title: Sleep/wake disruption in Alzheimer's disease: APOE status and longitudinal course.
abstract: Disturbed sleep is a major clinical problem in Alzheimer's disease (AD). Apolipoprotein epsilon4 (APOE epsilon4) carrier status may increase risk of AD, yet there are no data on relations between APOE status and progression of sleep disturbance in AD. The objective of this study was to determine if sleep parameters in AD patients change over time as a function of APOE carrier status. Forty-four community-dwelling AD patients with diagnosis of probable AD were followed from early stages of disease. Their sleep/wake parameters were compared according to APOE status. For APOE epsilon4 carriers, only wake after sleep onset (WASO) increased in association with lower cognitive function as indicated by the Mini-Mental State Examination (MMSE); for non-epsilon4 subjects, increases in WASO and declines in total sleep time, sleep efficiency, and the amplitude of the rest/activity circadian rhythm over time were associated with lower performance on the MMSE. In these data, APOE status was associated with the progression of sleep/wake disturbances in AD. Overall, there was greater deterioration on sleep parameters in patients negative for the epsilon4 allele.
authors.affiliation: National Institute of Aging/Alzheimer's Disease Core Center, Palo Alto VA Health Care System (151Y), 3801 Miranda Avenue, Palo Alto, CA 94304, USA. yesavage@stanford.edu
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Yesavage
authors.forename: Leah
authors.initials: L
authors.lastname: Friedman
authors.forename: Helena
authors.initials: H
authors.lastname: Kraemer
authors.forename: Jared R
authors.initials: JR
authors.lastname: Tinklenberg
authors.forename: Ahmad
authors.initials: A
authors.lastname: Salehi
authors.forename: Art
authors.initials: A
authors.lastname: Noda
authors.forename: Joy L
authors.initials: JL
authors.lastname: Taylor
authors.forename: Ruth
authors.initials: R
authors.lastname: O'Hara
authors.forename: Greer
authors.initials: G
authors.lastname: Murphy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000235:genetics*; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D006580:Genetic Carrier Screening; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010641:Phenotype; D017286:Polysomnography; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000235:genetics*
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E