Obstructive sleep apnoea and venous thromboembolism: pathophysiological links and clinical implications.

Fecha de publicación: 01/02/2019

Autores de IIS La Fe

• Alberto García Ortega

  Autor

• Raquel López Reyes

  Autor

• María José Selma Ferrer

  Autor

• 

  Miguel Ángel Martínez García

  Autor

Participantes ajenos a IIS La Fe

• Mañas E
• García-Sánchez A
• Oscullo G
• Jiménez D

Grupos

• Neumología

  

  Leader

  Miguel Ángel Martínez García

Abstract

Obstructive sleep apnoea (OSA) and pulmonary embolism (PE) remain major health issues worldwide. Data from pathophysiological studies suggest that both intermittent hypoxia and sleep fragmentation are associated with increased blood coagulability, endothelial dysfunction and venous stasis. There is growing evidence that OSA is potentially prevalent in and a risk factor for PE. Conversely, patients with acute PE have two to four times greater risk of moderate-to-severe OSA. The role of continuous positive airway pressure (CPAP) treatment in improving clinically meaningful outcomes in PE patients remains unclear, although some authors have suggested that CPAP could improve the hypercoagulability state and normalise circadian alterations in some of the coagulation molecules, as observed in patients with OSA. Emerging research highlights the complex interdependent relationships between OSA and PE, emphasising the need for rigorous, well-powered trials that address the impact of OSA and its treatment on the prevention and management of PE. Undoubtedly, these will require closer collaboration between the sleep medicine and clinical/venous thromboembolism communities.