polite when scheduling her appointments, but was often anxious about the in-home visits and would frequently call study staff to confirm a visit if the research staff was running as little as five minutes late. In addition, Patient B made it clear that she had other priorities that took precedence over the diagnosis and treatment of her OSA. For instance, during her initially scheduled in-home polysomnographic evaluation, Patient B was reluctant to have the sleep study because she had just been to the hairdresser and feared wearing the equipment would ruin her newly-coiffed hair. She, therefore, requested that the study is rescheduled to a night before her next scheduled hair appointment, and this was accommodated by study staff.

With an AHI of 46, the sleep study revealed obstructive sleep apnea in the severerange and CPAP was presented to her as a treatment. Salient positives that could potentially promote CPAP adherence included her pre-existing understanding of CPAP resulting from a family member's prior use of the machine and her desire to decrease her current daytime sleepiness. Salient negatives that could serve as potential barriers included her concern for the condition of her hair and the potential for discomfort from the pressure of the mask. She seemed to understand the benefits of using CPAP; however, she voiced a guarded willingness to use the device because she continued to question her stroke diagnosis and how CPAP therapy would fit into her cerebrovascular treatment regimen.

Patient B's first few months of CPAP were successful: she wore the mask 85% of nights, for greater than four hours each night. However, during this