Skip to main content
Top
Published in: Sleep and Breathing 2/2016

01-05-2016 | Review

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

Authors: Domenico Maurizio Toraldo, Michele De Benedetto, Egeria Scoditti, Francesco De Nuccio

Published in: Sleep and Breathing | Issue 2/2016

Login to get access

Abstract

Introduction

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with severe cardiovascular events, morbidity and mortality. Recent evidence has highlighted OSAS as an independent risk factor for an excessive platelet activation and arterial thrombosis, but the underlying mechanisms have not yet been determined. Studies in cell culture and animal models have significantly increased our understanding of the mechanisms of inflammation in OSAS. Hypoxia is a critical pathophysiological element that leads to an intense sympathetic activity, in association with systemic inflammation, oxidative stress and procoagulant activity. While platelet dysfunction and/or hypercoagulability play an important role in the pathogenesis of vascular disease, there are limited studies on the potential role of blood viscosity in the development of vascular disease in OSAS.

Conclusion

Further studies are required to determine the precise role of hypercoagulability in the cardiovascular pathogenesis of OSAS, particularly its interaction with oxidative stress, thrombotic tendency and endothelial dysfunction. Nasal continuous positive airway pressure (nCPAP), the gold standard treatment for OSAS, not only significantly reduced apnea-hypopnoea indices but also markers of hypercoagulability, thus representing a potential mechanisms by which CPAP reduces the rate of cardiovascular morbidity and mortality in OSAS patients.
Literature
1.
2.
go back to reference McNicholas WT, Bonsigore MR (2007) Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 29:156–78CrossRefPubMed McNicholas WT, Bonsigore MR (2007) Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 29:156–78CrossRefPubMed
3.
go back to reference Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353:2034–41CrossRefPubMed Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353:2034–41CrossRefPubMed
4.
go back to reference Dziewas R, Humpert M, Hopmann B, Kloska SP, Lüdemann P, Ritter M, Dittrich R, Ringelstein EB, Young P, Nabavi DG (2005) Increased prevalence of sleep apnea in patients with recurring ischemic stroke compared with first stroke victims. J Neurol 252:1394–8CrossRefPubMed Dziewas R, Humpert M, Hopmann B, Kloska SP, Lüdemann P, Ritter M, Dittrich R, Ringelstein EB, Young P, Nabavi DG (2005) Increased prevalence of sleep apnea in patients with recurring ischemic stroke compared with first stroke victims. J Neurol 252:1394–8CrossRefPubMed
6.
go back to reference Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046–53CrossRefPubMed Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046–53CrossRefPubMed
7.
go back to reference Savransky V, Nanayakkara A, Li J, Bevans S, Smith PL, Rodriguez A, Polotsky VY (2007) Chronic intermittent hypoxia induces atherosclerosis. Am J Respir Crit Care Med 175:1290–7CrossRefPubMedPubMedCentral Savransky V, Nanayakkara A, Li J, Bevans S, Smith PL, Rodriguez A, Polotsky VY (2007) Chronic intermittent hypoxia induces atherosclerosis. Am J Respir Crit Care Med 175:1290–7CrossRefPubMedPubMedCentral
8.
go back to reference Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF (2007) Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 176:706–12CrossRefPubMed Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF (2007) Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 176:706–12CrossRefPubMed
12.
go back to reference Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T, American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, American Heart Association Stroke Council, American Heart Association Council on Cardiovascular Nursing, American College of Cardiology Foundation (2008) Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 118(10):1080–111. doi:10.1161/CIRCULATIONAHA.107.189375 CrossRefPubMed Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T, American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, American Heart Association Stroke Council, American Heart Association Council on Cardiovascular Nursing, American College of Cardiology Foundation (2008) Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 118(10):1080–111. doi:10.​1161/​CIRCULATIONAHA.​107.​189375 CrossRefPubMed
13.
