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Semin Respir Crit Care Med
DOI: 10.1055/a-2517-7880
Review Article

Pulmonary Embolism and Obstructive Sleep Apnea

Alberto García-Ortega
1   Respiratory Department, Doctor Peset University Hospital, Valencia, Spain
2   Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
,
Ana Pedro-Tudela
1   Respiratory Department, Doctor Peset University Hospital, Valencia, Spain
2   Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
,
Laura Taberner-Lino
1   Respiratory Department, Doctor Peset University Hospital, Valencia, Spain
2   Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
,
Esther Barreiro
3   Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
4   Pulmonology Department, Hospital del Mar, Barcelona, Spain
5   Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
6   Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
,
Miguel Ángel Martínez-García
6   Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
7   Respiratory Department, La Fe University and Polytechnic Hospital, Valencia, Spain
,
Grace Oscullo
7   Respiratory Department, La Fe University and Polytechnic Hospital, Valencia, Spain
8   The Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
› Author Affiliations
Funding None.
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Abstract

Pulmonary embolism (PE) and obstructive sleep apnea (OSA) remain a major health issue worldwide with potential overlapping pathophysiological mechanisms. PE, the most severe form of venous thromboembolism, is associated with high morbidity and mortality, presenting challenges in management and prevention, especially in high-risk populations. OSA is a prevalent condition characterized by repeated episodes of upper airway closure resulting in intermittent hypoxia and sleep fragmentation. Although the understanding of epidemiological and pathogenic relationships between OSA and PE is still limited, current data suggest that interactions between these two conditions appear to be relevant. OSA is emerging as a novel risk factor for PE, potentially affecting all components of Virchow's triad: hypercoagulability, endothelial dysfunction, and venous stasis. Epidemiological studies indicate a high prevalence of undiagnosed OSA in acute PE patients. Moderate-to-severe OSA has been linked to worse clinical presentations and outcomes. Furthermore, OSA has been associated with increased risks of PE recurrence and mortality. Future research directions should include clarifying the bidirectional relationship between these conditions and evaluating the effectiveness and safety of continuous positive airway pressure therapy in improving outcomes in patients with concurrent acute PE and OSA.

Keywords

pulmonary embolism - sleep apnea - coagulation - inflammation - sleep-disordered breathing - venous thromboembolism


Publication History

Accepted Manuscript online:
22 January 2025

Article published online:
18 February 2025

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