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Review
. 2024 Jun 8;5(1):zpae033.
doi: 10.1093/sleepadvances/zpae033. eCollection 2024.

Obesity hypoventilation syndrome, literature review

Bertha Nachelly Orozco González  1 , Nidia Rodriguez Plascencia  1 , Julio Augusto Palma Zapata  2 , Alondra Esthefanía Llamas Domínguez  2 , Jesús Sacramento Rodríguez González  3 , Juan Manuel Diaz  4 , Miguel Ponce Muñoz  3 , Silvia Denise Ponce-Campos  5
Affiliations
Review

Obesity hypoventilation syndrome, literature review

Bertha Nachelly Orozco González et al. Sleep Adv. .

Abstract

Obesity is a global health concern that has been increasing over the years, and it is associated with several pathophysiological changes affecting the respiratory system, including alveolar hypoventilation. Obesity hypoventilation syndrome (OHS) is one of the six subtypes of sleep-hypoventilation disorders. It is defined as the presence of obesity, chronic alveolar hypoventilation leading to daytime hypercapnia and hypoxia, and sleep-disordered breathing. The existence of a sleep disorder is one of the characteristics that patients with OHS present. Among them, 90% of patients have obstructive sleep apnea (OSA), and the remaining 10% of patients with OHS have non-obstructive sleep hypoventilation without OSA or with mild OSA. This review aims to provide a comprehensive understanding of the epidemiological and pathophysiological impact of OHS and to highlight its clinical features, prognosis, and severity, as well as the available treatment options.

Keywords: OSA; chronic fatigue; hypoxia; obesity; sleep disordered breathing; sleepiness.

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Figures

Figure 1.
Figure 1.
Diagnosis of obesity hypoventilation syndrome. The diagnosis is made by the combination of obesity, sleep-disordered breathing, and daytime hypercapnia in the absence of a neuromuscular, mechanical, or metabolic cause of hypoventilation (some of these conditions include chronic obstructive pulmonary disease, restrictive lung disease, kyphoscoliosis, hypothyroidism, neuromuscular diseases, and central hypoventilation). COPD, chronic obstructive pulmonary disease; OHS, obesity hypoventilation syndrome; OSA, obstructive sleep apnea; PaCO2, arterial carbon dioxide tension; PaO2, partial pressure of oxygen.
Figure 2.
Figure 2.
Main pathophysiological mechanisms of OHS. OHS is a medical condition caused by excess body fat, which changes the respiratory system, reducing lung volume and causing air trapping. Alterations in respiratory drive and leptin resistance are factors that contribute to the development of this condition. Patients with OHS experience obstructive apneas and hypopneas during supine sleep.
Figure 3.
Figure 3.
The mainstays of OHS treatment. The treatment approach involves correcting sleep disordered breathing, reducing weight, and managing comorbidities.
Figure 4.
Figure 4.
General management of OHS. Continuous positive airway pressure (CPAP) is the first-line treatment for OHS patients with severe obstructive sleep apnea (OSA). For OHS patients with no OSA or milder forms of OSA, noninvasive ventilation (NIV) should be considered the primary therapy. If patients initially treated with CPAP do not respond positively to therapy despite objectively documented high levels of adherence to CPAP, they should be switched to NIV therapy. AHI, apnea–hypopnea index.
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References

    1. Hales CM, Carroll MD, Fryar CD, Ogden CL.. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018 Key findings Data from the National Health and Nutrition Examination Survey. NCHS Data Brief. 2020;360:1–4. https://www.cdc.gov/nchs/products/index.htm - PubMed
    1. Campos-Nonato I, Galván-Valencia O, Hernández-Barrera L, Oviedo-Solís C, Barquera S.. Prevalence of obesity and associated risk factors in Mexican adults: results of the Ensanut 2022. Salud Publica Mex. 2023;65:238–247. doi: 10.21149/14809 - DOI - PubMed
    1. Böing S, Randerath WJ.. Chronic hypoventilation syndromes and sleep-related hypoventilation. J Thorac Dis. 2015;7(8):1273–1285. doi: 10.3978/j.issn.2072-1439.2015.06.10 - DOI - PMC - PubMed
    1. Ito E, Inoue Y; [The International Classification of Sleep Disorders, third edition. American Academy of Sleep Medicine. Includes bibliographies and index]. Nihon Rinsho. 2015;73(6):916–923. http://europepmc.org/abstract/MED/26065120 - PubMed
    1. Dickens C. The Posthumous Papers of the Pickwick Club, by Charles Dickens. With Eight Illustrations. London, Chapman and Hall... 1869. (Chapman and Hall, ed.). London; 1869.

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