Background: The recognition of comorbidities in OSA is essential, as they can exacerbate the disease burden, complicate management, and contribute to poorer patient outcomes.This study aimed to evaluate the prevalence of comorbidities in patients with obstructive sleep apnea (OSA) and analyze the association between OSA severity and various medical conditions.Materials and Methods: This cross-sectional observational study included 130 patients diagnosed with OSA at a tertiary care hospital. Diagnosis was confirmed through polysomnography (PSG) or home sleep apnea testing (HSAT) with an apnea-hypopnea index (AHI) ≥5 events per hour. Demographic data, lifestyle factors, and clinical characteristics were collected. Comorbidities, including cardiovascular, metabolic, respiratory, and neuropsychiatric conditions, were assessed using clinical history, laboratory tests, and validated screening tools. OSA severity was categorized as mild, moderate, or severe. Statistical analysis was conducted using descriptive statistics and multiple regression analysis.Results: The study population had a mean age of 48.75 ± 15.42 years, with a male predominance (64.62%). Most patients were overweight or obese, with a mean BMI of 29.63 ± 5.52 kg/m². Hypertension (55.38%), dyslipidemia (50.00%), and diabetes mellitus (40.00%) were the most prevalent comorbidities. Neuropsychiatric conditions, including depression (34.62%), anxiety (30.00%), and cognitive impairment (24.62%), were common. Respiratory disorders such as chronic obstructive pulmonary disease (20.00%) and asthma (17.69%) were also noted. Gastroesophageal reflux disease (GERD) was present in 40.77% of patients. Multiple regression analysis did not identify statistically significant predictors of OSA severity.Conclusion: This study highlights the high prevalence of cardiovascular, metabolic, respiratory, and neuropsychiatric comorbidities in patients with OSA. The findings underscore the importance of early screening and a multidisciplinary approach for managing OSA and its associated complications. Further research is needed to explore additional predictors influencing OSA severity.