Study Objective: Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The present study is aimed to determine whether a contextual relationship exists between OSA and cerebral WMC. Design: Cross-sectional analyses conducted in a population-based study. Setting: Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center. Participants: 503 individuals (mean age 59.63±7.48) who were free of previously diagnosed cardiovascular and neurological diseases. Measurements and Results: Participants underwent one-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] ＜5, n=289), mild OSA (AHI 5-15, n=161), and moderate-severe OSA (AHI ≥15, n=53). White matter change (WMC) was identified with brain magnetic resonance imaging (MRI) and was found in 199 (39.56%) individuals. Multivariate logistic regression analyses adjusted for covariates revealed that individuals with moderate-severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95%, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95% CI 1.02-4.05).