 SAMPLE SIZE: This is an exploratory physiological study with the primary outcome being an improvement in morning pre-dose trough inspiratory capacity IC by 200 ml. A sample size of 20 will provide at least 80 to detect this treatment difference based on a standard deviation SD of approximately 0.2 L for a response difference in trough IC vanNoord, 2006, a two-tailed test and a p0.05. The investigators anticipate that all patients will not consent to instrumentation; however, the investigators are hoping for n12 with respiratory mechanical measurements. Due to the complexity of the study and its measurements, an interim analysis will be conducted after 10 subjects have been completed. 