Kahya Melike, Vidoni Eric, Burns Jeffrey M, Thompson Ashley N, Meyer Kayla, Siengsukon Catherine F
1 Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
2 Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
J Geriatr Psychiatry Neurol. 2017 Sep;30(5):273-279. doi: 10.1177/0891988717720301. Epub 2017 Jul 27.
The apolipoprotein (APOE) ε4 allele, a well-described genetic risk factor for late-onset Alzheimer disease (AD), is associated with sleep disturbances even in cognitively normal older adults, although it is not clear whether this association is independent of sleep apnea. We sought to extend previous studies by examining whether cognitively normal older adults without self-reported sleep apnea who carry the APOE ε4 allele have altered sleep characteristics compared to noncarriers. Data from N = 36 (APOE ε4 carriers [n = 9], noncarriers [n = 27]) cognitively normal older adults (Clinical Dementia Rating [CDR] scale = 0) without self-reported sleep apnea were used for these analyses. Participants wore an actigraph for 7 days to determine sleep characteristics. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to assess sleep quality and daytime sleepiness, respectively. The APOE ε4 carriers had a higher number of awakenings compared to the noncarriers ( P = .02). There was no significant difference in the PSQI global score and the ESS; however, the PSQI subcomponent of daily disturbances was significantly higher in APOE ε4 carriers ( P = .03), indicating increased daytime dysfunction is related to disrupted sleep. This study provides evidence that individuals who are cognitively normal and genetically at risk of AD may have disrupted sleep. These findings are consistent with prior studies and suggest that sleep disruption may be present in the presymptomatic stages of AD.
载脂蛋白（APOE）ε4等位基因是一种已被充分描述的晚发性阿尔茨海默病（AD）的遗传风险因素，即使在认知正常的老年人中也与睡眠障碍有关，尽管尚不清楚这种关联是否独立于睡眠呼吸暂停。我们试图通过研究携带APOE ε4等位基因但无自我报告睡眠呼吸暂停的认知正常老年人与非携带者相比是否具有改变的睡眠特征来扩展先前的研究。本分析使用了来自N = 36名认知正常的老年人（临床痴呆评定量表[CDR] = 0）的数据，这些老年人无自我报告的睡眠呼吸暂停（APOE ε4携带者[n = 9]，非携带者[n = 27]）。参与者佩戴活动记录仪7天以确定睡眠特征。匹兹堡睡眠质量指数（PSQI）和爱泼华嗜睡量表（ESS）分别用于评估睡眠质量和白天嗜睡程度。与非携带者相比，APOE ε4携带者的觉醒次数更多（P = .02）。PSQI总分和ESS没有显著差异；然而，APOE ε4携带者的PSQI日常干扰子成分显著更高（P = .03），表明白天功能障碍增加与睡眠中断有关。这项研究提供了证据，表明认知正常且有AD遗传风险的个体可能存在睡眠中断。这些发现与先前的研究一致，并表明睡眠中断可能存在于AD的症状前阶段。
