Background To analyze the association between obstructive sleep apnea syndrome (OSAS) and some hematological variables such as mean platelet volume (MPV), platelet distribution width (PDW), and the impact of positive airway pressure (PAP) treatment on these parameters. Methods The participants of the present prospective study consist of 36 OSAS patients diagnosed with polysomnography and recommended PAP treatment and 30 healthy members as the control group. Complete blood analyses were conducted to the patient group twice; before the initiation of the PAP treatment and 1 month after regular PAP use. The control group was administered a complete blood analyses only once. Patient and control group were compared in terms of various parameters such as MPV, PDW, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) values, and platelet counts. Results MPV value of the patient group was before and after PAP treatment significantly higher than the control group (respectively;Z = 2.246;p = 0.025, andZ = 2.033;p = 0.042). However, there were no statistically significant differences in the values before and after PAP treatment in the patient group (Z = 0.727;p = 0.467). In terms of platelet numbers and PDW values, no significant differences were determined (p > 0.05). Conclusion MPV value was significantly elevated in OSAS patients. However, the 1 month of PAP treatment was insufficient in decreasing elevated MPV values.