ObjectiveTo explore the association between the ZJU index and obstructive sleep apnea hypopnea syndrome (OSAHS) and to develop a prediction model based on ZJU index. MethodsClinical data of patients diagnosed by polysomnography were retrospectively collected from January 2021 to July 2024. Participants were categorized into OSAHS and non-OSAHS groups, and the general data of the two groups were compared. Regression analysis was performed to analyze the influencing factors of OSAHS, a prediction model of OSAHS was constructed based on the ZJU index, and the diagnostic efficacy was evaluated by using the subject's work characteristics (ROC) curve and calibration curve. Rusults A total of 211 patients were included in this study, including 165 in the OSAHS group and 46 in the non-OSAHS group. The multifactorial results showed that ZJU index and gender were the influencing factors for the occurrence of OSAHS (P<0.05), and a prediction model was constructed by combining the ZJU index with gender, and the area under the ROC curve (AUC) was 0.786 (95%CI: 0.717-0.85). The sensitivity was 51.5% and the specificity was 91.3%. The calibration curve showed good agreement between predicted and actual results. ConclusionZJU index is associated with OSAHS, and the prediction model constructed by ZJU index combined with gender could be well used to predict the occurrence of OSAHS.