Recruitment Strategies Comparing Different Strategies in Sleep Apnea and Prediabetes

Inclusion Criteria: * Prediabetes: A1c value of 6.0-6.4% and fasting glucose of 100-125 mg/dl * Moderate-to-severe OSA \[4% oxygen desaturation index (ODI) ≥ 20/h\] * Ability to provide informed consent * Able to comply with all study procedures and be available for the study duration * Availability of smart phone Exclusion Criteria: * BMI \< 28 or ≥ 38 kg/m2 * Type 1 or Type 2 diabetes mellitus * Pregnancy * Use of glucose-lowering or weight loss medications (e.g., metformin, orlistat, phentermine) * Prior or anticipated bariatric surgery * Current use of PAP or oral appliance therapy for OSA * Commercial driver * Report of a motor vehicle accident or near-miss due to sleepiness within 2 years * Epworth Sleepiness Scale score10 \> 18 * Current (prevalent) use of oral corticosteroids (within 1 month) * Participation in a concurrent clinical trial * Unstable medical conditions: uncontrolled angina and/or congestive heart failure, uncontrolled blood pressure or resistant hypertension \[BP ≥ 160/100 among those with hypertension, requiring 3 or more meds\], severe chronic obstructive pulmonary disease, cancer, or active psychiatric disease * Other sleep disorders (e.g., circadian rhythm disorder, working night or rotation shift, short sleep duration based on self-reported habitual sleep patterns \< 5 hrs/night) * Use of supplemental oxygen during wakefulness or sleep * Central sleep apnea (central apnea index ≥ 5/h) or Cheyne-Stokes respiration (\> 10 minutes of continues period breathing) on the screening home sleep test Resting awake SpO2 \< 90% * Chronic opiate use. * Use of illicit drug / marijuana use more than once per week * Difficulty understanding or speaking English * Anything that, in the opinion of the site investigator, would place the participant at increased risk or preclude a participant's ability to adhere to study protocols or complete the study