Sleep Ventilation for Patients With Advanced Hypercapnic COPD

Exclusion Criteria

• •Subjects will be excluded from participation in the study for a history of:
• •Significant sleep disordered breathing (AHI 4% ≥ 15 events/hour) or high clinical suspicion (BMI ≥ 35)
• •Neuromuscular disease or other causes of hypoventilation
• •Abnormalities of the thorax or lungs other than COPD
• •Already treated with home NIPPV
• •Unable to wean from ventilator during admission
• •Unable to wean from NIPPV, pH \< 7.30
• •Recent tracheotomy decannulation
• •History of severe depression or bipolar disorder requiring prior hospitalization or suicide attempts or ideation
• •Cognitive impairment (such as advanced dementia) that would limit ability to provide consent or to use NIPPV
• •Active recreational drug use
• •Unstable housing that would limit ability to use NIPPV
• •Severe heart failure (New York Heart Association stage IV)
• •Active/unstable CAD