Evidence map›Paper›PMID 29417392›Full record

ArticleSleep & breathing = Schlaf & Atmung2018

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

Moh'd Al-Halawani, Sreelatha Naik, Michael Chan, Iouri Kreinin, Jonathan Meiers, Meir Kryger

Abstract read
PubMed Publisher
In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Inflammatory biomarkers of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in 563 severe OSA patients before and after surgery.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2023
    Article
  3. Article
  4. Serendipity.Sleep advances : a journal of the Sleep Research Society · 2023
    Article
  5. Article
  6. Article
  7. Article
  8. Treatment of obstructive sleep apnea with CPAP improves chronic inflammation measured by neutrophil-to-lymphocyte ratio.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Moh'd Al-HalawaniSection of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA. mhalawanimd@gmail.com.ORCID http://orcid.org/0000-0002-7639-2923
Sreelatha NaikSection of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Michael ChanSection of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Iouri KreininSection of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Jonathan MeiersVeterans Affairs Connecticut Healthcare System, West Haven, CT, 06516, USA.
Meir KrygerSection of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Yale University · USBeth Israel Deaconess Medical Center · USVA Connecticut Healthcare System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObstructive sleep apnea has been associated with chronic inflammation triggered by nocturnal hypoxemia. The neutrophil-to-lymphocyte ratio (NLR) is a measure of subclinical systemic inflammation. We hypothesize that NLR levels would improve as chronic inflammation diminishes in obstructive sleep apnea (OSA) patients treated with mandibular advancement devices (MADs).

methodsWe studied patients with OSA who were treated with MAD as a first-line treatment or because they could not tolerate CPAP. We obtained pre-treatment and post-treatment complete blood counts. NLR was calculated by dividing the number of neutrophils by the number of lymphocytes obtained from the CBCs. Patients with other conditions known to affect NLR were excluded from the study.

resultsWe compared the values of NLR and oxygen desaturation index (ODI) before and after treatment with MAD in 22 patients who met inclusion criteria and completed the study protocol. There was a significant difference in NLR before and after treatment (p = 0.01). There was also a significant difference in the 3% ODI and 4% ODI before and after treatment with MAD (p = 0.014, 0.007), respectively. A subgroup analysis compared NLR in two groups of patients, the optimally treated and suboptimally treated. There was a significant decrease in the NLR in the optimally treated group (n = 10) (p < 0.01), whereas it did not change in the suboptimally treated group (n = 12) (p = 0.349).

conclusionThe 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.

Indexed as

AdultBiomarkersContinuous Positive Airway PressureFemaleHumansInflammation MediatorsLymphocytesMaleMandibular AdvancementMiddle AgedNeutrophilsSleep Apnea, ObstructiveBiomarkersInflammation MediatorsInflammationMandibular advancement devicesNeutrophil-to-lymphocyte ratioObstructive sleep apneaOral appliances

Identifiers

PMID29417392
OpenAlexW2786799754

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.