Response to “Failure to Acknowledge Prior Studies” by Peretz Lavie

We appreciate Dr Lavie’s interest in our recent study. We regret that he feels an intentional slight was directed toward him and his previous work. Nothing could be further from the truth. As the title clearly indicates, the goal of this study was to revisit a question many prior authors had previously examined. This study was clearly not intended to be a systematic review or meta-analysis on the topic, which would have included an exhaustive literature search and citations of the many previous studies that have been conducted. This study represented a slightly different view on this previously examined topic where sleep apnea severity data collected from home sleep testing were compared with mortality from a public access mortality database. The self-stated goal of the study was “to thoroughly evaluate a large ambulatory sleep test patient database and objectively evaluate the association between OSAS severity and all-cause mortality” ¹ (emphasis added). This design is different from Dr Lavie’s study, in which in-laboratory polysomnography data were compared with mortality records. ² Although we acknowledge Dr Lavie’s concerns, we do not agree with his assertion that our recent study “essentially replicated” his previous study. Although the findings of the studies are similar, the methodologies to test sleep apnea severity (home testing vs in laboratory) and the populations under study (American men/women vs Israeli men) were quite different. We certainly respect his right to critique the study and welcome constructive comments. No disrespect was intended to Dr Lavie or the many, many other authors who have published on this topic. However, we do feel the study is clearly and honestly portrayed as revisiting a topic previously studied by many authors and was not in any way intended to be the first or definitive study on the topic or an exhaustive systematic review. We do believe it does offer an interesting viewpoint that home sleep test data from a large ambulatory cohort also show an association between sleep-disordered breathing severity and all-cause mortality.