Abstract: Objective To evaluate the effect of postural therapy in patients with positional obstructive sleep apnea（OSA） and hypertension. Methods Hypertensive patients aged 18 years or above who visited the hypertension center of the People’s Hospital of Xinjiang Uygur Autonomous Region from September to December 2020 were continuously enrolled. All patients completed multi-lead sleep monitoring and ambulatory blood pressure, etc. Finally, a total of 60 patients who met the diagnostic criteria of position related obstructive sleep apnea（POSA） and completed the "tennis back pad method" postural therapy overnight were included for analysis. The changes of sleep parameters and blood pressure levels before and after treatment were compared. Results Supine sleep time 80.8（40.4-118.0） vs 149.1（87.7-228.1） min, Z=-4.708, P＜0.001, total sleep apnea hypopnea index（AHI） 10.9（6.7-17.1） vs 17.0（10.2-24.2） times/h, Z=-4.388, P＜0.001, supine AHI （30.5±22.3） vs（41.0±23.7） times/h, t=4.326, P＜0.001, sleep time with blood oxygen saturation（SaO₂）＜90%（TST90） 11.9（4.4-31.0） vs 23.0（4.9-78.7） min, Z=-3.178, P=0.001 and morning diastolic blood pressure （87.9±10.1） vs（91.9±11.4） mm Hg, t=3.135, P=0.003 were significantly decreased after postural therapy, while the mean SaO₂ 93.0%（92.0%-94.0%） vs 92.0%（91.0%-93.0%）, Z=-4.624, P＜0.001 and the lowest SaO₂ 82.0%（79.0%-85.0%） vs 81.0%（77.0%-84.0%）, Z=-3.048, P=0.002 were significantly increased. The level of systolic blood pressure （139.6±12.6） vs（142.6±15.3） mm Hg in the morning before and after treatment had no significant difference（t=1.781, P=0.080）. Correlation analysis showed that the change of TST_supine(ΔTST_supine) was positively correlated with the change of AHI（ΔAHI）（r_s =0.291, P=0.036） and negatively correlated with the change of AHI_supine(ΔAHI_supine)（r_s =-0.466, P=0.001）. Multiple linear regression analysis showed that ΔTST _supine was the influencing factor of the change of AHI before and after postural therapy（B=0.412, P=0.004）. Conclusion Short-term postural therapy can effectively reduce sleep-disordered breathing events, improve nighttime hypoxia and morning diastolic blood pressure in positional OSA with hypertension.