<p>Current research provides limited evidence for connections between metal exposure, as an emerging environmental risk factor, and obstructive sleep apnea (OSA) risk. This study aimed to examine the associations between blood and urine metal exposure and OSA risk. This cross-sectional study recruited participants and extracted data from the 2017–2020 round survey of the National Health and Nutrition Examination Survey. OSA was ascertained using the STOP questionnaire. Eight metals in blood samples were detected in 3,857 participants, and seven metals in urine samples from 1,902 participants. The combined effects of blood or urinary metal mixtures on OSA were assessed using Weighted Quantile Sum (WQS) regression and Quantile-based g-computation (Qgcomp) models. Odds ratio (OR) with 95% confidence interval (CI) was estimated using a weighted logistic regression model. Restricted cubic spline (RCS) models were applied to display the nonlinear associations. Both the WQS model (OR: 1.362, 95% CI: 1.123–1.652) and the Qgcomp models (OR: 1.259, 95% CI: 1.070–1.483) revealed that urinary metal mixtures were positively associated with OSA, with mercury and nickel contributing the highest weights. For each metal, RCS models were applied but significant nonlinear associations were only observed between blood mercury and urinary chromium and OSA risk. In single-metal models, most individual metals did not show significant associations after adjustment. This study identified nonlinear associations between blood mercury and urinary chromium concentrations and OSA risk, and exposure to mixtures of urinary metals was associated with an increased OSA risk.</p>