Our study demonstrated that short-term NIV dramatically improves sleep and blood gases but does not alter inflammatory, metabolic, or cardiovascular markers. This suggests a need to address these comorbidities by offering combined treatment modalities. Programs aimed at reducing the detrimental consequences of obesity systematically target an increase in physical activity and a reduction in sedentary behaviors. In their recent work in patients with OHS, Murphy and colleagues2 reported objective improvement in physical activity after 3 months of nocturnal NIV. This elegant study, including patients both in a stable state and in post-acute respiratory failure, compared two ventilatory modes with a randomized control design. Therefore, all patients were exposed to NIV treatment. Thus, it is disputable whether weight loss and physical activity improvements were related to NIV per se or to lifestyle changes associated with inclusion in a clinical research protocol. Moreover, patients placed on NIV during post-acute respiratory failure were likely to have low physical activity at baseline, whereas a dramatic improvement in activity was expected after 3 months of recovery.