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medRxiv PreprintsInternational30 October 2026

Prototyping OSA: A New Framework for Predicting Cardiovascular Outcomes and CPAP Benefit

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Rationale: Obstructive sleep apnea (OSA) is associated with major adverse cardiac events (MACE); continuous positive airway pressure (CPAP) has not reduced MACE in randomized trials. We hypothesized that multi-domain machine learning would identify OSA subgroups differing in cardiovascular risk and CPAP response. Methods: We conducted a secondary analysis of SAVE trial data. After preprocessing, Gaussian mixture models were fitted; Bayesian information criterion and C-index selected five prototypes. Cox models estimated MACE risk by prototype. Baseline quality of life (EQoL), Epworth Sleepines
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