Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cost Effective Strategy to Evaluate Veterans With Sleep Apnea
Brief Summary: This research study is comparing home and in-laboratory testing of veterans with suspected obstructive sleep apnea, a common breathing disorder during sleep. It is hoped that home testing will be equally effective in improving quality of life but have lower cost than in-lab testing. These findings will allow veterans to have greater access to diagnosis and treatment of their sleep apnea.


Options:
A: Inclusion Criteria:

* Intermediate to high probability of having OSA based on an adjusted neck circumference \> 43 cm (17 inches)
* Presence of excessive daytime sleepiness (Epworth sleepiness scale ≥ 12) Apnea-hypopnea index \>= 15 on diagnostic testing to continue in study

Exclusion Criteria:

* Severe chronic insomnia, other condition with \< 4 hrs of sleep per night
* Unstable medical conditions
* Major psychiatric diagnosis
* Unable to undergo home testing
* Concerns about unsafe driving
* Severe COPD or restrictive lung disease
* Chronic narcotic use
* Alcohol abuse
* History of cataplexy
* Moderate to severe restless legs syndrome symptoms
* Pre-existing diagnosis of sleep apnea
* Prior experience with positive airway pressure treatment of sleep apnea
* Anticipated upper airway surgery or gastric bypass surgery in 4 months
* Decisional impairment for consenting
* Hypoventilation syndrome, identified in the medical record
* Waking oxygen saturation \< 92%
B: Inclusion Criteria:

* Physician diagnosis of obstructive sleep apnea syndrome plus polysomnography demonstrating greater than 10 apneas plus hypopneas per hour of sleep
* Age 18-80 years
* Ability to use a telephone without assistance

Exclusion Criteria:

N/A
C: Inclusion Criteria:

Individuals willing to participate must meet the following eligibility criteria prior to enrollment:

* Patients referred for a sleep evaluation for suspected sleep apnea.
* Age 18 years or older
* Living within 90 miles of the Sleep Center.

Exclusion Criteria:

Individuals will be excluded from the study for the following reasons:

* Unable or unwilling to provide informed written consent.
* Lack of telephone access or inability to return for follow-up testing.
* A history of prior sleep evaluations, OSA treatment, or sleep disorder in addition to OSA.
* A clinically unstable chronic medical condition as defined by a new diagnosis or change in medical management in the previous 3 months of cardiac disease, thyroid disease, diabetes, depression or psychosis, cirrhosis, or recently diagnosed cancer.
* Individuals already on long term oxygen therapy or requiring bilevel positive airway pressure.
* Individuals with rotating shift work or irregular work schedules over the last 6 months.
* Suspected or confirmed to be pregnant. A pregnancy test will be performed using the urine sample obtained at the initial visit.
* Inability to complete the Assessment Battery - e.g. less than a 5th grade reading level
D: Inclusion Criteria:

1. Aged 18 years or over.
2. Newly diagnosed of OSA and will be starting CPAP therapy

Exclusion Criteria:

1. Not suitable for CPAP therapy
2. Previously received CPAP therapy
3. Possesses restrictive and obstructive pulmonary diseases
4. Possesses hypoventilation
5. Under unstable health conditions
6. pregnant
7. History of psychiatric illness

Answer: C