The threshold for diagnosis is AHI 5 with symptoms (eg, sleepiness) or Theprevalenceofmoder- ate to severe sleep apnea (AHI >15) among US adults 50 to 70 years of age is estimated to be 10%.318 Prevalence is higher in men than women and increases sharply with age and BMI. Sleep apnea is associated with increased risk for mortality,302 and risk factors including Sleep apnea affects 38% to 40% (AHI >20) of patients with stroke, with >90% of cases being OSA rather than central sleep Limited data suggest that patients with acute ischemic stroke and OSA are at increased risk for func- tional impairment, stroke recurrence, and death, although causation is not established.314,327 329 Limited data from small trials show that treatment with CPAP is safe after stroke, reduces the AHI, improves sleepiness, and may improve neurological function.304 311 Effects on vascular recurrence are uncertain, although a planned ancillary analysis in the SAVE study (Sleep Apnea Cardiovascular Endpoints) revealed that risk for stroke was lower among participants (all had a history of coronary artery disease or cerebrovascular disease) who had better adherence to CPAP therapy (HR, 0.56 [95% CI, 0.32 1.00]). Recommendation-Specific Supportive Text 1. 