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Alternative names Return to top
Pickwickian syndromeDefinition Return to top
Obesity hypoventilation syndrome (OHS) is a condition related to (but can occur separately from) obstructive sleep apnea. In OHS, a very obese person does not breathe a sufficient amount of oxygen during sleep or while awake.
Causes, incidence, and risk factors Return to top
The cause of OHS in unknown, but it likely involves a combination of a disorder in the brain's control over breathing and the effects of obesity on the chest wall. With the excess weight of massive obesity, the muscles of the chest wall can have difficulty expanding the chest enough to exchange air efficiently.
This results in a decreased ability to oxygenate the blood, and the retention of carbon dioxide (see respiratory acidosis). Affected individuals suffer from chronic fatigue due to sleep loss, poor sleep quality, and chronic hypoxia (decreased blood oxygen).
Morbid (massive or excessive) obesity is the main risk factor.
Symptoms Return to top
The main symptoms of OHS are due to sleep deprivation, which results from sleep loss and poor sleep quality (see obstructive sleep apnea).
In addition, symptoms of chronic hypoxia (low blood oxygen level) can also occur, such as shortness of breath or fatigue after minimal physical effort.
Signs and tests Return to top
Persons with OHS are usually very overweight. Physical signs that suggest OHS include:
Tests done to confirm the diagnosis include:
Treatment Return to top
The treatment involves mechanical ventilation to help the person breath. Options include:
Other therapies are aimed at weight loss, which may lead to reversal of the OHS.
Support Groups Return to top
Support groups may help patients with OHS, or their family members, adjust to the lifestyle changes that are required for successful treatment. In addition, support groups may provide information about new treatments that are developed.Expectations (prognosis) Return to top
When treated, OHS has a good prognosis. Untreated, it can lead to serious cardiovascular complications, severe disability or death.Complications Return to top
Complications of OHS include complications of excessive sleepiness, such as:
OHS may also include cardiovascular complications, such as
Calling your health care provider Return to top
Call your health care provider if you experience excessive daytime sleepiness, or any other symptoms that suggest OHS.Prevention Return to top
Avoid obesity. Update Date: 10/22/2003 Updated by: Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |