To the Editor In a recent meta-analysis, Sánchez-de-la-Torre and colleagues found that “adherence to CPAP [continuous positive airway pressure] was associated with a reduced MACCE [major adverse cardiac and cerebrovascular event] recurrence risk, suggesting that treatment adherence is a key factor in secondary cardiovascular prevention in patients with OSA [obstructive sleep apnea].” The authors acknowledged that “selection bias” may have affected their results, adjusted for several covariates, then asserted that the “results of this meta-analysis provide a rigorous basis for recommendations about the types of patients with OSA and established cardiovascular disease most likely to benefit from CPAP treatment…”
