Obstructive Sleep Apnea with High Pulse Wave Amplitude Drops Index: A Specific Phenotype for Cardiovascular Benefit from Continuous Positive Airway Pressure?/Reply

Solelhac et al express gratitude towards Chen et al for their comments on their study. Chen et al mention that excessive daytime sleepiness in obstructive sleep apnea (OSA) is linked to a higher risk of cardiovascular death, which has been reported in some studies but not all. They suggest that the analysis may have excluded patients with moderate-to-severe disease, leading to an underestimation of cardiovascular risk. They clarify that patients with OSA and severe sleepiness were indeed excluded from their study. They also mention that the proportion of patients with high sleepiness scores in their study aligns with previous findings in clinic-based cohorts. The aim of their analysis was not to determine the incidence of cardiovascular events, but rather to assess the association between pulse wave amplitude drop index and the incidence of cardiovascular events in different types of participants. They highlight that the significant association found in samples with varying degrees of sleepiness is a strength of their analysis.