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BackgroundOsteoarthritis (OA) is characterized by high morbidity and disability. While studies have demonstrated that OA is correlated with age-related diseases, few have shown the potential relationship between OA and obstructive sleep apnea syndrome (OSAS). OSAS is characterized by intermittent hypoxia and hypercapnia. We hypothesize that these stressors induce aging and increase the prevalence of OA.MethodsThe study included 10,641 participants drawn from the National Health and Nutrition Examination Survey (NHANES) dataset during 2005–2008 and 2015–2018. The correlation between OSAS and OA was analyzed using multivariable logistic regression, aging-related biomarkers were calculated, and the role of aging was explored through mediation analysis.ResultsOSAS was associated with an elevated risk of OA (for quartile 4 vs. quartile 1, odds ratio (OR) 2.31, 95% confidence interval (CI) 1.34 to 3.99; p-value for the trend = 0.004) after adjusting covariates. In the 20–59 years and > 60 years subgroup, the OSAS patients showed a similar trend (for quartile 4 vs. quartile 1, OR 5.69, 95% CI 2.75 to 11.8; p-value for the trend |