The aim of this study was to establish cardiac damage related to nocturnal ischemia using heart type fatty acid binding protein (h-fabp), which reaches detectable levels in plasma after being released from myocytes in case of ischemia in obstructive sleep apnea syndrome (OSAS) patients without coronary artery disease (CAD). Fifty patients diagnosed with OSAS in our sleep laboratory with polysomnographic analysis (PSG), who did not have any previous history of cardiac disease and in whom CAD was ruled out with myocardium perfusion scintigraphy, were included in the study. Control group comprised 19 volunteers without history of cardiac disease and risk factors in whom OSAS was excluded with PSG analysis. Blood samples were drawn from the patients to examine h-fabp, creatine kinase (CK), creatine kinase-MB (CK-MB), aspartate aminotransferase (AST), troponin I levels before and after sleep. No significant difference was found in CK, CK-MB, AST, Troponin I, and h-fabp levels before and after sleep in patient and control groups (p > 0.05). No significant difference was found between groups in terms of CK, CK-MB, AST, and Troponin I levels before and after sleep, while a significant difference was found between them with regard to h-fabp levels before (p = 0.006) and after sleep (p = 0.022). When arithmetical mean of the fabp levels before and after sleep was taken in the patient group, it was found that mean value of h-fabp was associated with the desaturated period in sleep which was under 80% (p = 0.04). H-fabp seems to be a marker that will enable the detection of cardiac injury in the early asymptomatic period in OSAS patients before development of disease that can be detected by imaging methods. Further studies are required to investigate the relation between the value of h-fabp and the development of cardiac dysfunction in the long term.