38634644
DOI: 10.1093/sleep/zsae094

Abstract

Study objectives: Apolipoprotein E ɛ4 (APOE4) is the strongest genetic risk factor for Alzheimer's disease (AD). In addition, APOE4 carriers may exhibit sleep disturbances, but conflicting results have been reported, such that there is no clear consensus regarding which aspects of sleep are impacted. Our objective was to compare objective sleep architecture between APOE4 carriers and non-carriers, and to investigate the modulating impact of age, sex, cognitive status and obstructive sleep apnea.

Methods: 198 dementia-free participants aged >55 years old (mean age: 68.7 ± 8.08 years old, 40.91% women, 41 APOE4 carriers) were recruited in this cross-sectional study. They underwent polysomnography, APOE4 genotyping and a neuropsychological evaluation. ANCOVAs assessed the effect of APOE4 status on sleep architecture, controlling for age, sex, cognitive status and the apnea-hypopnea index. Interaction terms were added between APOE4 status and covariates.

Results: REM sleep percentage (F=9.95, p=0.002, ηp2=0.049) and duration (F=9.23, p=0.003, ηp2=0.047) were lower in APOE4 carriers. The results were replicated in a subsample of 112 participants without moderate-to-severe obstructive sleep apnea. There were no significant interactions between APOE4 status and age, sex, cognitive status and obstructive sleep apnea in the whole sample.

Conclusions: Our results show that APOE4 carriers exhibit lower REM sleep duration, including in cognitively unimpaired individuals, possibly resulting from early neurodegenerative processes in regions involved in REM sleep generation and maintenance.

Keywords: APOE4; Alzheimer’s disease; REM sleep; aging; dementia; mild cognitive impairment; polysomnography; sleep.