Aim To investigate the relationship between blood lipid levels and rapid eye movement (REM) and non-REM related obstructive sleep apnea hypopnea syndrome (OSAHS) by retrospective analysis of the related data of hypertension patients with OSAHS. Methods Retrospective analysis was made on 478 patients who were hospitalized in the Hypertension Department of Anzhen Hospital from January 1,7 to December 1,0 and did not take lipid-lowering drugs in the first half of the year. Collecting general data (gender, age, height and weight) of patients at admission, detecting total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC) and high density lipoprotein cholesterol (HDLC), and recording oxygen reduction index, minimum oxygen saturation, average oxygen saturation, sleep apnea hypopnea index (AHI), 24 h systolic blood pressure (24h SBP) and 24 h diastolic blood pressure (24h DBP). According to whether hypertension patients had OSAHS or not, they were divided into two groups:without OSAHS group and with OSAHS group. The clinical data of the two groups were compared, and the related influencing factors of OSAHS were analyzed by multivariate linear regression equation, spearman equation was used to analyze the correlation between blood lipid level and various indexes of OSAHS. In addition, according to different types of OSAHS, the correlation between AHI and blood lipid indicators in REM OSAHS and non-REM OSAHS patients was analyzed. Results Multivariate linear regression analysis showed that body mass index (BMI) and TG were the relevant influencing factors of OSAHS (P＜0.05). Spearman equation analysis showed that TC was positively correlated with BMI and arousal index (P＜0.05), HDLC was negatively correlated with BMI, hypoxemia index, longest apnea time, arousal index and AHI, and positively correlated with the lowest oxygen saturation (all P＜0.05); TG was positively correlated with BMI, hypoxemia index, arousal index and AHI, and negatively correlated with the lowest and average oxygen saturation (P＜0.05); AHI_non-REM was positively correlated with TC, TG and negatively correlated with HDLC in patients with OSAHS of different types (P＜0.05); AHIREM was positively correlated with TC and TG levels (P＜0.05), but not with HDLC (P＞0.05). Conclusions In patients with hypertension, BMI and TG levels are independent risk factors of OSAHS, and TG can be an independent risk factor positively correlated with the severity of OSAHS; non-REM OSAHS may affect HDLC synthesis by regulating the level of body hormones and thus change the blood lipid.