Objective To analyze the changes of neutrophil/lymphocyte ratio （NLR）， platelet/ lymphocyte ratio （PLR）， sleep structure and short-term prognosis in patients with acute ischemic stroke and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods From January 2021 to March 2022，a total of 106 patients with acute ischemic stroke in the Department of Neurology of Beijing Daxing People's Hospital were selected as research subjects. All the patients were monitored by polysomnography （PSG）. According to the apnea hypopnea index （AHI）， the patients were divided into non OSAHS group （n=52）， mild OSAHS group （n=24） and moderate to severe OSAHS group （n=30）. The changes of NLR，PLR and PSG sleep parameters were compared among the three groups. The difference of neurological function among the three groups was compared by Barthel index and modified Rankin score at the 3-month follow-up after discharge. Results The differences in NLR and PLR level among the 3 groups were statistically significant ［1.90 （1.60，2.71） vs 2.30（1.70， 4.12） vs 2.35（1.67， 6.40）， （161.00±74.10） vs （207.10±90.10） vs （214.30±96.60）］ （P ＜ 0.05）. The levels of NLR and PLR in moderate and severe OSAHS group were significantly higher than those in non OSAHS group， and the difference was statistically significant （P ＜ 0.05）. There were statistically significant differences in the proportions of REM phase， NREM phase 1， NREM phase 3 and awakening times among the three groups［（17.78±6.13）% vs（15.21±5.29）% vs （13.97±5.03）%，（15.01±8.62）% vs （19.26±10.93）% vs（20.39±9.14）%， （15.58±9.55）% vs （11.43±5.49）% vs （9.81±5.86）%， 4.00（3.00， 6.00） vs 5.00 （4.00， 6.00） vs 6.00（5.00， 8.00）］ （P＜ 0.05）. The proportion of NREM phase 1 in severe OSAHS group was higher than that in non OSAHS group， the proportion of NREM phase 3 and REM phase was lower than that in non OSAHS group， and the number of awakenings was higher than that in non OSAHS group， with statistical significance （P＜ 0.05）. The Barthel index and the modified Rankin score of the three groups at the time of 3 months after discharge were statistically significant ［（87.40±9.20） vs （83.54±9.61） vs （82.67±6.07）， 1.00（0， 2.00） vs 2.00（0.25， 3.00） vs 2.00（1.00， 3.00）］ （P ＜ 0.05）. Barthel index of patients in mild， moderate and severe OSAHS group was lower than that in non OSAHS group， and the modified Rankin score was higher than that in non OSAHS group， the difference was statistically significant （P＜ 0.05）. Conclusions Moderate and severe OSAHS increases the levels of NLR and PLR in patients with stroke，and increases the number of sleep awakenings. The inflammatory reaction promoted by hypoxia and sleep structure disorder may be related to the adverse short-term prognosis of acute ischemic stroke.