go back to reference Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Tanaka A, Oda N, Okada S, Ohta S, Naito H, Adachi M (2005) Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 172:625–30CrossRefPubMed Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Tanaka A, Oda N, Okada S, Ohta S, Naito H, Adachi M (2005) Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 172:625–30CrossRefPubMed
14.
go back to reference Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112:2660–7CrossRefPubMed Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112:2660–7CrossRefPubMed
17.
go back to reference Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE, Sleep Heart Health Study Investigators (2004) Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 160:521–30CrossRefPubMed Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE, Sleep Heart Health Study Investigators (2004) Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 160:521–30CrossRefPubMed
19.
go back to reference Davì G, Gresele P, Violi F, Basili S, Catalano M, Giammarresi C, Volpato R, Nenci GG, Ciabattoni G, Patrono C (1997) Diabetes mellitus, hypercholesterolemia, and hypertension but not vascular disease per se are associated with persistent platelet activation in vivo. Evidence derived from the study of peripheral arterial disease. Circulation 96:69–75CrossRefPubMed Davì G, Gresele P, Violi F, Basili S, Catalano M, Giammarresi C, Volpato R, Nenci GG, Ciabattoni G, Patrono C (1997) Diabetes mellitus, hypercholesterolemia, and hypertension but not vascular disease per se are associated with persistent platelet activation in vivo. Evidence derived from the study of peripheral arterial disease. Circulation 96:69–75CrossRefPubMed
22.
go back to reference Pignatelli P, De Biase L, Lenti L, Tocci G, Brunelli A, Cangemi R, Riondino S, Grego S, Volpe M, Violi F (2005) Tumor necrosis factor-alpha as trigger of platelet activation in patients with heart failure. Blood 106:1992–4CrossRefPubMed Pignatelli P, De Biase L, Lenti L, Tocci G, Brunelli A, Cangemi R, Riondino S, Grego S, Volpe M, Violi F (2005) Tumor necrosis factor-alpha as trigger of platelet activation in patients with heart failure. Blood 106:1992–4CrossRefPubMed
23.
go back to reference Tyagi T, Ahmad S, Gupta N, Sahu A, Ahmad Y, Nair V, Chatterjee T, Bajaj N, Sengupta S, Ganju L, Singh SB, Ashraf MZ (2014) Altered expression of platelet proteins and calpain activity mediate hypoxia-induced prothrombotic phenotype. Blood 123:1250–60. doi:10.1182/blood-2013-05-501924 CrossRefPubMed Tyagi T, Ahmad S, Gupta N, Sahu A, Ahmad Y, Nair V, Chatterjee T, Bajaj N, Sengupta S, Ganju L, Singh SB, Ashraf MZ (2014) Altered expression of platelet proteins and calpain activity mediate hypoxia-induced prothrombotic phenotype. Blood 123:1250–60. doi:10.​1182/​blood-2013-05-501924 CrossRefPubMed
24.
go back to reference Ten VS, Pinsky DJ (2002) Endothelial response to hypoxia: physiologic adaptation and pathologic dysfunction. Curr Opin Crit Care 8:242–50CrossRefPubMed Ten VS, Pinsky DJ (2002) Endothelial response to hypoxia: physiologic adaptation and pathologic dysfunction. Curr Opin Crit Care 8:242–50CrossRefPubMed
25.
go back to reference Taylor CT, Kent BD, Crinion SJ, McNicholas WT, Ryan S (2014) Human adipocytes are highly sensitive to intermittent hypoxia induced NF-kappaB activity and subsequent inflammatory gene expression. Biochem Biophys Res Commun 447:660–5. doi:10.1016/j.bbrc.2014.04.062 CrossRefPubMed Taylor CT, Kent BD, Crinion SJ, McNicholas WT, Ryan S (2014) Human adipocytes are highly sensitive to intermittent hypoxia induced NF-kappaB activity and subsequent inflammatory gene expression. Biochem Biophys Res Commun 447:660–5. doi:10.​1016/​j.​bbrc.​2014.​04.​062 CrossRefPubMed
26.
go back to reference Larsson PT, Wallén NH, Hjemdahl P (1994) Norepinephrine-induced human platelet activation in vivo is only partly counteracted by aspirin. Circulation 89:1951–7CrossRefPubMed Larsson PT, Wallén NH, Hjemdahl P (1994) Norepinephrine-induced human platelet activation in vivo is only partly counteracted by aspirin. Circulation 89:1951–7CrossRefPubMed
27.
go back to reference Lévy P, Pépin JL, Arnaud C, Tamisier R, Borel JC, Dematteis M, Godin-Ribuot D, Ribuot C (2008) Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives. Eur Respir J 32:1082–95. doi:10.1183/09031936.00013308 CrossRefPubMed Lévy P, Pépin JL, Arnaud C, Tamisier R, Borel JC, Dematteis M, Godin-Ribuot D, Ribuot C (2008) Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives. Eur Respir J 32:1082–95. doi:10.​1183/​09031936.​00013308 CrossRefPubMed
28.
