title: 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.
authors.affiliation: Sleep Disorder Center, Morristown Memorial Hospital, Morristown, NJ, USA. mepstein@pol.net
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Epstein
authors.forename: Leopoldo N
authors.initials: LN
authors.lastname: Segal
authors.forename: Sherin M
authors.initials: SM
authors.lastname: Ibrahim
authors.forename: Neil
authors.initials: N
authors.lastname: Friedman
authors.forename: Rami
authors.initials: R
authors.lastname: Bustami
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000453:epidemiology*; D012913:Snoring / Q000150:complications / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed
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