Sleep Apnea and Tromboembolic Disease
Sleep Apnea and Tromboembolic Disease
There is some evidence for a hypercoagulable state in sleep apnea-hipopnea syndrome (SAHS),
 which could play a role in the increased cardiovascular morbility and mortality. Respiratory
 alterations (hypoxia, hypoxia- reoxygenation) and sleep fragmentation that these patients
 suffer during the sleep may induce modifications in clotting-fibrinolisis factors that may be
 a risk factor for venous thromboembolism (VTE).

 OBJECTIVES:To calculate and compare the prevalence of sleep apnea-hipopnea syndrome in
 patients with venous thromboembolism with a gender, aged and BMI matched control group.
 Assessment of the association between SAHS and other risk factors for VTE. To compare
 clotting- fibrinolisis patterns, sleep parameters, blood pressure and pulmonary arterial
 obstruction index in patients with SAHS and VTE and those ones without SAHS.
DESIGN: Case-control study.

 METHODS: 133 SAHS patients and 133 controls will be studied. The study includes:

 a) medical history; b) anthropometric variables (weight, height, body mass index, Mallampati
 index); c) sleepiness tested by Epworth scale; d) London Chest Activity of Daily Living
 Scale; e) conventional polysomnography (PSG); f) testing: clotting-fibrinolisis factors
 (factor V, VII, VIII; C and S protein, plasminogen tissular activator (t-PA) and inhibitor of
 plasminogen activator (PAI-1); g) d-dimer and thrombin-antithrombin III complex; h) basic
 biochemical profile and hemograma; i) Pulmonary artery obstruction index.
Inclusion Criteria:

 -  Case group:

 -  Pulmonary embolism diagnosed by CT Pulmonary Angiography.

 -  Control group:

 -  randomly selected from among patients in two primary health care centers in Mallorca
 without tromboembolic disease

 Exclusion Criteria:

 -  Refusal to sign informed consent.

 -  Expected survival less than 12 months

 -  Long-term oxygen therapy

 -  Hospital admission in the previous two months.

 -  Familiar thrombophilia