TY - JOUR T1 - Obstructive sleep apnoea and venous thromboembolism: pathophysiological links and clinical implications JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00893-2018 SP - 1800893 AU - Alberto García-Ortega AU - Eva Mañas AU - Raquel López-Reyes AU - María José Selma AU - Aldara García AU - Grace Oscullo AU - David Jiménez AU - Miguel Ángel Martínez-García Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/10/18/13993003.00893-2018.abstract N2 - Obstructive sleep apnoea (OSA) and pulmonary embolism (PE) remain a major health issue 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 and a risk factor for PE. Conversely, patients with acute PE have 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. The 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. These will undoubtedly require closer collaboration between the sleep medicine and clinical/VTE communities.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Garcia-Ortega has nothing to disclose.Conflict of interest: Dr. Mañas has nothing to disclose.Conflict of interest: Dr. Lopez-Reyes has nothing to disclose.Conflict of interest: Dr. Selma has nothing to disclose.Conflict of interest: Dr. Garcia has nothing to disclose.Conflict of interest: Dr. Oscullo has nothing to disclose.Conflict of interest: Dr. Jimenez has nothing to disclose. ER -