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AIM: To investigate the relationship among sleep apnea hypopnea syndrome(SAHS), nocturnal hypotension(NHP)and nonarteritic anterior ischmic optic neuropathy(NAION). METHODS:The retrospective study participants included 31 patients with NAION and 31 age- and sex-matched controls. Twenty-four hour ambulatory blood pressure monitoring was used to evaluate the presence of NHP in NAION group and in control group. Berlin questionnaire was involved to evaluate the risk of SAHS. All participants underwent full-night respiratory polysomnography for monitoring apnea-hypopnea index(AHI), minimum oxygen saturation(MOS). RESULTS: Totally 23 NAION patients(74%)presented with NHP, which was found in 14 control subjects(45%). The incidence of NHP was significantly higher among NAION patients compared to the controls(P=0.020). Of the 31 NAION patients, 22 patients(71%)had SAHS, compared to 13(42%)control subjects. Logistic regression analysis showed that NHP(OR=2.762, 95% CI: 1.275-3.746), AHI(OR=2.959, 95% CI: 1.478-6.432)and MOS(OR=3.058, 95% CI: 1.734-7.743)were risk factors for NAION.CONCLUSION: SAHS and NHP were related with NAION. Taking precautions against SAHS and NHP may be crucial to the prevention and cure of NAION.