Abstract: Objective To observe the influence of obstructive sleep apnea syndrome(OSAS) on glucose metabolism in middle-aged hypertensive patients. Methods The whole-night polysomnography(PSG) was performed in the hypertensive patients suspected of OSAS in our department between January to December 2010, and 895 patients were confirmed. According to exclusion criteria, middle-aged people aged between 40 and 60 were selected for follow-up. A total of 306 complete follow-up data were collected in 2017, including 86 patients without OSAS and 220 patients with OSAS(they were divided into mild, moderate and severe groups according to sleep respiratory disorder index(AHI) of OSAS patients). The follow-up included age, sex, blood pressure, fasting blood sugar, glycosylated hemoglobin, date of diabetes diagnosis and use of hypoglycemic drugs. The average follow-up time was(4.41±2.44) years. The incidence of glycometabolism disorder, the average fasting blood glucose and glycosylated hemoglobin level were compared among the different groups. Results Among middle-aged people, the incidence of diabetes mellitus and glucose metabolism disorder was 18.6% and 28.6% respectively in patients with hypertension and OSAS, which were higher than those in hypertension patients without OSAS(8.1% and 23.3%). The incidence of pre-diabetes in hypertension patients without OSAS(15.1%) was higher than that in hypertension patients with OSAS(10.0%). Conclusion The glycometabolism disorder is more likely to occur in hypertensive patients with OSAS. The incidence of glycometabolism disorder is positively correlated with the severity of OSAS.