We sincerely appreciate the thoughtful comments by Wang et al. [1] regarding our recent publication. Their insights highlight important aspects of nocturnal blood pressure (BP) peak and provide valuable perspectives on the interpretation and clinical implications of our findings [2].

We fully agree that intermittent oscillometric monitoring may underestimate very short-term BP surges compared with beat-to-beat continuous recordings. Indeed, this limitation underscores the need for further validation using more precise technologies. Although the gold-standard method is invasive, it is not practical for routine clinical use. Previously, we developed an oscillometric BP monitoring method capable of detecting BP surges triggered by oxygen desaturation due to hypoxia in patients with sleep apnea syndrome [3]. In fact, a case report demonstrated that an exaggerated BP increase detected by this device was associated with a higher risk of recurrent stroke [4]. Another approach, pulse transit time (PTT), defined as the travel time of the systolic pressure wave between two arterial sites—typically the aortic valve and a peripheral site—has emerged as a novel cuffless technique for continuous BP monitoring. We compared BP parameters, including BP variability, obtained from beat-to-beat PTT-estimated BP (eBPBTB) and from intermittent PTT-estimated BP at fixed time intervals (eBPINT) in patients suspected of having sleep-disordered breathing [5]. Although BP variability showed similar trends between eBPBTB and eBPINT, discrepancies were observed in both minimum and maximum BP values. These findings suggest that continuous BP monitoring may be more sensitive in detecting nocturnal BP peaks than conventional intermittent monitoring.