go back to reference Heinrich J, Balleisen L, Schulte H, Assmann G, van de Loo J (1994) Fibrinogen and factor VII in the prediction of coronary risk. Results from the PROCAM study in healthy men. Arterioscler Thromb 14:54–9CrossRefPubMed Heinrich J, Balleisen L, Schulte H, Assmann G, van de Loo J (1994) Fibrinogen and factor VII in the prediction of coronary risk. Results from the PROCAM study in healthy men. Arterioscler Thromb 14:54–9CrossRefPubMed
29.
go back to reference Robinson GV, Pepperell JC, Segal HC, Davies RJ, Stradling JR (2004) Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials. Thorax 59:777–82CrossRefPubMedPubMedCentral Robinson GV, Pepperell JC, Segal HC, Davies RJ, Stradling JR (2004) Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials. Thorax 59:777–82CrossRefPubMedPubMedCentral
30.
go back to reference Hui DS, Ko FW, Fok JP, Chan MC, Li TS, Tomlinson B, Cheng G (2004) The effects of nasal continuous positive airway pressure on platelet activation in obstructive sleep apnea syndrome. Chest 125:1768–75CrossRefPubMed Hui DS, Ko FW, Fok JP, Chan MC, Li TS, Tomlinson B, Cheng G (2004) The effects of nasal continuous positive airway pressure on platelet activation in obstructive sleep apnea syndrome. Chest 125:1768–75CrossRefPubMed
31.
go back to reference Akinnusi ME, Paasch LL, Szarpa KR, Wallace PK, El Solh AA (2009) Impact of nasal continuous positive airway pressure therapy on markers of platelet activation in patients with obstructive sleep apnea. Respiration 77:25–31. doi:10.1159/000158488 CrossRefPubMed Akinnusi ME, Paasch LL, Szarpa KR, Wallace PK, El Solh AA (2009) Impact of nasal continuous positive airway pressure therapy on markers of platelet activation in patients with obstructive sleep apnea. Respiration 77:25–31. doi:10.​1159/​000158488 CrossRefPubMed
32.
go back to reference Bokinsky G, Miller M, Ault K, Husband P, Mitchell J (1995) Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure. A preliminary investigation. Chest 108:625–30CrossRefPubMed Bokinsky G, Miller M, Ault K, Husband P, Mitchell J (1995) Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure. A preliminary investigation. Chest 108:625–30CrossRefPubMed
33.
go back to reference Phillips CL, McEwen BJ, Morel-Kopp MC, Yee BJ, Sullivan DR, Ward CM, Tofler GH, Grunstein RR (2012) Effects of continuous positive airway pressure on coagulability in obstructive sleep apnoea: a randomised, placebo-controlled crossover study. Thorax 67:639–44. doi:10.1136/thoraxjnl-2011-200874 CrossRefPubMed Phillips CL, McEwen BJ, Morel-Kopp MC, Yee BJ, Sullivan DR, Ward CM, Tofler GH, Grunstein RR (2012) Effects of continuous positive airway pressure on coagulability in obstructive sleep apnoea: a randomised, placebo-controlled crossover study. Thorax 67:639–44. doi:10.​1136/​thoraxjnl-2011-200874 CrossRefPubMed
34.
go back to reference von Känel R, Loredo JS, Ancoli-Israel S, Dimsdale JE (2006) Association between sleep apnea severity and blood coagulability: treatment effects of nasal continuous positive airway pressure. Sleep Breath 10:139–46CrossRef von Känel R, Loredo JS, Ancoli-Israel S, Dimsdale JE (2006) Association between sleep apnea severity and blood coagulability: treatment effects of nasal continuous positive airway pressure. Sleep Breath 10:139–46CrossRef
35.
go back to reference Toukh M, Pereira EJ, Falcon BJ, Liak C, Lerner M, Hopman WM, Iscoe S, Fitzpatrick MF, Othman M (2012) CPAP reduces hypercoagulability, as assessed by thromboelastography, in severe obstructive sleep apnoea. Respir Physiol Neurobiol 183:218–23. doi:10.1016/j.resp.2012.06.022 CrossRefPubMed Toukh M, Pereira EJ, Falcon BJ, Liak C, Lerner M, Hopman WM, Iscoe S, Fitzpatrick MF, Othman M (2012) CPAP reduces hypercoagulability, as assessed by thromboelastography, in severe obstructive sleep apnoea. Respir Physiol Neurobiol 183:218–23. doi:10.​1016/​j.​resp.​2012.​06.​022 CrossRefPubMed
36.
go back to reference Saarelainen S, Hasan J, Siitonen S, Seppälä E (1996) Effect of nasal CPAP treatment on plasma volume, aldosterone and 24-h blood pressure in obstructive sleep apnoea. J Sleep Res 5:181–5CrossRefPubMed Saarelainen S, Hasan J, Siitonen S, Seppälä E (1996) Effect of nasal CPAP treatment on plasma volume, aldosterone and 24-h blood pressure in obstructive sleep apnoea. J Sleep Res 5:181–5CrossRefPubMed
37.
