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CC BY-NC-ND 4.0 · Sleep Sci 2025; 18(01): e17-e24
DOI: 10.1055/s-0044-1788286
Original Article

APOE Polymorphism, Obstructive Sleep Apnea, and Cognitive Function

Elisangela Macedo Gara
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Thiago Tanaka Goya
2   Department of Cardiopneumology, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Rosyvaldo Ferreira-Silva
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Larissa Matheus
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Renato Marques Jordão
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Marlon Lemos Araújo
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Alanna Joselle Silva
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
,
Renan Segalla Guerra
2   Department of Cardiopneumology, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Geraldo Lorenzi-Filho
2   Department of Cardiopneumology, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Linda Massako Ueno-Pardi 
1   Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
2   Department of Cardiopneumology, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations Funding Source Dra. Linda M. Ueno-Pardi receives funding from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, # 2015/14795-0 and 2010/15064-6).
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Abstract

Objective Obstructive sleep apnea (OSA) is associated with the apolipoprotein E ε4 polymorphic allele (APOE ε4) and with worse cognitive function. However, the influence of APOE ε4 on cognitive function in patients with moderate-to-severe OSA is controversial. The present study evaluated the influence of APOE ε4 polymorphism and cognitive function in sedentary OSA patients with no other major comorbidities.

Materials and Methods In total, 55 middle-aged patients underwent conventional nocturnal polysomnography, APOE ε4 polymorphism genotyping, cognitive evaluation (attention, inhibitory control, frontal functions, processing speed, and episodic memory), and they filled out the International Physical Activity Questionnaire.

Results Overall, 13 patients had no or mild OSA, and 42 had moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥ 15 events/h of sleep) and APOE ε4 was present in 7.7% and 21.4% of the patients in each group respectively. Among patients with moderate-to-severe OSA, the sleep parameters were similar in the groups of APOE ε4 carriers and noncarriers. Compared with patients with no or mild OSA, the cognitive parameters were worse for processing speed (Digit Symbol Test) and attention (Stroop Color Word Test, SCWT-Part 2) among the patients with moderate-to-severe OSA. The difference was present even after the exclusion of APOE ε4 carriers. Among patients with moderate-to-severe OSA, APOE ε4 carriers presented worse episodic memory, evaluated through the Rey Auditory Verbal Learning Test, than APOE ε4 noncarriers.

Conclusion Moderate-to-severe OSA is associated with poor cognitive function that is further impaired by the presence of APOE ε4 polymorphism.

Keywords

sleep - cognition - apolipoprotein

Supplementary Material



Publication History

Received: 31 August 2023

Accepted: 05 February 2024

Article published online:
23 July 2024

© 2024. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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