Abstract Obstructive sleep apnoea (OSA) is highly prevalent among the Australian Indigenous population. Among other populations OSA has been linked to an increased risk of cardiac and respiratory disease and hospital presentations. It is plausible that CPAP adherence would reduce this risk. However, no such literature exists pertaining to the Indigenous Australian population. Indigenous Australian patients with OSA (assessed 2011-2020) and at least one hospital recorded (assessed 2011 – 2021) were included. ICD codes were used to assess hospital presentations and defined as Respiratory, Circulatory or Metabolic. Metabolic related hospital presentations were the most common (3,111 presentations, 66% of patients) followed by Circulatory system (1,900 presentations, 51% of patients) and Respiratory system (1,373 presentations, 45% of patients). Among the patients who had at least one of each respective presentation, the median number and rate of presentations was highest for Metabolic issues (median 4 presentations, rate 1.19/year), followed by Circulatory issues (median 3.5 presentations, rate 0.91/year) and Chronic Respiratory issues (median 3 presentations, rate 0.7/year). Adherence to CPAP significantly decreased the rate of Respiratory related presentations (beta -1.07 (95% CI -1.9, -0.2)). A high rate of hospital presentations exists among Indigenous Australian patients with OSA. Promoting the use of CPAP among Indigenous Australian patients may aid in reducing morbidity and mortality.