Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings

Juan J. Madrid-Valero; Nicola L. Barclay; Richard Rowe; Rotem Perach; Daniel J. Buysse; Juan R. Ordoñana; Thalia C. Eley; Alice M. Gregory

doi:10.1017/S0033291719004070

Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings

Juan J. Madrid-Valero, Nicola L. Barclay, Richard Rowe, Rotem Perach, Daniel J. Buysse, Juan R. Ordoñana, Thalia C. Eley, Alice M. Gregory

Social Genetic & Developmental Psychiatry

Research output: Contribution to journal › Article › peer-review

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Abstract

Background Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. Methods In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. Results Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. Conclusions Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

Original language	English
Pages (from-to)	1175 - 1182
Number of pages	8
Journal	Psychological Medicine
Volume	51
Issue number	7
Early online date	6 Feb 2020
DOIs	https://doi.org/10.1017/S0033291719004070
Publication status	Published - May 2021

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@article{5490fa3be6814a90b457e83432b085e3,

title = "Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings",

abstract = "Background Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. Methods In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. Results Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. Conclusions Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.",

author = "Madrid-Valero, {Juan J.} and Barclay, {Nicola L.} and Richard Rowe and Rotem Perach and Buysse, {Daniel J.} and Ordo{\~n}ana, {Juan R.} and Eley, {Thalia C.} and Gregory, {Alice M.}",

note = "Funding Information: Conflict of interest. Djb is working as a consultant for Bayer, BeHealth Solutions and Emmi Solutions. He is receiving license fees for the Pittsburgh Sleep Quality Index (PSQI), the Daytime Insomnia Symptoms Scale (DISS) and the Brief Behavioral Treatment of Insomnia (BBTI). He is associated with the CME Institute. Non-financial Disclosure: None. AMG: Financial Disclosure – Alice Gregory is an advisor for a project sponsored by Johnson{\textquoteright}s Baby. She has written two books: Nodding Off (Bloomsbury Sigma, 2018) and The Sleepy Pebble and Other Stories (Flying Eye Books, 2019). She is a regular contributor to BBC Focus magazine and has contributed to other outlets (such as The Conversation, The Guardian and Balance Magazine). She occasionally receives sample products related to sleep (e.g. blue light blocking glasses) and has given a paid talk to a business. Non-financial Disclosure – none. TCE: is part funded by a program grant from the UK Medical Research Council (MR/M021475/1). This study presents independent research (part-) funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. JJMV, NLB, RR, RP and JRO declare no conflict of interest. Funding Information: Financial support. Jjmv was supported by a predoctoral scholarship from the Fundaci{\'o}n S{\'e}neca (19814/FPI/15). G1219 study: Waves 1–3 funded by the WT Grant Foundation, the University of London Central Research fund and a Medical Research Council Training Fellowship (G81/343) and Career Development Award (G120/635) to Thalia C. Eley. Wave 4 supported by the Economic and Social Research Council (RES-000-22-2206) and the Institute of Social Psychiatry (06/07–11) to Alice M. Gregory. Funding Information: Jjmv was supported by a predoctoral scholarship from the Fundaci?n S?neca (19814/FPI/15). G1219 study: Waves 1-3 funded by the WT Grant Foundation, the University of London Central Research fund and a Medical Research Council Training Fellowship (G81/343) and Career Development Award (G120/635) to Thalia C. Eley. Wave 4 supported by the Economic and Social Research Council (RES-000-22-2206) and the Institute of Social Psychiatry (06/07-11) to Alice M. Gregory. Publisher Copyright: Copyright {\textcopyright} 2020 Cambridge University Press. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = may,

doi = "10.1017/S0033291719004070",

language = "English",

volume = "51",

pages = "1175 -- 1182",

journal = "Psychological Medicine",

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TY - JOUR

T1 - Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings

AU - Madrid-Valero, Juan J.

AU - Barclay, Nicola L.

AU - Rowe, Richard

AU - Perach, Rotem

AU - Buysse, Daniel J.

AU - Ordoñana, Juan R.

AU - Eley, Thalia C.

AU - Gregory, Alice M.

N1 - Funding Information: Conflict of interest. Djb is working as a consultant for Bayer, BeHealth Solutions and Emmi Solutions. He is receiving license fees for the Pittsburgh Sleep Quality Index (PSQI), the Daytime Insomnia Symptoms Scale (DISS) and the Brief Behavioral Treatment of Insomnia (BBTI). He is associated with the CME Institute. Non-financial Disclosure: None. AMG: Financial Disclosure – Alice Gregory is an advisor for a project sponsored by Johnson’s Baby. She has written two books: Nodding Off (Bloomsbury Sigma, 2018) and The Sleepy Pebble and Other Stories (Flying Eye Books, 2019). She is a regular contributor to BBC Focus magazine and has contributed to other outlets (such as The Conversation, The Guardian and Balance Magazine). She occasionally receives sample products related to sleep (e.g. blue light blocking glasses) and has given a paid talk to a business. Non-financial Disclosure – none. TCE: is part funded by a program grant from the UK Medical Research Council (MR/M021475/1). This study presents independent research (part-) funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. JJMV, NLB, RR, RP and JRO declare no conflict of interest. Funding Information: Financial support. Jjmv was supported by a predoctoral scholarship from the Fundación Séneca (19814/FPI/15). G1219 study: Waves 1–3 funded by the WT Grant Foundation, the University of London Central Research fund and a Medical Research Council Training Fellowship (G81/343) and Career Development Award (G120/635) to Thalia C. Eley. Wave 4 supported by the Economic and Social Research Council (RES-000-22-2206) and the Institute of Social Psychiatry (06/07–11) to Alice M. Gregory. Funding Information: Jjmv was supported by a predoctoral scholarship from the Fundaci?n S?neca (19814/FPI/15). G1219 study: Waves 1-3 funded by the WT Grant Foundation, the University of London Central Research fund and a Medical Research Council Training Fellowship (G81/343) and Career Development Award (G120/635) to Thalia C. Eley. Wave 4 supported by the Economic and Social Research Council (RES-000-22-2206) and the Institute of Social Psychiatry (06/07-11) to Alice M. Gregory. Publisher Copyright: Copyright © 2020 Cambridge University Press. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/5

Y1 - 2021/5

N2 - Background Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. Methods In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. Results Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. Conclusions Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

AB - Background Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. Methods In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. Results Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. Conclusions Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

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U2 - 10.1017/S0033291719004070

DO - 10.1017/S0033291719004070

M3 - Article

SN - 0033-2917

VL - 51

SP - 1175

EP - 1182

JO - Psychological Medicine

JF - Psychological Medicine

IS - 7

ER -

Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings

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