Dataset Information

Snoring and the risk of obstructive sleep apnea in patients with pulmonary embolism.

ABSTRACT:

Background

Obstructive sleep apnea (OSA) is associated with prothrombotic effects that could lead to venous thromboembolic disease. We performed a prospective cross-sectional study to determine the prevalence of snoring and risk of OSA in patients with acute pulmonary embolism (PE).

Methods

We evaluated 270 consecutive patients who underwent a computed tomographic angiogram for suspected PE. Patients without PE served as a control group. Demographic and clinical characteristics were analyzed. The Berlin Questionnaire was used to determine the presence of snoring and the risk of OSA. A subset of patients also underwent formal nocturnal polysomnography.

Results

PE was present in 71 (26%) of the 270 patients who underwent a computed tomographic angiogram. When compared with patients without PE, patients with PE had a significantly higher prevalence of snoring (75% vs 50%, odds ratio = 2.91, 95% confidence interval: 1.60, 5.33, P = 0.001) and an increased risk of having OSA, as defined by the Berlin Questionnaire (65% vs 36%, odds ratio = 3.25, confidence interval: 1.84, 5.72, P < 0.001). Results from the multivariate analysis showed that PE was independently associated with risk of OSA (OR = 2.78, P = 0.001).

Conclusions

We found a higher prevalence of snoring and high risk of OSA in patients diagnosed with acute PE, in comparison with patients in whom PE was suspected but ruled out. This association might be independent of other risks factors common to both OSA and PE. Therefore, OSA may represent a risk factor for the development of PE.

SUBMITTER: Epstein MD

PROVIDER: S-EPMC2910466 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Publications

Snoring and the risk of obstructive sleep apnea in patients with pulmonary embolism.

Epstein Matthew D MD Segal Leopoldo N LN Ibrahim Sherin M SM Friedman Neil N Bustami Rami R

Sleep 20100801 8

<h4>Background</h4>Obstructive sleep apnea (OSA) is associated with prothrombotic effects that could lead to venous thromboembolic disease. We performed a prospective cross-sectional study to determine the prevalence of snoring and risk of OSA in patients with acute pulmonary embolism (PE).<h4>Methods</h4>We evaluated 270 consecutive patients who underwent a computed tomographic angiogram for suspected PE. Patients without PE served as a control group. Demographic and clinical characteristics we ...[more]

PMID: 20815188

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Project description:Due to its effects, like an exaggerated negative intrathoracic pressure, sympathetic activation, systemic inflammation, oxidative stress, and endothelial dysfunction, obstructive sleep apnea (OSA) has been involved as a cause in multiple cardiovascular diseases. These diseases include coronary artery disease, hypertension, heart failure, and pulmonary hypertension (PH). Furthermore, OSA often coexists with chronic thromboembolic pulmonary hypertension (CTEPH) in clinical practice. However, few studies focus on OSA and its relationship with CTEPH. This study aims to determine whether OSA has an influence on the clinic status of patients with CTEPH, and to identify what possible factors are associated with OSA in CTEPH. Patients who were newly diagnosed with CTEPH and received overnight polysomnography (PSG) monitoring from September 2015 to December 2017 were enrolled. OSA was defined as apnea-hypopnea index (AHI) of ?5/h and the obstructive events at ?50%. Baseline clinical characteristics and parameters were collected and compared between CTEPH patients with and without OSA. In addition, logistic regression analysis was performed to identify possible factors associated with OSA in CTEPH. Fifty-seven patients with CTEPH were eventually enrolled. Among them, 32 patients were diagnosed with OSA by PSG. CTEPH patients with OSA showed an older age, a higher body mass index (BMI), a higher hemoglobin level, a lower oxygen saturation and a worse World Health Organization functional class (WHO FC) (all P<0.05) when compared to CTEPH patients without OSA. In addition, sleep data including AHI, oxygen desaturation index and minimum oxygen saturation were also statistically different between two groups (all P<0.05). Adjusted for age, sex and BMI, hemoglobin [odd ratio (OR) =1.057, 95% confidence interval (CI): 1.001-1.117, P=0.046], oxygen saturation (OR =0.718, 95% CI: 0.554-0.929, P=0.012), N-terminal pro-brain natriuretic peptide (OR =1.001, 95% CI: 1.000-1.002, P=0.016), mean right atrium pressure (OR =1.284, 95% CI: 1.030-1.600, P=0.026), mean pulmonary arterial pressure (mPAP) (OR =1.087, 95% CI: 1.001-1.180, P=0.048), cardiac index (CI) (OR =0.058, 95% CI: 0.008-0.433, P=0.037), pulmonary vascular resistance (OR =1.004, 95% CI: 1.001-1.007, P=0.014) and WHO FC III-IV (OR =18.550, 95% CI: 2.363-144.128, P=0.005) were associated with OSA in CTEPH. Multivariate logistic regression analysis demonstrated CI (OR =0.051, 95% CI: 0.003-0.868, P=0.040) was independently associated with OSA in CTEPH in addition to age, sex and BMI. OSA may aggravate the clinical status of CTEPH patients to some degree. In turn, a worse hemodynamics, oxygenation state and cardiac function are associated with OSA in CTEPH after being adjusted for age, sex and BMI. Among them, CI is the most important parameter in indicating the coexistence of OSA and CTEPH.

Dataset Information

Snoring and the risk of obstructive sleep apnea in patients with pulmonary embolism.

Background

Methods

Results

Conclusions

Publications

Snoring and the risk of obstructive sleep apnea in patients with pulmonary embolism.

Similar Datasets

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