The effect of continuous positive airway pressure treatment on the systemic immune-inflammation index in obstructive sleep apnea syndrome
Nurullah Türe1, Muhammet Fatih Topuz2, Gönül Akdağ3, Pınar Yıldız Gülhan4, Mehmet Varol5
1Kulak Burun Boğaz,kütahya Sağlık Bilimleri Üniversitesi,kütahya, Türkiye
2Kulak Burun Boğaz,acıbadem Üniversitesi,i̇stanbul, Türkiye
3Nöroloji,kütahya Sağlık Bilimleri Üniversitesi,kütahya, Türkiye
4Göğüs Hastalıkları,düzce Üniversitesi Tıp Fakültesi,konuralp, Düzce, Türkiye
5Kulak Burun Boğaz,kütahya Şehir Hastanesi,kütahya, Türkiye
Keywords: Continuous positive airway pressure, hemogram, obstructive sleep apnea syndrome, systemic immune inflammation index.
Abstract
OBJECTIVE: This study aims to investigate the effect of continuous positive airway pressure (CPAP) treatment on the systemic immune-inflammation index (SII) in patients with obstructive sleep apnea syndrome (OSAS).
METHODS: In this retrospective cohort study, records of 197 OSAS patients (132 males, 65 females; median age: 55 years; range, 26 to 85 years) who underwent polysomnography and hemogram testing and were recommended CPAP therapy between January 2020 and April 2022 were analyzed. Forty-nine healthy volunteers (32 males, 17 females; median age: 31 years; range, 18 to 64 years) without OSAS-related complaints were included as controls. Hemogram-derived neutrophil, lymphocyte, and platelet counts were used to calculate neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and SII. These indices were compared between groups, and pre- and posttreatment values in OSAS patients. Correlations between CPAP duration and inflammatory indices were also examined.
RESULTS: The moderate OSAS group (n=45) showed a nonsignificant decrease in SII after CPAP (p=0.173), whereas the severe OSAS group (n=152) demonstrated a significant increase (p=0.041). Duration of CPAP use was positively correlated with changes in platelet-to-lymphocyte ratio (r=0.151, p=0.034) and SII (r=0.157, p=0.028).
CONCLUSION: Treatment with CPAP was associated with a nonsignificant reduction in systemic inflammation in moderate OSAS but paradoxically increased SII in severe OSAS. These findings suggest that CPAP alone may be insufficient to normalize systemic inflammation in advanced OSAS, and additional interventions such as weight loss or adjunctive therapies may be required.