What’s wrong with pausing inspiration while sleeping? Obstructive sleep apnea hypoventilation syndrome (OSAHS), also known as “snoring disorder”. OSAHS is caused by localized obstruction or collapse of the upper whistle during sleep, resulting in sleep apnea and hypoventilation, which leads to nocturnal snoring and typical symptoms of sleep structural disorders, and long-term nocturnal oxygen desaturation, resulting in nocturnal hypoxia and daytime symptoms such as drowsiness, sleepiness, lack of concentration and fatigue. What is the relationship between hypertension and OSAHS? Hypertension often coexists with OSAHS, and the 7th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hypertension in the United States in 2003 clearly identified OSAHS as the number one cause of secondary hypertension. The results of several studies suggest that at least 30% of patients with hypertension have OSAHS in combination, and the prevalence of hypertension in patients with OSAHS is as high as 50% to 80%. A prospective study published in the New England Journal of Medicine showed that after 4 years of follow-up, the incidence of new-onset hypertension was 42% higher in patients with OSAHS than in those without OSAHS. Our study by Li Nanfang et al. confirmed that OSAHS accounted for 42.92% of the causes of secondary hypertension in hospitalized patients with hypertension, and was the first cause of secondary hypertension, far surpassing anxiety disorders (15.04%) and primary aldosteronism (12.12%), etc. A review published in JAMA in 2014 concluded that 70% of patients with refractory hypertension had a combination of OSAHS Therefore, we believe that there is a complex causal relationship between OSAHS and hypertension, which influence each other. The main risk factors for OSAHS are: 1. obesity; 2. age: the prevalence increases with age in adulthood, and increases in women after menopause, and stabilizes after age 70; 3. gender: significantly more men than women have OSAHS during their reproductive years; 4. anatomical abnormalities of the upper airway; 5. family history of OSAHS; 6. long-term heavy alcohol consumption and/or sedative-hypnotic or muscle relaxant drugs; 7. chronic smoking; 8, Long-term smoking; 8. Other related diseases: hypothyroidism, acromegaly, hypopituitarism, etc. Sleep monitoring – the gold standard for OSAHS diagnosis: Laboratory polysomnography (PSG) is now recognized as the gold standard for OSAHS diagnosis. Compared to other diagnostic methods, PSG has the highest accuracy in detecting not only obstructive sleep whistling disorders but also other forms of concurrent sleep whistling disorders. In cases of hypertension with obesity, or with significant nocturnal snoring, nocturnal apnea, and significant maxillofacial anatomical abnormalities, ABPM and PSG monitoring are recommended to confirm the diagnosis of sleep apnea-associated hypertension and to grade the extent of the condition. How is OSAHS treated? The basic goal of treatment for OSAHS is to remove the upper whistle obstruction during sleep and promote quality sleep based on early diagnosis and selection of appropriate treatment. For the treatment of OSAHS, medication is not the first option. Lifestyle interventions such as smoking and alcohol cessation and weight loss are required first. Different approaches are chosen depending on the patient, rather than surgical treatment as a uniform solution. If there is significant upper whistle obstruction, the obstruction can be removed surgically, the most common in internal medicine is non-invasive whistle-assisted whistle, including continuous positive pressure ventilation (CPAP), bi-level positive pressure ventilation (BiPAP) and smart CPAP. in recent years oral orthoses have also become more commonly used to widen the upper whistle by moving the lower jaw forward.