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Sleep Disorders
Volume 2012, Article ID 634920, 9 pages
Research Article

Association of Plasma Homocysteine with Self-Reported Sleep Apnea Is Confounded by Age: Results from the National Health and Nutrition Examination Survey 2005-2006

1Lata Medical Research Foundation, Nagpur, 440022, India
2Cleveland Clinic Sleep Disorders Center, Cleveland, OH 44195, USA
3Advanced Education in General Dentistry program, Case School of Dental Medicine, Cleveland, OH 44206, USA
4Texas Biomedical Research Institute, San Antonio, TX 78227-5301, USA

Received 15 October 2011; Revised 10 November 2011; Accepted 14 November 2011

Academic Editor: Sophia Schiza

Copyright © 2012 Tushar P. Thakre et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


High levels of plasma homocysteine are implicated in the pathogenesis of cardiovascular diseases especially if accompanied by sleep apnea, but a direct pathogenetic link between plasma homocysteine levels and obstructive sleep apnea is debatable. This association can have far-reaching public health implications considering the inverse association between folate and plasma homocysteine. We used data from the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES) to test the hypothesized associations. Of the 4490 subjects included in analysis, 177 reported sleep apnea. Age-standardized and design-effect-corrected prevalence rates were differential across gender, plasma homocysteine, and red cell folate status. Plasma homocysteine was positively correlated with age ( , ). Multivariate analyses using sociodemographic and clinical covariates demonstrated that plasma homocysteine levels retained their respective associations with self-reported sleep apnea in all models except when age was included as a covariate. Our results demonstrate that the claimed association of plasma homocysteine with sleep apnea may be confounded by age.