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. 2010 Aug;33(8):1069-74.
doi: 10.1093/sleep/33.8.1069.

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

Matthew D Epstein  1 , Leopoldo N Segal, Sherin M Ibrahim, Neil Friedman, Rami Bustami
Affiliations

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

Matthew D Epstein et al. Sleep. 2010 Aug.

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.

Trial registration: ClinicalTrials.gov NCT00409045.

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Figures

Figure 1
Figure 1
Trial profile
Figure 2
Figure 2
Multivariate logistic regression model for pulmonary embolism (N = 270). Model includes groups of individual risk factors. OR refers to odds ratio; CI, confidence interval; OSA, obstructive sleep apnea.
See this image and copyright information in PMC

Comment in

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