title: Sleep-disordered breathing in deep vein thrombosis and acute pulmonary embolism.
abstract: Sleep-disordered breathing (SDB) may trigger thromboembolic events by enhancing intravascular clot formation. The primary objective of the present nested case-control study was to investigate whether the prevalence of SDB is increased in patients with deep vein thrombosis (DVT) and/or acute pulmonary embolism (PE). 82 consecutive patients with DVT and/or PE (cases) were prospectively enrolled irrespective of SDB-related symptoms and formed matched pairs with patients without DVT and/or PE (controls) according to sex and pre-defined categories of age and body mass index. The prevalence of SDB (respiratory disturbance index assessed by polygraphy ≥ 15 events·h(-1)) was significantly greater in the cases with DVT and/or PE than in controls (40 versus 26%, p=0.046) and was predominantly obstructive in nature. Multiple regression analysis revealed that SDB was significantly associated with DVT and/or PE (OR 2.28, 95% CI 1.08-4.85; p=0.032) independent of established risk factors for thrombosis. In the sex-specific analyses this association was significant in females (OR 4.14, 95% CI 1.05-16.36; p=0.042), but not in males (OR 1.55, 95% CI 0.57-4.21; p=0.391). SDB occurs more frequently in females with DVT and/or PE than in controls matched for anthropometric variables, and is independently associated with the occurrence of these thromboembolic events.
authors.affiliation: Center for Sleep Medicine Dept of Internal Medicine II, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. michael.arzt@klinik.uni-regensburg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Arzt
authors.forename: Ruth
authors.initials: R
authors.lastname: Luigart
authors.forename: Carola
authors.initials: C
authors.lastname: Schum
authors.forename: Lars
authors.initials: L
authors.lastname: Lüthje
authors.forename: Annika
authors.initials: A
authors.lastname: Stein
authors.forename: Iris
authors.initials: I
authors.lastname: Koper
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hecker
authors.forename: Rio
authors.initials: R
authors.lastname: Dumitrascu
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000150:complications / Q000453:epidemiology*