Aim. Obstructive sleep apnea (OSA) can be associated with the metabolic syndrome. Adip o cyte fatty acid-binding protein (A-FABP) may play a role in OSA. The aim of this study was to determine whether cont i nuous positive airway pressure (CPAP) treatment results in decreased serum A-FABP levels. Subjects and methods. 81 patients (70 males, a mean age of 53.9±10.3 years) were evaluated by polysomnography, diagnosed with OSA and indicated for CPAP treatment. Anthropometric, clinical and laboratory investigations were carried out and repeated after 1 month/ 1 year of CPAP treatment. The data were analyzed using the SPSS Statistics 15 software (SPSS Inc., Chicago, USA). Results. Patients had significantly decreased A-FABP levels (34.4 ng/ml; 31.2 ng/ml; 24.8 ng/ml; P=0.048; P=0.001) and improved OSA parameters: AHI (53.9; 5.0; 5.6; P<0.0001), mean nocturnal oxygen saturation (91%; 93%; 94%, P<0.0001), ODI (55;9;8, P<0.0001), and percentage of sleep time with oxygen saturation below 90% (28.2; 0.2; 0, P<0.0001). BMI, waist, neck circumference, and blood pressure did not statistically significantly change. Conclusion. CPAP therapy in OSA patients has a positive effect on A-FABP levels. Decreased A-FABP levels play an important role in regulating glucose metabolism and affect the regulation of lipid metabolism and thus may contribute to decrease in the cardiovascular complications of OSA.