Sleep Scientists Defend Vigilance Test Cutoff in Treated Sleep Apnea Debate

A technical dispute over how to flag lingering daytime sleepiness in patients treated for obstructive sleep apnea has turned into a public debate about the limits of clinical testing. In a formal reply in the Journal of Clinical Sleep Medicine, researchers from the University of Miami defended their approach in the MAGNETO study while acknowledging that the field still lacks a fully validated cutoff. The team reiterated use of a psychomotor vigilance task threshold—more than five lapses—to define residual sleepiness, drawing on earlier work in adherent patients. They note obstructive sleep apnea affects hundreds of millions worldwide, and a subset remains dangerously sleepy despite positive airway pressure therapy.