We thank Dr Gregoretti et al for their interest in our recent article1 and are happy to respond to their comments. The diagnosis and treatment of obstructive sleep apnea (OSA) in the perioperative setting is still evolving and will undoubtedly be modified as clinical evidence becomes available. The meta-analysis by Ramachandran and Josephs2 suggests that the STOP-Bang (snoring tiredness, observed apneas, elevated BP and BMI, age, neck circumference, and male gender) questionnaire is an average predictor of the diagnosis of OSA and an excellent predictor of severe OSA. Given the paucity of evidence to support the view that mild to moderate OSA is associated with significant adverse perioperative outcomes, we believe that substantial effort should focus on identifying and treating patients with severe OSA. In fact, identifying and treating patients with mild OSA in the nonperioperative setting3 has had the same impact on systemic disease as treating patients with severe OSA. Accordingly, some authors4 have suggested that mild OSA without hypoxia can be treated with standard postoperative monitoring.