CPAP reduces hypercoagulability, as assessed by thromboelastography, in severe obstructive sleep apnoea
Mazen Toukh1, Effie J Pereira, Bani J Falcon
1Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
Respiratory Physiology & Neurobiology
|July 10, 2012
Summary
Severe obstructive sleep apnoea (OSA) indicates hypercoagulability. Continuous positive airway pressure (CPAP) treatment significantly reduced this hypercoagulability, suggesting a link between OSA, blood clotting, and cardiovascular risk.
Area of Science:
- Cardiovascular Medicine
- Sleep Medicine
- Hematology
Background:
- Obstructive sleep apnoea (OSA) is linked to heightened cardiovascular risks.
- Hypercoagulability, an increased tendency for blood to clot, is a potential contributing factor to OSA's cardiovascular complications.
Purpose of the Study:
- To investigate if patients with severe OSA exhibit hypercoagulability.
- To determine if continuous positive airway pressure (CPAP) treatment can mitigate this hypercoagulability.
Main Methods:
- A prospective crossover study involving twelve patients with severe OSA.
- Patients were randomized to two-week periods of CPAP or no-CPAP, separated by a one-week washout.
- Thromboelastography assessed coagulability; apnoea-hypopnea indices (AHI) measured OSA severity.
Main Results:
- Baseline thromboelastography revealed hypercoagulable states in most patients (shorter clotting times, increased clot formation rate, strength, and clotting indices).
- CPAP treatment significantly reduced AHI (p=0.0003).
- CPAP also significantly decreased clot strength (p=0.019) and clotting index (p=0.014).
Conclusions:
- Patients with severe obstructive sleep apnoea demonstrate measurable hypercoagulability.
- Thromboelastography is effective in detecting this hypercoagulability.
- CPAP therapy effectively reduces the hypercoagulable state associated with OSA.
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