Obesity hypoventilation syndrome (OHS) causes poor breathing in some people with obesity. It leads to lower oxygen and higher carbon dioxide levels in the blood.
Pickwickian syndrome
The exact cause of OHS is not known. It is believed that OHS results from a defect in the brain's control over breathing. Excess weight against the chest wall also makes it harder for the muscles to draw in a deep breath and to breathe quickly enough. This worsens the brain's breathing control. As a result, the blood contains too much carbon dioxide and not enough oxygen.
The main symptoms of OHS are due to lack of sleep and include:
Symptoms of low blood oxygen level (chronic hypoxia) and high carbon dioxide can occur. Symptoms include shortness of breath or feeling tired after little effort.
Treatment involves breathing assistance using special machines (mechanical ventilation). Options include:
Treatment is started in the hospital or as an outpatient.
Other treatments are aimed at weight loss, which can reverse OHS, although it is often difficult to achieve.
Babak Mokhlesi is a Pulmonary Medicine specialist and an Intensive Care Medicine expert in Chicago, Illinois. Mokhlesi has been practicing medicine for over 29 years and is rated as an Elite expert by MediFind in the treatment of Obesity Hypoventilation Syndrome (OHS). He is also highly rated in 7 other conditions, according to our data. His top areas of expertise are Obstructive Sleep Apnea, Obesity Hypoventilation Syndrome (OHS), Excessive Daytime Sleepiness, and Drowsiness. He is licensed to treat patients in Illinois. Mokhlesi is currently accepting new patients.
Juan Masa practices in Caceres, Spain. Masa is rated as an Elite expert by MediFind in the treatment of Obesity Hypoventilation Syndrome (OHS). He is also highly rated in 5 other conditions, according to our data. His top areas of expertise are Obesity Hypoventilation Syndrome (OHS), Obstructive Sleep Apnea, Obesity, and Excessive Daytime Sleepiness.
Nicholas Hart practices in London, Greater London, United Kingdom. Hart is rated as an Elite expert by MediFind in the treatment of Obesity Hypoventilation Syndrome (OHS). He is also highly rated in 15 other conditions, according to our data. His top areas of expertise are Obesity Hypoventilation Syndrome (OHS), Chronic Obstructive Pulmonary Disease (COPD), Obstructive Sleep Apnea, Post Polio Syndrome, and Colostomy.
Untreated, OHS can lead to serious heart and blood vessel problems, severe disability, or death.
OHS complications related to a lack of sleep may include:
OHS can also cause heart problems, such as:
Contact your provider if you are very tired during the day or have any other symptoms that suggest OHS.
Maintain a healthy weight. Use your CPAP or BiPAP treatment as your provider prescribed.
Summary: Chronic hypercapnic respiratory failure (CHRF) in the context of Chronic Obstructive Pulmonary Disease (COPD) and Obesity Hypoventilation Syndrome (OHS) is associated with increased mortality. The availability and effectiveness of domiciliary Non-invasive ventilation (NIV) treatment (when indicated) is key as this treatment can improve quality of life and reduce health-care costs from associated b...
Summary: Continuous positive airway pressure and non-invasive ventilation are common treatment modalities for obstructive sleep apnea, central sleep apnea, and chronic alveolar hypoventilation from a variety of causes. Use of positive airway pressure (PAP) requires use of an interface, commonly referred to as a mask. There are a range of mask options available, differing in configuration and sizing, includ...
Published Date: August 01, 2021
Published By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 05/23/2022.
Malhotra A, Powell F. Disorders of ventilatory control. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 80.
Mokhlesi B, Tamisier R. Obesity-hypoventilation syndrome. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 138.
Mokhlesi B, Masa JF, Brozek JL, et al. Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019;200(3):e6-e24. PMID: 31368798 pubmed.ncbi.nlm.nih.gov/31368798/.