Abstract: Objective To investigate the effect of subcortical arousal response on glucose metabolism in patients with essential hypertension and obstructive sleep apnea hyponea syndrome (OSAHS). Methods Between October, 2015 to May, 2016, 102 patients meeting the diagnostic criteria were selected in the center of hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region. All patients underwent nocturnal polysomnography and fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c) and pulse transit time (PTT) determination. According to the apnea hypopnea index (AHI), the subjects were divided into two groups:hypertension control group and hypertension combined with OSAHS group (further divided into 3 subgroups:mild, moderate and severe). The parameters of OSAHS, PTT, FBG and HbA1c were compared among groups, and the influence factors of glucose metabolism disorder were analyzed by stepwise regression analysis. Results In the moderate and severe OSAHS with hypertensive groups, PTT arousal index increased significantly compared with mild OSAHS and control group. In the severe OSAHS group FBG significantly increased than that in other groups. Correlation analysis showed that FBG was positively correlated with PTT arousal index (r=0.253, P=0.014) and oxygen desaturation index (r=0.242, P=0.015); HbA1c were positively correlated with PTT arousal index (r=0.326, P=0.001). Stepwise multiple linear regression analysis showed that PTT arousal index was the independent factor of FBG (β=0.007, P=0.018); age and PTT arousal index were independent factors of HbA1c (β=0.018, P=0.037; β=0.005, P=0.040 respectively). Conclusion There is a significant increase in subcortical arousal in moderate and severe OSAHS with hypertension patients, which may be one of the mechanisms of glucose metabolism disorder. Glucose metabolism disorders should be routinely screened in patients with OSAHS and hypertension.