go back to reference Reinhart WH, Oswald J, Walter R, Kuhn M (2002) Blood viscosity and platelet function in patients with obstructive sleep apnea syndrome treated with nasal continuous positive airway pressure. Clin Hemorheol Microcirc 27:201–7PubMed Reinhart WH, Oswald J, Walter R, Kuhn M (2002) Blood viscosity and platelet function in patients with obstructive sleep apnea syndrome treated with nasal continuous positive airway pressure. Clin Hemorheol Microcirc 27:201–7PubMed
38.
go back to reference Tazbirek M, Slowinska L, Skoczynski S, Pierzchala W (2009) Short-term continuous positive airway pressure therapy reverses the pathological influence of obstructive sleep apnea on blood rheology parameters. Clin Hemorheol Microcirc 41:241–9. doi:10.3233/CH-2009-1175 PubMed Tazbirek M, Slowinska L, Skoczynski S, Pierzchala W (2009) Short-term continuous positive airway pressure therapy reverses the pathological influence of obstructive sleep apnea on blood rheology parameters. Clin Hemorheol Microcirc 41:241–9. doi:10.​3233/​CH-2009-1175 PubMed
39.
go back to reference Cross MD, Mills NL, Al-Abri M, Riha R, Vennelle M, Mackay TW, Newby DE, Douglas NJ (2008) Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial. Thorax 63:578–83. doi:10.1136/thx.2007.081877 CrossRefPubMed Cross MD, Mills NL, Al-Abri M, Riha R, Vennelle M, Mackay TW, Newby DE, Douglas NJ (2008) Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial. Thorax 63:578–83. doi:10.​1136/​thx.​2007.​081877 CrossRefPubMed
40.
go back to reference Shitrit D, Peled N, Shitrit AB, Meidan S, Bendayan D, Sahar G, Kramer MR (2005) An association between oxygen desaturation and D-dimer in patients with obstructive sleep apnea syndrome. Thromb Haemost 94:544–7PubMed Shitrit D, Peled N, Shitrit AB, Meidan S, Bendayan D, Sahar G, Kramer MR (2005) An association between oxygen desaturation and D-dimer in patients with obstructive sleep apnea syndrome. Thromb Haemost 94:544–7PubMed
41.
go back to reference von Känel R, Loredo JS, Powell FL, Adler KA, Dimsdale JE (2005) Short-term isocapnic hypoxia and coagulation activation in patients with sleep apnea. Clin Hemorheol Microcirc 33:369–77 von Känel R, Loredo JS, Powell FL, Adler KA, Dimsdale JE (2005) Short-term isocapnic hypoxia and coagulation activation in patients with sleep apnea. Clin Hemorheol Microcirc 33:369–77
42.
go back to reference Steiner S, Jax T, Evers S, Hennersdorf M, Schwalen A, Strauer BE (2005) Altered blood rheology in obstructive sleep apnea as a mediator of cardiovascular risk. Cardiology 104:92–6CrossRefPubMed Steiner S, Jax T, Evers S, Hennersdorf M, Schwalen A, Strauer BE (2005) Altered blood rheology in obstructive sleep apnea as a mediator of cardiovascular risk. Cardiology 104:92–6CrossRefPubMed
43.
go back to reference Kaditis AG, Alexopoulos EI, Kalampouka E, Kostadima E, Angelopoulos N, Germenis A, Zintzaras E, Gourgoulianis K (2004) Morning levels of fibrinogen in children with sleep-disordered breathing. Eur Respir J24:790–7CrossRef Kaditis AG, Alexopoulos EI, Kalampouka E, Kostadima E, Angelopoulos N, Germenis A, Zintzaras E, Gourgoulianis K (2004) Morning levels of fibrinogen in children with sleep-disordered breathing. Eur Respir J24:790–7CrossRef
44.
go back to reference Shimizu M, Kamio K, Haida M, Ono Y, Miyachi H, Yamamoto M, Shinohara Y, Ando Y (2002) Platelet activation in patients with obstructive sleep apnea syndrome and effects of nasal-continuous positive airway pressure. Tokai J Exp Clin Med 27:107–12PubMed Shimizu M, Kamio K, Haida M, Ono Y, Miyachi H, Yamamoto M, Shinohara Y, Ando Y (2002) Platelet activation in patients with obstructive sleep apnea syndrome and effects of nasal-continuous positive airway pressure. Tokai J Exp Clin Med 27:107–12PubMed
46.
go back to reference Guardiola JJ, Matheson PJ, Clavijo LC, Wilson MA, Fletcher EC (2001) Hypercoagulability in patients with obstructive sleep apnea. Sleep Med 2:517–23CrossRefPubMed Guardiola JJ, Matheson PJ, Clavijo LC, Wilson MA, Fletcher EC (2001) Hypercoagulability in patients with obstructive sleep apnea. Sleep Med 2:517–23CrossRefPubMed
47.
go back to reference Choi JB, Loredo JS, Norman D, Mills PJ, Ancoli-Israel S, Ziegler MG, Dimsdale JE (2006) Does obstructive sleep apnea increase hematocrit? Sleep Breath 10:155–60CrossRefPubMed Choi JB, Loredo JS, Norman D, Mills PJ, Ancoli-Israel S, Ziegler MG, Dimsdale JE (2006) Does obstructive sleep apnea increase hematocrit? Sleep Breath 10:155–60CrossRefPubMed
48.
go back to reference Krieger J, Sforza E, Delanoe C, Petiau C (1992) Decrease in haematocrit with continuous positive airway pressure treatment in obstructive sleep apnoea patients. Eur Respir J 5:228–33PubMed Krieger J, Sforza E, Delanoe C, Petiau C (1992) Decrease in haematocrit with continuous positive airway pressure treatment in obstructive sleep apnoea patients. Eur Respir J 5:228–33PubMed
