Evidence map›Paper›PMID 41826514›Full record

ArticleCommunications medicine2026

Individualized treatment effects of CPAP on secondary cardiovascular outcomes in non-sleepy obstructive sleep apnea patients.

Oren Cohen, Zainab Al-Taie, Vaishnavi Kundel, Samira Khan, Kavya Devarakonda, Vi Le, Philip M Robson, Craig S Anderson, Mathias Baumert, Kelly Loffler and 3 more

Abstract read
PubMed Full text at PMC Publisher
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Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Oren Cohen *Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID http://orcid.org/0009-0004-2827-9063
Zainab Al-Taie *Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Vaishnavi KundelDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Samira KhanDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Kavya DevarakondaDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID http://orcid.org/0000-0002-4374-4670
Vi LeDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Philip M RobsonBioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Craig S AndersonThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Mathias BaumertDiscipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia.ORCID http://orcid.org/0000-0003-2984-2167
Kelly LofflerAdelaide Institute for Sleep Health/Flinders Health and Medical Research Institute Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.ORCID http://orcid.org/0000-0003-3302-5995
R Doug McEvoyAdelaide Institute for Sleep Health/Flinders Health and Medical Research Institute Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Mayte Suárez-FariñasCenter for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Mayte.SuarezFarinas@mssm.edu.
Neomi A ShahDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. neomi.shah@mssm.edu.ORCID http://orcid.org/0009-0000-1828-1216

Funding

Multidisciplinary Research Training in Sleep ScienceT32HL160511 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI INDU A AYAPPA, ANDREW W VARGA · 2023 to 2026
$1.5M
Use of Novel Multi-modality Imaging to Evaluate the Relationship Between Sleep Duration, Vascular Inflammation, and Visceral AdiposityK23HL161324 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Vaishnavi Kundel · 2022 to 2026
$956k
NHLBI NIH HHS K23 HL161324NHLBI NIH HHS T32 HL160511
6 · The paper itself

Abstract

backgroundContinuous positive airway pressure (CPAP) remains the cornerstone of therapy for obstructive sleep apnea, yet its impact on preventing cardiovascular disease remains uncertain. Despite widespread clinical use, randomized controlled trials have not shown cardiovascular benefits with CPAP. Emerging evidence suggests that obstructive sleep apnea is a heterogeneous disease, and a uniform approach to treatment may obscure potential benefits or harm for individuals.

methodsTo address this, we applied causal survival forest analysis to data from the SAVE trial (n = 2,687), the largest clinical trial evaluating CPAP for cardiovascular disease prevention, to estimate individualized treatment effect scores for each participant.

resultsOur model reveals significant heterogeneity in treatment response across the cohort (area under the target operator characteristic curve 2.6; 95% confidence interval 2.03-4.55; p < 0.001). Survival analysis demonstrates that participants in the tertile predicted to benefit from CPAP experienced a 100-fold improvement in event-free survival when randomized to CPAP (p < 0.001), whereas those in the tertile predicted to be harmed experienced a > 100-fold increase in major adverse cardiovascular outcomes (p < 0.001).

conclusionsTo our knowledge, these findings provide the first evidence of individualized treatment effect estimates for CPAP therapy in obstructive sleep apnea. These results also highlight the potential for precision medicine approaches to guide treatment decisions, reduce cardiovascular disease risk, and avoid harm in susceptible individuals.

Identifiers

PMID41826514
PMCPMC13128901

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.