Please select the eligibility criteria that correspond to the clinical trial below.
Title: Continuous Positive Airway Pressure for the Treatment of Acute Ischemic Stroke: A Feasibility Pilot Study
Brief Summary: New stroke therapies are needed. This study seeks to provide the preliminary data needed to plan a future study that will evaluate the efficacy of using continuous positive airway pressure (CPAP) to treat stroke patients who have sleep apnea. Our goal is to use this therapy to reduce stroke symptom severity.


Options:
A: Inclusion Criteria: acute ischemic stroke with NIH Stroke Scale \>=2 -

Exclusion Criteria: respiratory distress; COPD requiring oxygen; primary intracranial hemorrhage on admission brain imaging; time from symptom onset to sleep study or CPAP treatment \>72 hours or time from hospital admission to sleep study or CPAP treatment \>48 hours; life expectancy less than 6 months; inability to provide informed consent; inability to communicate in English; residence outside the greater New Haven area; or any condition where the monitoring required by the study would constitute a risk to the patient or impair his or her care.

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B: Inclusion Criteria:

* Adults (18-70 yrs of age) with a subacute stroke (1-12 months)
* Diagnosis of sleep apnea and acceptance of CPAP therapy:

Exclusion Criteria:

* Patients with sopor/coma
* Any form of dementia (Mini-Mental State Examination \<20)
* Previously diagnosed sleep apnea and established CPAP therapy
* Purely central sleep apnea
* Chronic obstructive pulmonary disease more than Gold III
* Cancer
* Severe kidney diseases
* Coexisting causes of daytime sleepiness (e.g. narcolepsy, night or rotating shift-work; self-reported average sleep duration \<4 h)
* A major psychiatric or any other acute medical condition
* Patients unable or unwilling to comply with the protocol
C: Inclusion Criteria:

1. Obstructive Sleep Apnea (defined by Apnea-hypopnea index \[AHI\] \> 5 per hour; with hypopneas defined as greater than 30% reduction in airflow with 4 or greater drop in oxygen saturation). AHI will be determined by full night or split-night polysomnography.
2. Age range 21 - 85 years old.
3. Stable medical history and no change in medications, including anti-hypertensive and thyroid replacement, in the previous 4 months.
4. No regular use (\> 3 times/week) of sedative or hypnotic medications in the last 4 months.

Exclusion Criteria:

1. Central sleep apnea (central apnea index \> 5 per hour and \>50% of Apnea-hypopnea index constituted by central apneas and non-obstructive hypopneas).
2. Complex sleep apnea or CPAP emergent central apnea (Central apnea index \> 5 per hour during CPAP titration with \>50% of Apnea-hypopnea index constituted by central apneas and non-obstructive hypopneas).
3. Requiring oxygen or bi-level positive airway pressure for treatment of OSA or hypoventilation.
4. Decompensated cardiac (heart failure or angina) or pulmonary (severe COPD or uncontrolled asthma) disease
5. Chronic narcotic use
6. Nasal obstruction (nasal congestion score \> 15) or enlarged tonsils
7. Diagnosis of another sleep disorder in addition to OSA based on PSG (e.g., periodic limb movement disorder \[ 15 limb movements/hour of sleep with arousal\], central sleep apnea \[ 50% of apneas on diagnostic PSG are central apneas\], insomnia, obesity hypoventilation syndrome, or narcolepsy).
8. Previous treatment with positive airway pressure, home oxygen therapy, tracheotomy, uvulopalatopharyngoplasty, or other surgery for OSA.
9. Night shift workers in situations or occupations where they regularly experience jet lag, or have irregular work schedules by history over the last 6 months.
10. Routine consumption of more than 2 alcoholic beverages per day.
11. Recent or recurring history of recreational drug use leading to tolerance or dependence.
12. Unable to perform tests due to inability to communicate verbally, inability to write and read in English; less than a 5th grade reading level; visual, hearing or cognitive impairment (e.g. previous head injury); or upper extremity motor deficit (e.g., previous stroke that prevents patient from using CPAP treatment).
D: Inclusion Criteria:

* Patients aged \> 18 years of age who are referred to the University of Chicago sleep laboratory for split-night polysomnography by a non-sleep physician and who have a consultation appointment with a sleep physician following the appointment
* Have not had prior contact with a sleep physician or prior exposure to CPAP therapy.

Exclusion Criteria: Subjects will be excluded for any of the following characteristics: -Non-English speaking

* Illiterate
* Sleep study is negative for sleep apnea (apnea-hypopnea index \< 5 events/hr)
* Subject does not undergo CPAP titration during the in-laboratory polysomnogram
* Subject does not have a working telephone number
* Poor eyesight or hearing
* Dementia

Answer: A