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Are cardiorespiratory complications a question of epigenetics?

The character Joe from Charles Dickens’ The Posthumous Papers of the Pickwick Club (1837) was markedly obese and often fell asleep in an uncontrollable way during the day (1). This is probably one of the first cases of sleep apnea syndrome described in the literature. Sleep apnea is most often due to upper airway obstructions during sleep (2) and is regarded as a national disease affecting approximately 4% of the adult population. It results in intermittent hypoxia, leading to cardiovascular complications such as hypertension, coronary artery disease, heart failure, and stroke (3). The incidence of intermittent hypoxia is also common among infants, particularly if they are born prematurely (4). It increases the risk for developing cerebral palsy and sudden infant death syndrome (SIDS) (5).