Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC, Canada.
Department of Psychology, Université de Montréal, Montreal, QC, Canada.
Sleep. 2024 Jul 11;47(7). doi: 10.1093/sleep/zsae094.
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 (OSA).
A total of 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.
Rapid eye movement (REM) sleep percentage (F = 9.95, p = .002, ηp2 = 0.049) and duration (F = 9.23, p = .003, ηp2 = 0.047) were lower in APOE4 carriers. The results were replicated in a subsample of 112 participants without moderate-to-severe OSA. There were no significant interactions between APOE4 status and age, sex, cognitive status, and OSA in the whole sample.
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.
载脂蛋白 E ɛ4（APOE4）是阿尔茨海默病（AD）最强的遗传风险因素。此外，APOE4 携带者可能表现出睡眠障碍，但结果相互矛盾，因此对于哪些方面的睡眠受到影响尚无明确共识。我们的目的是比较 APOE4 携带者和非携带者的客观睡眠结构，并研究年龄、性别、认知状态和阻塞性睡眠呼吸暂停（OSA）的调节作用。
本横断面研究共纳入 198 名年龄＞55 岁（平均年龄：68.7±8.08 岁，40.91%为女性，41 名 APOE4 携带者）的无痴呆症参与者。他们接受了多导睡眠图、APOE4 基因分型和神经心理学评估。在控制年龄、性别、认知状态和呼吸暂停低通气指数后，采用协方差分析（ANCOVA）评估 APOE4 状态对睡眠结构的影响。添加了 APOE4 状态与协变量之间的交互项。
快速眼动（REM）睡眠百分比（F=9.95，p=0.002，ηp2=0.049）和持续时间（F=9.23，p=0.003，ηp2=0.047）在 APOE4 携带者中较低。在没有中重度 OSA 的 112 名参与者的亚组中得到了复制。在整个样本中，APOE4 状态与年龄、性别、认知状态和 OSA 之间没有显著的相互作用。
我们的结果表明，APOE4 携带者表现出 REM 睡眠时间较短，包括在认知功能未受损的个体中，这可能是由于涉及 REM 睡眠产生和维持的区域的早期神经退行性过程所致。
