This systematic review and meta-analysis aimed to evaluate the association between the triglyceride-glucose (TyG) index and obstructive sleep apnea (OSA). The study included ten studies involving 16,726 individuals, comparing OSA patients with healthy controls. The meta-analysis found that OSA patients had significantly higher TyG index levels compared to healthy controls (SMD 0.856, 95% CI 0.579 to 1.132, P < 0.001). The TyG index also demonstrated diagnostic ability for OSA, with a pooled AUC of 0.681 (95% CI 0.627 to 0.735). However, no significant differences were observed in TyG index levels between different severities of OSA. The study concluded that the TyG index is a valuable and easy-to-measure marker of insulin resistance (IR) in OSA, useful for both diagnosis and prognosis. This marker could be implemented in routine clinical practice to aid in decision-making and patient stratification.This systematic review and meta-analysis aimed to evaluate the association between the triglyceride-glucose (TyG) index and obstructive sleep apnea (OSA). The study included ten studies involving 16,726 individuals, comparing OSA patients with healthy controls. The meta-analysis found that OSA patients had significantly higher TyG index levels compared to healthy controls (SMD 0.856, 95% CI 0.579 to 1.132, P < 0.001). The TyG index also demonstrated diagnostic ability for OSA, with a pooled AUC of 0.681 (95% CI 0.627 to 0.735). However, no significant differences were observed in TyG index levels between different severities of OSA. The study concluded that the TyG index is a valuable and easy-to-measure marker of insulin resistance (IR) in OSA, useful for both diagnosis and prognosis. This marker could be implemented in routine clinical practice to aid in decision-making and patient stratification.