49.
go back to reference Krieger J, Sforza E, Barthelmebs M, Imbs JL, Kurtz D (1990) Overnight decrease in hematocrit after nasal CPAP treatment in patients with OSA. Chest 97:729–30CrossRefPubMed Krieger J, Sforza E, Barthelmebs M, Imbs JL, Kurtz D (1990) Overnight decrease in hematocrit after nasal CPAP treatment in patients with OSA. Chest 97:729–30CrossRefPubMed
50.
go back to reference Wright J, White J (2000) Continuous positive airways pressure for obstructive sleep apnoea. Cochrane Database Syst Rev 2:CD001106PubMed Wright J, White J (2000) Continuous positive airways pressure for obstructive sleep apnoea. Cochrane Database Syst Rev 2:CD001106PubMed
51.
go back to reference Leech JA, Onal E, Lopata M (1992) Nasal CPAP continues to improve sleep-disordered breathing and daytime oxygenation over long-term follow-up of occlusive sleep apnea syndrome. Chest 102:1651–5CrossRefPubMed Leech JA, Onal E, Lopata M (1992) Nasal CPAP continues to improve sleep-disordered breathing and daytime oxygenation over long-term follow-up of occlusive sleep apnea syndrome. Chest 102:1651–5CrossRefPubMed
52.
go back to reference Dikmenoğlu N, Ciftçi B, Ileri E, Güven SF, Seringeç N, Aksoy Y, Ercil D (2006) Erythrocyte deformability, plasma viscosity and oxidative status in patients with severe obstructive sleep apnea syndrome. Sleep Med 7:255–61CrossRefPubMed Dikmenoğlu N, Ciftçi B, Ileri E, Güven SF, Seringeç N, Aksoy Y, Ercil D (2006) Erythrocyte deformability, plasma viscosity and oxidative status in patients with severe obstructive sleep apnea syndrome. Sleep Med 7:255–61CrossRefPubMed
54.
go back to reference von Känel R, Dimsdale JE (2003) Hemostatic alterations in patients with obstructive sleep apnea and the implications for cardiovascular disease. Chest 124:1956–67CrossRef von Känel R, Dimsdale JE (2003) Hemostatic alterations in patients with obstructive sleep apnea and the implications for cardiovascular disease. Chest 124:1956–67CrossRef
55.
go back to reference Nobili L, Schiavi G, Bozano E, De Carli F, Ferrillo F, Nobili F (2000) Morning increase of whole blood viscosity in obstructive sleep apnea syndrome. Clin Hemorheol Microcirc 22:21–7PubMed Nobili L, Schiavi G, Bozano E, De Carli F, Ferrillo F, Nobili F (2000) Morning increase of whole blood viscosity in obstructive sleep apnea syndrome. Clin Hemorheol Microcirc 22:21–7PubMed
56.
go back to reference Takahashi K, Chin K, Nakamura H, Morita S, Sumi K, Oga T, Matsumoto H, Niimi A, Fukuhara S, Yodoi J, Mishima M (2008) Plasma thioredoxin, a novel oxidative stress marker, in patients with obstructive sleep apnea before and after nasal continuous positive airway pressure. Antioxid Redox Signal 10:715–26. doi:10.1089/ars.2007.1949 CrossRefPubMed Takahashi K, Chin K, Nakamura H, Morita S, Sumi K, Oga T, Matsumoto H, Niimi A, Fukuhara S, Yodoi J, Mishima M (2008) Plasma thioredoxin, a novel oxidative stress marker, in patients with obstructive sleep apnea before and after nasal continuous positive airway pressure. Antioxid Redox Signal 10:715–26. doi:10.​1089/​ars.​2007.​1949 CrossRefPubMed
57.
go back to reference Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC (1995) Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med 332:635–41CrossRefPubMed Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC (1995) Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. N Engl J Med 332:635–41CrossRefPubMed
59.
go back to reference Maruyama K, Morishita E, Sekiya A, Omote M, Kadono T, Asakura H, Hashimoto M, Kobayashi M, Nakatsumi Y, Takada S, Ohtake S (2012) Plasma levels of platelet-derived microparticles in patients with obstructive sleep apnea syndrome. J Atheroscler Thromb 19:98–104CrossRefPubMed Maruyama K, Morishita E, Sekiya A, Omote M, Kadono T, Asakura H, Hashimoto M, Kobayashi M, Nakatsumi Y, Takada S, Ohtake S (2012) Plasma levels of platelet-derived microparticles in patients with obstructive sleep apnea syndrome. J Atheroscler Thromb 19:98–104CrossRefPubMed
60.
go back to reference Toraldo DM, De Nuccio F, Mauro S, Spirito F, Distante A, Nicolardi G (2013) Frequency of human leukocyte antigens, plasminogen activator inhibitor-1 and methylenetetrahydrofolate reductase gene polymorphisms in obstructive sleep apnea-hypopnea syndrome with or without pulmonary artery hypertension. J Sleep Disorders Ther 2(131):2013 Toraldo DM, De Nuccio F, Mauro S, Spirito F, Distante A, Nicolardi G (2013) Frequency of human leukocyte antigens, plasminogen activator inhibitor-1 and methylenetetrahydrofolate reductase gene polymorphisms in obstructive sleep apnea-hypopnea syndrome with or without pulmonary artery hypertension. J Sleep Disorders Ther 2(131):2013
