This study will look at the effects of the drug Symbicort on sleep quality. Symbicort is an inhaled medication that contains 2 drugs. One is a medication that opens up the airways (formoterol). The other is a steroid to decrease airway inflammation (budesonide). Symbicort is not an experimental medication. It is approved by the Food and Drug Administration for use in patients with emphysema. Patients with severe emphysema commonly sleep poorly. The cause of poor sleep in these patients is unknown. Symbicort may improve sleep quality by opening the airways and reducing lung inflammation. It is not known for sure if these effects actually improve sleep and quality of life. It is hoped that this study will answer this question.

Inclusion Criteria:

• Moderate to severe emphysema (GOLD stages 2 and 3)

Exclusion Criteria:

• Use of supplemental oxygen,
• A recent COPD exacerbation within the past 4 weeks.
• A previous diagnosis of obstructive sleep apnea
• A known urinary outflow obstruction,
• Glaucoma
• History of an allergic reaction to one of the study medications.