Purpose <p>To determine the influence of type D personality on the prevalence of cardiovascular diseases (CVD), anxiety, depression, sleep quality and insomnia in OSA patients.</p> Methods <p>Patients planned for a polysomnography filled out the DS-14 questionnaire, Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). History of cardiovascular diseases and current medication intake were assessed.</p> Results <p>In a cohort of 948, OSA patients with type D personality did not have CVD more often (40%) compared to OSA patients without type D personality (42%) (<i>P</i> = 0.625). Out of 395 patients with OSA and CVD, 70% were treated for isolated arterial hypertension (AHT) and 30% for cerebrovascular and/or cardiac pathologies. Cerebrovascular and/or cardiac pathologies were significantly more prevalent in OSA patients with type D personality vs. without (39% vs. 26%; <i>P</i> = 0.001). In OSA patients with CVD and type D personality, medication intake was significantly higher (&gt; 2 cardiovascular medications (<i>P</i> = 0.009), anxiolytics (<i>P</i> = 0.001), antidepressants (<i>P</i> = 0.011), sleep medication (<i>P</i> = 0.002)) as well as scores of HADS for anxiety (<i>P</i> &lt; 0.0001) and depression (<i>P</i> &lt; 0.0001), ISI (P = &lt; 0.0001) and PSQI (<i>P</i> &lt; 0.0001).</p> Conclusion <p>The prevalence of CVD in OSA patients was not related to the presence of type D personality. Apart from arterial hypertension, cerebrovascular and/or cardiac pathologies were more frequently observed in OSA patients with type D personality. In OSA patients with CVD, the presence of type D personality was associated with more depression, anxiety, insomnia, poor sleep quality and more medication intake.</p>