Table 1.

The inclusion and exclusion criteria.

INCLUSION CRITERIA:

1. Diagnosis of COPD and OSA Overlap Syndrome (OS) (i.e., post-bronchodilator FEV1/FVC <70 and a polysomnogram or home-based study showing an Apnea Hypopnea Index >5

2. EDS-OS phenotype (ESS >10)

3. Treatment with Continuous Positive Airway Pressure (CPAP).

EXCLUSION CRITERIA

1. Montreal Cognitive Assessment (MoCA) <20.

2. Coronary artery disease, as defined by any of the following: history of coronary artery bypass grafting, prior positive stress test for ischemia, infarction, or angina

3. Orthopedic problems as defined by joint pain limiting ambulation

4. Fall risk, defined as >2 falls in the prior month

5. Hospitalization in prior month

6. Daytime home oxygen

7. Participation in structured exercise, defined as >1 h of moderate intensity activity and any high intensity activity performed over prior 7 days. Four questions adapted from the PASE questionnaire will be used to assess participation in moderate and high intensity exercise, over the previous week.

EDS-OS: Overlap Syndrome with Excessive Daytime Sleepiness phenotype; ESS: Epworth Sleepiness Scale; PASE: Physical Activity Scale for the Elderly.