Obstructive sleep apnea (OSA) is a risk factor for cardiovascular syndromes. Venous thromboembolism (VTE) is a chronic disease, and pulmonary embolism (PE) is the major expression of VTE and the third most frequent cardiovascular disease. An increasing and emerging number of cross-sectional and longitudinal studies have linked OSA to VTE, and have postulated different putative pathways to explain how OSA might increase the risk of PE.

We aim to provide a critical overview of the existing evidence about the complex relationship between these two conditions, with some factors and confounding variables still to be clarified. A global interpretation of the studies shows OSA is highly prevalent in VTE patients. This association represents a major public health burden, given the high prevalence and the mortality rates of both disorders. Although still not proven, OSA may induce a persistent hypercoagulable state that may contribute to increase VTE rate and its recurrence. Coagulant activity, platelet function and fibrinolytic system may improve after continuous positive airway pressure (CPAP) in OSA. However, there is a still a lack of randomized controlled trials to evaluate the potential of CPAP and/or extend oral anticoagulation to reduce PE incidence, recurrence and mortality by PE in patients with OSA.

阻塞性睡眠呼吸暂停（OSA）是心血管综合征的危险因素。静脉血栓栓塞症（VTE）是一种慢性疾病，而肺栓塞（PE）是VTE的主要表达形式，也是第三常见的心血管疾病。越来越多的横截面和纵向研究已将OSA与VTE相关联，并提出了不同的推定途径来解释OSA如何增加PE的风险。

我们旨在提供有关这两种情况之间复杂关系的现有证据的重要综述，其中一些因素和混淆变量仍有待澄清。研究的全球解释显示OSA在VTE患者中非常普遍。鉴于这两种疾病的高患病率和死亡率，该协会代表了主要的公共卫生负担。尽管尚未得到证实，但OSA可能会诱导持续的高凝状态，这可能有助于增加VTE率及其复发。在OSA中持续气道正压（CPAP）后，凝血活性，血小板功能和纤溶系统可能会改善。但是，仍然缺乏评估CPAP潜力和/或扩大口服抗凝药物以降低PE发生率的随机对照试验，