Neutrophil-to-lymphocyte ratio decreases in obstructive sleep apnea treated with mandibular advancement devices

Al-Halawani, Moh’d; Naik, Sreelatha; Chan, Michael; Kreinin, Iouri; Meiers, Jonathan C.; Kryger, Meir H.

doi:10.1007/s11325-018-1635-5

Cited by 11 publications

(5 citation statements)

References 26 publications

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“…Four previous reports found mild, but statistically significant correlations between NLR and AHI [ 54 , 79 , 81 , 85 ], and several prospective studies documented a decrease in NLR after OSA treatment (1 month with a mandibular advancement device [ 86 ], 3 months of CPAP [ 81 , 87 ]). On the contrary, Ozdemir et al [ 62 ], failed to document a significant impact of CPAP on NLR.…”

Section: Discussionmentioning

confidence: 99%

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

Zota

Adam

Marcu

et al. 2022

IJMS

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Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse, chronic hypoxia and a proinflammatory phenotype. The purpose of our study was to evaluate readily available inflammatory biomarkers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), WBC-to-MPV ratio (WMR) and lymphocyte-to-C-reactive protein ratio (LCR)) before and after CPAP in patients with moderate–severe OSA. We performed a prospective study that included patients with newly-diagnosed moderate–severe OSA. The control groups (patients without OSA and with mild OSA) were selected from the hospital polygraphy database. All subjects underwent routine blood panel, which was repeated in moderate–severe OSA patients after 8 weeks of CPAP. Our final study group included 31 controls, 33 patients with mild, 22 patients with moderate and 37 patients with severe OSA. CRP, ESR, NLR and WMR were correlated with OSA severity. After 8-week CPAP therapy, we documented a decrease in weight status, which remained statistically significant in both CPAP-adherent and non-adherent subgroups. Readily available, inexpensive inflammatory parameters can predict the presence of moderate–severe OSA, but are not influenced by short-term CPAP.

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Section: Discussionmentioning

confidence: 99%

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

Zota

Adam

Marcu

et al. 2022

IJMS

View full text Add to dashboard Cite

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“…Al-Halawani compared the NLR value in OSA patients before and after treatment with mandibular advancement devices. They found that NLR was higher in those with moderate to severe OSA than in those with mild OSA, and in the following subgroup analysis, there was a synchronously significant decline in the NLR and AHI in the group with optimal treatment [ 40 ]. There is a paucity of data on the predictive significance of NLR in patients with AD.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio Facilitates Identification of Obstructive Sleep Apnea in Patients with Type B Aortic Dissection

Jiang

et al. 2021

Canadian Respiratory Journal

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Purpose. To determine whether the neutrophil-to-lymphocyte ratio (NLR) aids in the detection of obstructive sleep apnea (OSA) in patients with type B aortic dissection (TBAD). Methods. 324 patients with TBAD or type B aortic intramural hematoma (TB-AIMH) underwent an overnight sleep study. We divided the eligible 256 studied subjects into three groups: group A (n = 109, TBAD patients with OSA), group B (n = 68, TB-AIMH patients with OSA), and group C (n = 79, TBAD patients without OSA). Baseline characteristics, biochemical and sleep parameters, and STOP-Bang questionnaire scores were collected. To assess the predictive efficacy of potential variables, multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used. Results. The study found that about 58% of TBAD patients and 54% of TB-AIMH patients had OSA, a majority of whom had moderate to severe OSA (95.41% and 89.71%, respectively). In the comparison of sleep parameters between patients with TBAD and TB-AIMH, no other than apnea and hypopnea index (AHI) made a significant difference. The multivariate logistic regression analysis showed that neutrophil-to-lymphocyte ratio (NLR) (odds ratio (OR): 3.614, 95% confidence interval (CI): 2.273–5.748, and P < 0.05 ) and STOP-Bang scores (OR: 1.97, 95% CI: 1.34–2.90, and P < 0.05 ) were both independent predictors for OSA in patients with TBAD. ROC curves showed NLR had higher sensitivity (65% versus 59%) and specificity (86% versus 57%) for OSA than the STOP-Bang questionnaire. Furthermore, NLR was positively correlated with AHI through the Spearman test (r = 0.398 and P < 0.05 ). Conclusion. NLR was an independent predictor of OSA in TBAD patients with higher sensitivity and specificity than the STOP-Bang questionnaire, and it was positively associated with AHI. NLR may aid in the diagnosis and risk stratification of OSA in TBAD patients.

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“…Inflammatory biomarkers. Al-Halawani et al [70] reported a significant change in the neutrophil-lymphocyte ratio, a hematologic index of systemic inflammation, after 3-months of MAD treatment. In subgroup analysis, only the optimally treated group showed a significant decrease.…”

Section: N-terminal Pro-brain-type Natriuretic Peptide (Nt-pro-bnp)mentioning

confidence: 99%

The multisystemic effects of oral appliance therapy for obstructive sleep apnea: A narrative review

Kim

Chung

et al. 2022

Medicine

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Obstructive sleep apnea (OSA) is a chronic condition accompanied by repeated obstruction of the upper airway during sleep despite respiratory efforts, resulting in intermittent hypoxemia, altered sleep structure, and sympathetic activation. Previous studies have shown a significant association between OSA and general health issues such as cardiovascular diseases, endocrine disorders, neurocognitive function decline, and poor quality of life. Continuous positive airway pressure (CPAP) has been considered as the first line treatment for OSA. However, accumulating evidence supports the role of oral appliance (OA) therapy, including mandibular advancement devices, as an alternative option for snoring and OSA patients who do not comply with or refuse CPAP usage. Despite a generally favorable outcome of OA therapy for OSA related respiratory indices, studies focusing on the impact of systemic effects of OA therapy in OSA patients are relatively scarce compared with the extensive literature focusing on the systemic effects of CPAP. Therefore, this article aimed to provide an overview of the current evidence regarding the multisystemic effects of OA therapy for OSA.

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Neutrophil-to-lymphocyte ratio decreases in obstructive sleep apnea treated with mandibular advancement devices

Abstract: The neutrophil-to-lymphocyte ratio may be useful in documenting improvement in inflammation for OSA patients treated with mandibular advancement devices. Our results specifically suggest that the NLR values are associated with the decrease in the ODI.

Cited by 11 publications

References 26 publications

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

Neutrophil-to-Lymphocyte Ratio Facilitates Identification of Obstructive Sleep Apnea in Patients with Type B Aortic Dissection

The multisystemic effects of oral appliance therapy for obstructive sleep apnea: A narrative review

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