Background: Individuals with chronic obstructive pulmonary disease (COPD) present a high prevalence of obstructive sleep apnea (OSA) and worse postural balance; however, the association between them is poorly known. Aim: Evaluate the occurrence of falls in individuals with COPD with obstructive sleep apnea. Methods: Patients with moderate to very severe COPD were included. They performed the type I polysomnography exam and were classified as no (noOSA), mild (mOSA), or moderate to severe (msOSA) OSA. Sleep quality (Pittsburg Sleep Quality Index) and sleepiness (Epworth Scale) were also assessed. One week later, the postural balance was assessed using a laboratory (Force Platform) and clinical test (Mini BESTest). Patients were then followed for six months by monthly phone calls, and the falls were registered. The groups were compared by ANOVA or Kruskal Wallis test. Results: Seventy individuals were evaluated (noOAS, n=30; mOSA, n=25; msOAS, n=15). The msOAS was older (71±7, 64±7, and 67±5years) and had better lung function (55±17, 42±14 and 43±13 FEV1%pred) than noOSA (p<0.05), but not with mOSA, respectively. The msOAS group presented greater total and anteroposterior displacements of the center of pressure (CoP) (42.2±16.1 and 2.45±0.53cm, respectively) and higher speed during postural adjustments (1.4±0.5cm/s) than noOSA group; p<0.05. In the msOSA, the recurrent fallers occurred in the first three months of the follow-up (100%), while in the other groups occurred in the last three months. There was no between-group difference in sleep quality, sleepiness, and clinical test. Conclusion: OSA severity is associated with postural balance and the risk of recurrent falls in COPD patients.