62.
go back to reference Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 19:CD001106 Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 19:CD001106
63.
go back to reference Takano K, Yamaguchi T, Uchida K (1992) Markers of a hypercoagulable state following acute ischemic stroke. Stroke 23:194–8CrossRefPubMed Takano K, Yamaguchi T, Uchida K (1992) Markers of a hypercoagulable state following acute ischemic stroke. Stroke 23:194–8CrossRefPubMed
64.
go back to reference Chin K, Kita H, Noguchi T, Otsuka N, Tsuboi T, Nakamura T, Shimizu K, Mishima M, Ohi M (1998) Improvement of factor VII clotting activity following long-term NCPAP treatment in obstructive sleep apnoea syndrome. QJM 91:627–33CrossRefPubMed Chin K, Kita H, Noguchi T, Otsuka N, Tsuboi T, Nakamura T, Shimizu K, Mishima M, Ohi M (1998) Improvement of factor VII clotting activity following long-term NCPAP treatment in obstructive sleep apnoea syndrome. QJM 91:627–33CrossRefPubMed
65.
go back to reference Grundt H, Nilsen DW, Hetland Ø, Valente E, Fagertun HE (2004) Activated factor 12 (FXIIa) predicts recurrent coronary events after an acute myocardial infarction. Am Heart J 147:260–6CrossRefPubMed Grundt H, Nilsen DW, Hetland Ø, Valente E, Fagertun HE (2004) Activated factor 12 (FXIIa) predicts recurrent coronary events after an acute myocardial infarction. Am Heart J 147:260–6CrossRefPubMed
66.
go back to reference Geiser T, Buck F, Meyer BJ, Bassetti C, Haeberli A, Gugger M (2002) In vivo platelet activation is increased during sleep in patients with obstructive sleep apnea syndrome. Respiration 69:229–34CrossRefPubMed Geiser T, Buck F, Meyer BJ, Bassetti C, Haeberli A, Gugger M (2002) In vivo platelet activation is increased during sleep in patients with obstructive sleep apnea syndrome. Respiration 69:229–34CrossRefPubMed
67.
go back to reference Ma J, Hennekens CH, Ridker PM, Stampfer MJ (1999) A prospective study of fibrinogen and risk of myocardial infarction in the Physicians’ Health Study. J Am Coll Cardiol 33:1347–52CrossRefPubMed Ma J, Hennekens CH, Ridker PM, Stampfer MJ (1999) A prospective study of fibrinogen and risk of myocardial infarction in the Physicians’ Health Study. J Am Coll Cardiol 33:1347–52CrossRefPubMed
68.
go back to reference Rångemark C, Hedner JA, Carlson JT, Gleerup G, Winther K (1995) Platelet function and fibrinolytic activity in hypertensive and normotensive sleep apnea patients. Sleep 18:188–94PubMed Rångemark C, Hedner JA, Carlson JT, Gleerup G, Winther K (1995) Platelet function and fibrinolytic activity in hypertensive and normotensive sleep apnea patients. Sleep 18:188–94PubMed
69.
go back to reference Rao M, Rajda G, Uppuluri S, Beck GR, Liu L, Bisognano JD (2010) The role of continuous positive airway pressure in the treatment of hypertension in patients with obstructive sleep apnea-hypoapnea syndrome: a review of randomized trials. Rev Recent Clin Trials 5:35–42CrossRefPubMed Rao M, Rajda G, Uppuluri S, Beck GR, Liu L, Bisognano JD (2010) The role of continuous positive airway pressure in the treatment of hypertension in patients with obstructive sleep apnea-hypoapnea syndrome: a review of randomized trials. Rev Recent Clin Trials 5:35–42CrossRefPubMed
70.
71.
go back to reference Oga T, Chin K, Tabuchi A, Kawato M, Morimoto T, Takahashi K, Handa T, Takahashi K, Taniguchi R, Kondo H, Mishima M, Kita T, Horiuchi H (2009) Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability. J Atheroscler Thromb 16:862–9CrossRefPubMed Oga T, Chin K, Tabuchi A, Kawato M, Morimoto T, Takahashi K, Handa T, Takahashi K, Taniguchi R, Kondo H, Mishima M, Kita T, Horiuchi H (2009) Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability. J Atheroscler Thromb 16:862–9CrossRefPubMed
72.
go back to reference Banner DW, D'Arcy A, Chène C, Winkler FK, Guha A, Konigsberg WH, Nemerson Y, Kirchhofer D (1996) The crystal structure of the complex of blood coagulation factor VIIa with soluble tissue factor. Nature 380:41–6CrossRefPubMed Banner DW, D'Arcy A, Chène C, Winkler FK, Guha A, Konigsberg WH, Nemerson Y, Kirchhofer D (1996) The crystal structure of the complex of blood coagulation factor VIIa with soluble tissue factor. Nature 380:41–6CrossRefPubMed
73.
