Condition in which severely overweight people fail to breathe rapidly or deeply enough
Medical condition
Obesity hypoventilation syndrome
Other names
Pickwickian syndrome
Obesity hypoventilation syndrome often improves with positive airway pressure treatment administered overnight by a machine such as this device.
Specialty
Respirology
Risk factors
Obesity
Obesity hypoventilation syndrome (OHS) is a condition in which severely overweight people fail to breathe rapidly or deeply enough, resulting in low oxygen levels and high blood carbon dioxide (CO2) levels. The syndrome is often associated with obstructive sleep apnea (OSA), which causes periods of absent or reduced breathing in sleep, resulting in many partial awakenings during the night and sleepiness during the day.[1] The disease puts strain on the heart, which may lead to heart failure and leg swelling.
Obesity hypoventilation syndrome is defined as the combination of obesity and an increased blood carbon dioxide level during the day that is not attributable to another cause of excessively slow or shallow breathing.[2]
The most effective treatment is weight loss, but this may require bariatric surgery to achieve.[3] Weight loss of 25 to 30% is usually required to resolve the disorder.[3] The other first-line treatment is non-invasive positive airway pressure (PAP), usually in the form of continuous positive airway pressure (CPAP) at night.[4][5] The disease was known initially in the 1950s, as "Pickwickian syndrome" in reference to a Dickensian character.[5]
^American Academy of Sleep Medicine. International Classification
of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
^ abMokhlesi, B; Masa, JF; Brozek, JL; Gurubhagavatula, I; Murphy, PB; Piper, AJ; Tulaimat, A; Afshar, M; Balachandran, JS; Dweik, RA; Grunstein, RR; Hart, N; Kaw, R; Lorenzi-Filho, G; Pamidi, S; Patel, BK; Patil, SP; Pépin, JL; Soghier, I; Tamae Kakazu, M; Teodorescu, M (1 August 2019). "Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline". American Journal of Respiratory and Critical Care Medicine. 200 (3): e6–e24. doi:10.1164/rccm.201905-1071ST. PMC 6680300. PMID 31368798.
^Olson AL, Zwillich C (2005). "The obesity hypoventilation syndrome". Am. J. Med. 118 (9): 948–56. doi:10.1016/j.amjmed.2005.03.042. PMID 16164877. S2CID 37801868.
^ abMokhlesi B, Tulaimat A (October 2007). "Recent advances in obesity hypoventilation syndrome". Chest. 132 (4): 1322–36. doi:10.1378/chest.07-0027. PMID 17934118. Archived from the original on 2008-12-08. Retrieved 2008-11-22.
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