LAUSR

Objectives The purpose of this study was to clarify the relationship between obstructive sleep apnea (OSA) and oxidative stress markers in blood. Methods We conducted a systematic literature search on databases including Pubmed and Embase for studies reporting circulating oxidative stress markers in patients with OSA and controls that were published between 1988 and June 2019. Standardized mean differences (SMDs) and 95% confidence intervals (95%CI) were calculated. Results Of the 2226 articles initially retrieved, 52 were included in our meta-analysis, covering a total of 12 oxidative stress markers. The concentrations of malondialdehyde (SMD = 1.18; 95%CI: 0.87, 1.49; p  < 0.001), thiobarbituric acid reactive substances (SMD = 1.82; 95%CI: 0.79, 2.86; p  = 0.001), advance oxidative protein products (SMD = 0.68; 95%CI: 0.14, 1.23; p  = 0.014), total oxidant capacity (SMD = 1.32; 95%CI: 0.33, 2.31; p  = 0.009), and asymmetric dimethylarginine (SMD = 0.32; 95%CI: 0.16, 0.47; p  < 0.001) in the blood of patients with OSA were higher than those of the control group, whereas the concentrations of thiols (SMD =  − 0.37; 95%CI: − 0.60, − 0.15; p  = 0.001) and nitric oxide (SMD =  − 2.61; 95%CI: − 4.02, − 1.21; p  < 0.001) were lower than those of the control group. Conclusions The oxidative stress markers in the blood of patients with OSA were aberrant, indicating an imbalanced state of oxidation and antioxidation in OSA.