go back to reference Hayashi M, Fujimoto K, Urushibata K, Takamizawa A, Kinoshita O, Kubo K (2006) Hypoxia-sensitive molecules may modulate the development of atherosclerosis in sleep apnoea syndrome. Respirology 11:24–31CrossRefPubMed Hayashi M, Fujimoto K, Urushibata K, Takamizawa A, Kinoshita O, Kubo K (2006) Hypoxia-sensitive molecules may modulate the development of atherosclerosis in sleep apnoea syndrome. Respirology 11:24–31CrossRefPubMed
74.
go back to reference Yan SF, Mackman N, Kisiel W, Stern DM, Pinsky DJ (1999) Hypoxia/hypoxemia-induced activation of the procoagulant pathways and the pathogenesis of ischemia-associated thrombosis. Arterioscler Thromb Vasc Biol 19:2029–35CrossRefPubMed Yan SF, Mackman N, Kisiel W, Stern DM, Pinsky DJ (1999) Hypoxia/hypoxemia-induced activation of the procoagulant pathways and the pathogenesis of ischemia-associated thrombosis. Arterioscler Thromb Vasc Biol 19:2029–35CrossRefPubMed
75.
go back to reference Bach RR (1998) Mechanism of tissue factor activation on cells. Blood Coagul Fibrinolysis 9(Suppl 1):S37–43PubMed Bach RR (1998) Mechanism of tissue factor activation on cells. Blood Coagul Fibrinolysis 9(Suppl 1):S37–43PubMed
76.
go back to reference Toraldo DM, De Nuccio F, Nicolardi G (2010) Fixed-pressure nCPAP in patients with obstructive sleep apnea (OSA) syndrome and chronic obstructive pulmonary disease (COPD): a 24-month follow-up study. Sleep Breath 14:115–23. doi:10.1007/s11325-009-0291-1 CrossRefPubMed Toraldo DM, De Nuccio F, Nicolardi G (2010) Fixed-pressure nCPAP in patients with obstructive sleep apnea (OSA) syndrome and chronic obstructive pulmonary disease (COPD): a 24-month follow-up study. Sleep Breath 14:115–23. doi:10.​1007/​s11325-009-0291-1 CrossRefPubMed
77.
go back to reference Barbieri SS, Amadio P, Gianellini S, Tarantino E, Zacchi E, Veglia F, Howe LR, Weksler BB, Mussoni L, Tremoli E (2012) Cyclooxygenase-2-derived prostacyclin regulates arterial thrombus formation by suppressing tissue factor in a sirtuin-1-dependent-manner. Circulation 126:1373–84. doi:10.1161/CIRCULATIONAHA.112.097295 CrossRefPubMed Barbieri SS, Amadio P, Gianellini S, Tarantino E, Zacchi E, Veglia F, Howe LR, Weksler BB, Mussoni L, Tremoli E (2012) Cyclooxygenase-2-derived prostacyclin regulates arterial thrombus formation by suppressing tissue factor in a sirtuin-1-dependent-manner. Circulation 126:1373–84. doi:10.​1161/​CIRCULATIONAHA.​112.​097295 CrossRefPubMed
78.
go back to reference Haus E (2007) Chronobiology of hemostasis and inferences for the chronotherapy of coagulation disorders and thrombosis prevention. Adv Drug Deliv Rev 59:966–84CrossRefPubMed Haus E (2007) Chronobiology of hemostasis and inferences for the chronotherapy of coagulation disorders and thrombosis prevention. Adv Drug Deliv Rev 59:966–84CrossRefPubMed
79.
go back to reference Goldberg RJ, Brady P, Muller JE, Chen ZY, de Groot M, Zonneveld P, Dalen JE (1990) Time of onset of symptoms of acute myocardial infarction. Am J Cardiol 66:140–4CrossRefPubMed Goldberg RJ, Brady P, Muller JE, Chen ZY, de Groot M, Zonneveld P, Dalen JE (1990) Time of onset of symptoms of acute myocardial infarction. Am J Cardiol 66:140–4CrossRefPubMed
80.
go back to reference von Känel R, Natarajan L, Ancoli-Israel S, Mills PJ, Wolfson T, Gamst AC, Loredo JS, Dimsdale JE (2013) Effect of continuous positive airway pressure on day/night rhythm of prothrombotic markers in obstructive sleep apnea. Sleep Med 14:58–65. doi:10.1016/j.sleep.2012.07.009 CrossRef von Känel R, Natarajan L, Ancoli-Israel S, Mills PJ, Wolfson T, Gamst AC, Loredo JS, Dimsdale JE (2013) Effect of continuous positive airway pressure on day/night rhythm of prothrombotic markers in obstructive sleep apnea. Sleep Med 14:58–65. doi:10.​1016/​j.​sleep.​2012.​07.​009 CrossRef
81.
go back to reference Felix HC, Bradway C, Chisholm L, Pradhan R, Weech-Maldonado R (2015) Prevalence of moderate to severe obesity among U.S. nursing home residents, 2000–2010. Res Gerontol Nurs 13:1–6. doi:10.3928/19404921-20150223-01 Felix HC, Bradway C, Chisholm L, Pradhan R, Weech-Maldonado R (2015) Prevalence of moderate to severe obesity among U.S. nursing home residents, 2000–2010. Res Gerontol Nurs 13:1–6. doi:10.​3928/​19404921-20150223-01
82.
83.
go back to reference Lyon CJ, Law RE, Hsueh WA (2003) Minireview: adiposity, inflammation, and atherogenesis. Endocrinology 144:2195–200CrossRefPubMed Lyon CJ, Law RE, Hsueh WA (2003) Minireview: adiposity, inflammation, and atherogenesis. Endocrinology 144:2195–200CrossRefPubMed
85.
