Please select the eligibility criteria that correspond to the clinical trial below.
Title: Non-invasive Positive Pressure Ventilation for the Treatment of Severe Stable Chronic Obstructive Pulmonary Disease
Brief Summary: Assessment of the effect and safety of noninvasive positive pressure ventilation for severe stable chronic obstructive pulmonary disease


Options:
A: Inclusion Criteria

* Newly diagnosed with OSA on overnight polysomnogram (PSG) with RDI between 5 and 30
* Score of greater than 11 on the Epworth Sleepiness Scale (ESS) on two administrations of the instrument (performed at prescreening and screening), each completed on a different day to avoid sporadic values and confirm the presence of excessive daytime sleepiness
* Stable medical history and no change in medications, including hypertension medications, in the 3 months prior to study entry
* Stable psychiatric history and no change in psychotropic medications in the 3 months prior to study entry
* Has access to a telephone

Exclusion Criteria

* Diagnosis of another sleep disorder in addition to OSA based on PSG, e.g., periodic limb movement disorder (greater than 10 limb movements per hour of sleep with arousal); central sleep apnea (greater than 5 or more central apneas); insomnia; sleep hypoventilation syndrome; or narcolepsy
* Previous treatment for sleep apnea with nasal CPAP, oral appliance, home oxygen therapy, uvulopalatopharyngoplasty, tracheotomy, or other surgery for OSA
* Oxygen or bi-level CPAP required for treatment of OSA
* Unable to return for study instructions or follow-up testing
* Medically unstable condition (e.g., heart attack, congestive heart failure, Cheyne-Stokes breathing, unstable angina, uncontrolled thyroid disease, unstable diabetes, depression or psychosis, ventricular arrhythmias, cirrhosis, or recently diagnosed cancer) in the 3 months prior to study entry
* Regular use (greater than 3 times per week) of sedative, hypnotic, or alerting medications (such as Modafinil) in the 3 months prior to study entry
* Chronic nasal congestion that would prevent the use of a nasal mask, in the 3 months prior to study entry
* History of automobile accidents due to excessive daytime sleepiness
* Employed in transportation-related safety sensitive occupation such as an airline pilot, truck driver, or train engineer
* Night shift worker regularly experiencing jet lag, or a history of irregular work schedules in the 6 months prior to study entry
* Regular use of alcohol as determined by answering yes to one or more of the questions on the CAGE questionnaire (i.e., alcohol dependent)
* Recent or recurring history of substance abuse leading to tolerance or dependence
* Pregnant; women must either be postmenopausal or confirmed not pregnant by a urine pregnancy test
* Unable to perform study tests, e.g., inability to communicate verbally; inability to write and read in English; less than a 5th grade reading level (evaluated using Flesch-Kincaid assessment); visual impairment; hearing impairment; cognitive impairment (e.g., previous head injury); or upper extremity motor deficit (e.g., previous stroke or spinal cord injury)
* Residing with an individual who is currently using CPAP treatment
B: Inclusion Criteria:

* Patient admitted with a NIV-requiring exacerbation of COPD
* COPD with a FEV1/FVC \<0.7 after bronchodilatation.
* ≥ 1 acute hypercapnic respiratory failure (AHRF \*).
* Optimal medical treatment of COPD, ie. inhaled steroids, long-acting β2-agonist Tiotropium, according to GOLD guidelines.
* Address in Capital Region
* Patients are able to give verbal consent and sign a written consent form and understand Danish-

Exclusion Criteria:

* Severely depressed level of consciousness / confusion / non-cooperative.
* Respiratory rate \<12/min
* Severe hypoxia, such as requiring more than 15L O2/min.
* Large amounts of sputum.
* Vomiting and high risk for aspiration.
* Inability to accept NIV.
* Recent abdominal, facial or upper airway surgery.
* Malignancy or life expectancy \<6 months because of disease other than COPD
* Known obstructive sleep apnea syndrome (OSA)
* Metabolic acidotic component - StHCO3- \< 20 mM
C: Inclusion Criteria:

* COPD (FEV1\< 50%, Tiffeneau \< 70%)
* Dyspnoea on exertion and a reduced exercise capacity
* Age 75 years or less
* PaCO2 \> 6.0 kPa at rest without oxygen

Exclusion Criteria:

* Cardial/neuromuscular diseases limiting a successful rehabilitation
* Obstructive sleep apnoea syndrome: apnea/hypopnea index (AHI) \> 10
* Previous exposure to chronic NIPPV
* Participation in a pulmonary rehabilitation program less than 18 months ago
D: Inclusion Criteria:

* clinically stable, hypercapnic GOLD stage IV COPD, aged 18 years or older, baseline arterial carbon dioxide pressure (PaCO2) of 6.7 kPa (50 mmHg) or higher and a pH higher than 7·35, measured after at least 1 h rest in a sitting position.

Exclusion Criteria:

* thorax or the lung other than COPD
* No smoking or Cigarette≤10/day
* obesity with a bodymass index (BMI) ≥40 kg/m²
* malignant co-morbidities,severe heart failure (New York Heart Association stage IV),unstable angina, and severe arrhythmias.

Answer: D