Table of ContentsView AllTable of ContentsBreathingSymptomsRisks and ComplicationsTreatmentReversing OHS
Table of ContentsView All
View All
Table of Contents
Breathing
Symptoms
Risks and Complications
Treatment
Reversing OHS
If you or a loved one has a high body mass index (BMI) and trouble breathing during the day and at night, you might have obesity hypoventilation syndrome (OHS). Obesity hypoventilation syndrome, also known as Pickwickian syndrome, can lead to heavy breathing, shortness of breath, low oxygen levels, and too much carbon dioxide in the blood.
Hypoventilation means “slow, shallow breathing.” OHS is different from sleep apnea because it also happens during the day, although about 90% of people with OHS also have sleep apnea.Treatment is important since OHS can be deadly if it’s not addressed. Weight loss is part of a treatment plan but is not the only way to treat OHS.
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A Note on BMIVerywell acknowledges that body mass index is an outdated and problematic measurement. However, because it is used in scientific literature, including in the definition of OHS, the article will reference BMI throughout to reflect information in the sources.
A Note on BMI
Verywell acknowledges that body mass index is an outdated and problematic measurement. However, because it is used in scientific literature, including in the definition of OHS, the article will reference BMI throughout to reflect information in the sources.
Obesity Hypoventilation Syndrome and Breathing: What Is the Link?
Healthcare providers don’t know why people with a high body weight develop OHS. The condition is tied to the brain’s ability to control breathing. Leptin, a hormone that impacts body weight, also impacts breathing, so it’s thought that people with OHS have a resistance to leptin. In addition, having more weight on the body can make it difficult for the lungs to expand.
Hypoventilation
Differences Between OHS and Sleep Apnea
Sleep apneais another breathing condition that is closely associated with obesity. It causes people to stop breathing while sleeping because their airway becomes blocked temporarily or because the brain is not prompting the body to breathe. This leads to low oxygen levels and other symptoms.
OHS is different from sleep apnea because it can occur both when a person is awakeorasleep. People with OHS don’t stop breathing, but they breathe too shallowly and too slowly to get enough oxygen. This also leads to low oxygen levels, andhigh carbon dioxide levels.
About 90% of people with OHS have sleep apnea. It’s most common for them to haveobstructive sleep apnea, the type in which the airway becomes blocked.
Could I Have OHS Symptoms?
The main symptoms of OHS are shortness of breath. People with this condition also experience fatigue because they do not get quality sleep. The symptoms of OHS include:
Getting an OHS Diagnosis
If you’re experiencing any symptoms of OHS, you should see your healthcare provider immediately. The condition can be deadly if it’s not treated.
A healthcare provider will conduct tests and a physical exam to diagnose you with OHS. The main test is a blood draw that measures the amount of oxygen and carbon dioxide in your blood.In addition, your healthcare provider may order a:
OHS Risks and Complications
OHS is a very serious condition. Without treatment, it can lead to:
It can even be fatal, so getting timely treatment is essential.
Treatment to Manage OHS
Treatments for OHS focus on getting enough oxygen into your blood system and helping you breathe easier. Your healthcare provider will discuss the treatments that are right for you. Treatment options include:
In extreme cases, healthcare providers might recommend atracheostomy, a surgical procedure to help a person breathe through a neck hole.
Treatment to Reverse OHS
Weight loss is often recommended as atreatment for OHS. For people with a very high body weight—those most likely to have OHS—weight loss is often an important part of overall health. However, studies note that the scientific evidence for weight loss to reverse OHS is weak. Unfortunately, it’s difficult to reverse OHS.
One scientific review found that people who lost 6% to 7% of their body weight didn’t see an improvement in their OHS symptoms compared to other patients who got treatment but didn’t lose weight.
However, people who lost a substantial amount of weight throughbariatric surgerydid see an improvement in OHS symptoms. Research shows that to see a big improvement in symptoms, people need to lose 25% to 30% of their body weight.If you have OHS, weight loss will likely be part of your treatment and health plan, even if it doesn’t lead to a reversal of your symptoms.
Ask your healthcare provider if any weight loss interventions are right for you.
Summary
Obesity hypoventilation syndrome (OHS) is a condition that makes it difficult to breathe in people who are overweight. Healthcare providers don’t know exactly what causes it, but believe it is tied to leptin, a hormone that regulates weight and breathing, and to the physical pressure of having extra weight on your chest. It’s very, very important to get treatment for OHS.
Without treatment, the condition can lead to heart failure and death. Treatments include oxygen and breathing supports, like a CPAP or BiPAP machine. Weight loss is usually recommended, too, although you need a significant weight loss to reverse OHS.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thoracic Society.Obesity hypoventilation syndrome.Shetty S, Parthasarathy S.Obesity hypoventilation syndrome. Curr Pulmonol Rep. 2015 Mar 1;4(1):42-55. doi: 10.1007/s13665-015-0108-6.MedlinePlus.Obesity hypoventilation syndrome (OHS).Kakazu MT, Soghier I, Afshar M, et al.Weight loss interventions as treatment of obesity hypoventilation syndrome. A systematic review. Annals ATS. 2020. doi: 10.1513/AnnalsATS.201907-554OC
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thoracic Society.Obesity hypoventilation syndrome.Shetty S, Parthasarathy S.Obesity hypoventilation syndrome. Curr Pulmonol Rep. 2015 Mar 1;4(1):42-55. doi: 10.1007/s13665-015-0108-6.MedlinePlus.Obesity hypoventilation syndrome (OHS).Kakazu MT, Soghier I, Afshar M, et al.Weight loss interventions as treatment of obesity hypoventilation syndrome. A systematic review. Annals ATS. 2020. doi: 10.1513/AnnalsATS.201907-554OC
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Thoracic Society.Obesity hypoventilation syndrome.Shetty S, Parthasarathy S.Obesity hypoventilation syndrome. Curr Pulmonol Rep. 2015 Mar 1;4(1):42-55. doi: 10.1007/s13665-015-0108-6.MedlinePlus.Obesity hypoventilation syndrome (OHS).Kakazu MT, Soghier I, Afshar M, et al.Weight loss interventions as treatment of obesity hypoventilation syndrome. A systematic review. Annals ATS. 2020. doi: 10.1513/AnnalsATS.201907-554OC
American Thoracic Society.Obesity hypoventilation syndrome.
Shetty S, Parthasarathy S.Obesity hypoventilation syndrome. Curr Pulmonol Rep. 2015 Mar 1;4(1):42-55. doi: 10.1007/s13665-015-0108-6.
MedlinePlus.Obesity hypoventilation syndrome (OHS).
Kakazu MT, Soghier I, Afshar M, et al.Weight loss interventions as treatment of obesity hypoventilation syndrome. A systematic review. Annals ATS. 2020. doi: 10.1513/AnnalsATS.201907-554OC
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