AIM:To investigate the relation of obstructive sleep apnea syndrome (OSAS) and heart rate variability (HRV). METHODS:Twenty patients with severe OSAS were recruited to undergo 7 hour polysomnography (PSG) and ECG monitoring in sleep lab,twenty age matched healthy were studied as controls. Time domain and frequency domain analysis of HRV were performed. RESULTS:HRV time domain indices including SDANN,SDNN,rMSSD in OSAS patients were significantly higher than those in the controls,SDNN index decreased remarkably. Freguency domain indices including VLF,LF,HF,LFnorm,HFnorm and LF/HF increased significantly compared with the controls. CONCLUSION:The sympathetic and parasympathetic nerve activity were enhanced,the former is prior to the latter.