{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:19:54Z","timestamp":1790396394724,"version":"4.1.0"},"reference-count":127,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T00:00:00Z","timestamp":1626220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Obstructive sleep apnea (OSA) is characterized by repeated episodes of intermittent hypoxia (IH) and is recognized as an independent risk factor for vascular diseases that are mediated by a multitude of mechanistic pathophysiological cascades including procoagulant factors. The pro-coagulant state contributes to the development of blood clots and to the increase in the permeability of the blood\u2013brain barrier (BBB). Such alteration of BBB may alter brain function and increase the risk of neurodegenerative diseases. We aim to provide a narrative review of the relationship between the hypercoagulable state, observed in OSA and characterized by increased coagulation factor activity, as well as platelet activation, and the underlying neural dysfunction, as related to disruption of the BBB. We aim to provide a critical overview of the existing evidence about the effect of OSA on the coagulation balance (characterized by increased coagulation factor activity and platelet activation) as on the BBB. Then, we will present the emerging data on the effect of BBB disruption on the risk of underlying neural dysfunction. Finally, we will discuss the potential of OSA therapy on the coagulation balance and the improvement of BBB.<\/jats:p>","DOI":"10.3390\/jcm10143099","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T10:13:42Z","timestamp":1626257622000},"page":"3099","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Obstructive Sleep Apnea, Hypercoagulability, and the Blood\u2013Brain Barrier"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3179-8118","authenticated-orcid":false,"given":"Cindy","family":"Zolotoff","sequence":"first","affiliation":[{"name":"U1059, Sainbiose, Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 de Lyon, Universit\u00e9 Jean Monnet Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8214-3010","authenticated-orcid":false,"given":"Laurent","family":"Bertoletti","sequence":"additional","affiliation":[{"name":"U1059, Sainbiose, Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 de Lyon, Universit\u00e9 Jean Monnet Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"},{"name":"Service de M\u00e9decine Vasculaire et Th\u00e9rapeutique, CHU Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-6036","authenticated-orcid":false,"given":"David","family":"Gozal","sequence":"additional","affiliation":[{"name":"Department of Child Health and the Child Health Research Institute, MU Women\u2019s and Children\u2019s Hospital, University of Missouri, Columbia, MO 65201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Mismetti","sequence":"additional","affiliation":[{"name":"Service de Pneumologie et d\u2019Oncologie Thoracique, CHU Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-7028","authenticated-orcid":false,"given":"Pascale","family":"Flandrin","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019H\u00e9matologie, H\u00f4pital Nord, CHU Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6115-7958","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Roche","sequence":"additional","affiliation":[{"name":"U1059, Sainbiose, Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 de Lyon, Universit\u00e9 Jean Monnet Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"},{"name":"Service de Physiologie Clinique et de l\u2019Exercice, Centre VISAS, CHU Saint Etienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Perek","sequence":"additional","affiliation":[{"name":"U1059, Sainbiose, Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 de Lyon, Universit\u00e9 Jean Monnet Saint-\u00c9tienne, F-42270 Saint-Priest-en-Jarez, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","article-title":"Prevalence of Obstructive Sleep Apnea in the General Population: A Systematic Review","volume":"34","author":"Senaratna","year":"2017","journal-title":"Sleep Med. 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