Effect of CPAP on Abnormal Gastroesophageal Reflux and Lung Inflammation in IPF

Inclusion Criteria:

• confirmed diagnosis of IPF based on the 2018 IPF guidelines

• high likelihood of OSA based on the STOP-BANG measure, with a score of 3 or greater

• patients on nintedanib, or in whom nintedanib will be initiated prior to enrollmentin the study

• able to participated in 24hr pH monitoring

• able to comply with CPAP treatment

• able to provide written informed consent prior to any study procedures

• willing to complete all study measurements and assessments in compliance with theprotocol

Exclusion Criteria:

• interstitial lung disease caused by conditions other than IPF

• severe concomitant illness limiting life expectancy (< 1 year)

• residual lung volume > or equal to 120% of predicted

• obstructive lung disease: FEV1/FVC ratio < 0.70

• current drug or alcohol dependence

• patients who are unable to tolerate nintedanib

• patients who are unable to use CPAP or are unwilling to participate in the 24 hr pHprobe placement

• patients who were diagnosed with recent IPF exacerbation within 4 weeks ofenrollment (may be rescheduled for enrollment once recovered)

• patients who have had prior nasal surgery or trauma that would make pH probeplacement difficult

• patients on anticoagulation (aspirin is not an exclusion)