Objective To study the risk factors for cognitive impaurment in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with ischemic stroke.Methods Three hundred and twenty-eight OSAHS patients with ischemic stroke were divided into cognitive impairment group (n=158) and cognitive impairment-free group (n=170) according to their MMSE score.The risk factors for their cognitive impairment were analyzed by multivariate logistic regression analysis and stratification analysis respectively.Results The blood glucose and lipid,AHI,LSaO2,infarction size and site,HIF-1 and Ngb level were significantly different between the two groups (P＜0.01).Multivariate logistic regression analysis showed that blood glucose and lipid,AHI,infarction site and Ngb level were the independent risk factors for cognitive impairment (OR=3.527,95％CI:1.559-7.983,P=0.002;OR=6.413,95 ％CI:2.766-14.865,P=0.000;OR=4.099,95％CI:1.694-9.918,P=0.002;OR=4.484,95％CI:1.950-10.310,P=0.000;OR=3.891,95 ％CI:1.759-8.606,P=0.001).Stratification analysis showed that high HIF-1 and Ngb levels were positively related with cognitive impairment in patients with AHI＞20 times/h,frontotemporal infarction,hyperglycosemia or hypoglycosemia,and dyslipidemia.Conclusion High HIF-1 and Ngb levels are independently related with cognitive impairment in OSAHS patients with ischemic stroke.