Obesity hypoventilation syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
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Obesity hypoventilation syndrome
Synonyms	Pickwickian syndrome
Pronounce
Specialty	Pulmonology
Symptoms	Daytime sleepiness, fatigue, headache, shortness of breath
Complications	Pulmonary hypertension, heart failure, cor pulmonale
Onset
Duration
Types
Causes	Obesity, sleep apnea
Risks
Diagnosis	Polysomnography, arterial blood gas
Differential diagnosis	Obstructive sleep apnea, chronic obstructive pulmonary disease
Prevention	Weight loss, lifestyle modification
Treatment	Positive airway pressure, weight loss surgery
Medication
Prognosis
Frequency
Deaths

Obesity Hypoventilation Syndrome (OHS), also known as Pickwickian syndrome, is a condition characterized by obesity, hypoventilation, and sleep apnea. It is a disorder in which poor breathing leads to increased blood carbon dioxide levels and decreased blood oxygen levels during sleep.

Pathophysiology

OHS is primarily caused by the combination of obesity and hypoventilation. The excess body weight places a burden on the respiratory system, leading to reduced lung volumes and impaired respiratory mechanics. This results in inadequate ventilation, particularly during sleep, when the body's drive to breathe is reduced.

Symptoms

Individuals with OHS often experience excessive daytime sleepiness, loud snoring, and episodes of apnea during sleep. Other symptoms may include morning headaches, fatigue, and depression.

Diagnosis

The diagnosis of OHS is based on the presence of obesity (body mass index > 30 kg/m_), hypoventilation (elevated arterial carbon dioxide levels), and sleep-disordered breathing. Polysomnography is often used to assess sleep apnea severity.

Treatment

The primary treatment for OHS is weight loss, which can improve respiratory function and reduce symptoms. Continuous Positive Airway Pressure (CPAP) therapy is commonly used to maintain airway patency during sleep. In some cases, bilevel positive airway pressure (BiPAP) may be more effective.

Prognosis

With appropriate treatment, individuals with OHS can experience significant improvement in symptoms and quality of life. However, untreated OHS can lead to serious complications, including pulmonary hypertension and heart failure.

See also

• Obesity
• Sleep apnea
• Respiratory failure
• Pulmonary hypertension