go back to reference Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–39CrossRefPubMed Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–39CrossRefPubMed
86.
go back to reference Loube DI, Loube AA, Mitler MM (1994) Weight loss for obstructive sleep apnea: the optimal therapy for obese patients. J Am Diet Assoc 94:1291–5CrossRefPubMed Loube DI, Loube AA, Mitler MM (1994) Weight loss for obstructive sleep apnea: the optimal therapy for obese patients. J Am Diet Assoc 94:1291–5CrossRefPubMed
87.
go back to reference Sands SA, Eckert DJ, Jordan AS, Edwards BA, Owens RL, Butler JP, Schwab RJ, Loring SH, Malhotra A, White DP, Wellman A (2014) Enhanced upper-airway muscle responsiveness is a distinct feature of overweight/obese individuals without sleep apnea. Am J Respir Crit Care Med 190:930–7. doi:10.1164/rccm.201404-0783OC CrossRefPubMedPubMedCentral Sands SA, Eckert DJ, Jordan AS, Edwards BA, Owens RL, Butler JP, Schwab RJ, Loring SH, Malhotra A, White DP, Wellman A (2014) Enhanced upper-airway muscle responsiveness is a distinct feature of overweight/obese individuals without sleep apnea. Am J Respir Crit Care Med 190:930–7. doi:10.​1164/​rccm.​201404-0783OC CrossRefPubMedPubMedCentral
88.
go back to reference Wolf J, Lewicka J, Narkiewicz K (2007) Obstructive sleep apnea: an update on mechanisms and cardiovascular consequences. Nutr Metab Cardiovasc Dis 17:233–40CrossRefPubMed Wolf J, Lewicka J, Narkiewicz K (2007) Obstructive sleep apnea: an update on mechanisms and cardiovascular consequences. Nutr Metab Cardiovasc Dis 17:233–40CrossRefPubMed
90.
go back to reference Pendlebury ST, Pépin JL, Veale D, Lévy P (1997) Natural evolution of moderate sleep apnoea syndrome: significant progression over a mean of 17 months. Thorax 52:872–8CrossRefPubMedPubMedCentral Pendlebury ST, Pépin JL, Veale D, Lévy P (1997) Natural evolution of moderate sleep apnoea syndrome: significant progression over a mean of 17 months. Thorax 52:872–8CrossRefPubMedPubMedCentral
91.
go back to reference Sforza E, Addati G, Cirignotta F, Lugaresi E (1994) Natural evolution of sleep apnoea syndrome: a five year longitudinal study. Eur Respir J 7:1765–70CrossRefPubMed Sforza E, Addati G, Cirignotta F, Lugaresi E (1994) Natural evolution of sleep apnoea syndrome: a five year longitudinal study. Eur Respir J 7:1765–70CrossRefPubMed
92.
go back to reference Kim NH, Lee SK, Eun CR, Seo JA, Kim SG, Choi KM, Baik SH, Choi DS, Yun CH, Kim NH, Shin C (2013) Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults. Sleep 36:723–9. doi:10.5665/sleep.2636 PubMedPubMedCentral Kim NH, Lee SK, Eun CR, Seo JA, Kim SG, Choi KM, Baik SH, Choi DS, Yun CH, Kim NH, Shin C (2013) Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults. Sleep 36:723–9. doi:10.​5665/​sleep.​2636 PubMedPubMedCentral
93.
go back to reference Chen X, Pensuksan WC, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) Obstructive sleep apnea and multiple anthropometric indices of general obesity and abdominal obesity among young adults. Int J Soc Sci Stud 2:89–99PubMedPubMedCentral Chen X, Pensuksan WC, Lohsoonthorn V, Lertmaharit S, Gelaye B, Williams MA (2014) Obstructive sleep apnea and multiple anthropometric indices of general obesity and abdominal obesity among young adults. Int J Soc Sci Stud 2:89–99PubMedPubMedCentral
95.
go back to reference Barceló A, Piérola J, de la Peña M, Esquinas C, Sanchez-de la Torre M, Ayllón O, Alonso A, Agusti AG, Barbè F (2012) Day-night variations in endothelial dysfunction markers and haemostatic factors in sleep apnoea. Eur Respir J 39:913–8. doi:10.1183/09031936.00039911 CrossRefPubMed Barceló A, Piérola J, de la Peña M, Esquinas C, Sanchez-de la Torre M, Ayllón O, Alonso A, Agusti AG, Barbè F (2012) Day-night variations in endothelial dysfunction markers and haemostatic factors in sleep apnoea. Eur Respir J 39:913–8. doi:10.​1183/​09031936.​00039911 CrossRefPubMed
Metadata
Title
Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure
Authors
Domenico Maurizio Toraldo
Michele De Benedetto
Egeria Scoditti
Francesco De Nuccio
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 2/2016
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-015-1227-6

Other articles of this Issue 2/2016

Sleep and Breathing 2/2016 Go to the issue

Sleep Breathing Physiology and Disorders • Review

Pathophysiology of central sleep apneas

Sleep Breathing Physiology and Disorders • Original Article

Missing teeth and pediatric obstructive sleep apnea

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine