Using the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Markers for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Observational Studies

Obstructive sleep apnea (OSA) is a chronic condition characterized by the partial or complete collapse of the airways during sleep, leading to hypoxemia (reduced oxygen flow to organs) and disrupted sleep. This study aims to establish robust evidence for the relationship between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and the severity and prognosis of OSA. A systematic review and meta-analysis were conducted using PubMed, Cochrane Central Register of Controlled Trials, Scopus, Medline, and Web of Science to gather all relevant articles. Twenty-six eligible articles were included in the study. The pooled outcomes indicated that the NLR and PLR were significantly higher in patients with OSA compared to controls. Subgroup analyses based on the severity of OSA showed that differences in the NLR were more pronounced in patients with severe OSA. Moreover, meta-regression analysis revealed that variations in mean age, BMI, and male proportion did not significantly affect the differences in the NLR and PLR. OSA has a significant impact on NLR and PLR levels, making them useful markers for detecting the inflammatory status in OSA patients.