Obesity hypoventilation syndrome is defined as alveolarhypoventilationwhile awake in a person withobesitywhere there is no other cause of the hypoventilation (such as a sedating drug). Ninety percent of people with obesity hypoventilation syndrome (OHS) also have an associated obstructive sleep apnea.
For those with obesity hypoventilation syndrome, it is critically important to seek treatment. As the condition may have serious and even fatal consequences, early and aggressive intervention may prove necessary. Learn about some of the possible treatment options for obesity hypoventilation syndrome and the goals of these treatments.
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Treatment Options
The treatment options for obesity hypoventilation syndrome (OHS) can be divided into tackling the two most important features of the disorder: weight loss and breathing support.
Weight Loss
As the name implies, obesity is a key contributor to the disorder. If substantial weight loss can be achieved, relief is obtained. This may be achieved through diet and exercise, but more than 100 pounds of weight loss may be necessary. As rapid weight loss could be dangerous, it is recommended that people do this under the supervision of their healthcare provider. Nutritionists may provide helpful guidance in making behavioral changes. Unfortunately, it is not possible to predict the exact amount of weight that must be lost for an individual to cure OHS.
Weight loss medications with close healthcare provider supervision might be considered in individuals who have been unable to lose weight with diet and lifestyle modifications.
Bariatric surgery may be considered for people with abody mass index(BMI) of 35 or more. It is helpful to have a sleep study called apolysomnogrambefore and after the surgery to monitor the benefits of the procedure. As the weight loss occurs over a period of months, it may be necessary to support breathing during this time with other treatments. If a patient has developed pulmonary hypertension as a consequence of the OHS, surgery may be considered too risky.
Obesity Hypoventilation Syndrome (OHS): What to Know
Breathing Support
The mainstay of treatment in OHS is to provide breathing support, often through the use ofcontinuous positive airway pressure (CPAP)orbilevel. These devices generate a pressurized flow of air that can keep the upper airway from collapsing during sleep.
It is also necessary to avoidalcoholand certain drugs that suppress your ability to breathe. Possible culprits includeprescription medications, such asbenzodiazepines, opiates, and barbiturates. You should review your medications with your healthcare provider to ensure that none of them put you at increased risk.
Goals of Treatment
Ultimately, the purpose of any treatment in obesity hypoventilation syndrome is to correct the underlying problems that contribute to the disease. The dysfunctional breathing that characterizes the disease leads to an imbalance in the chemical levels of the blood. Whencarbon dioxidecannot be properly removed, its levels increase and make the blood more acidic. This triggers a number of changes in the body that can have negative consequences.
Treatment can prevent drops in the oxygen saturation of your blood, elevation in the red blood cell count called erythrocytosis, pulmonary hypertension, and heart failure (known ascor pulmonale). Weight loss normalizes oxygen and carbon dioxide levels. The use of CPAP or bilevel, as well as other measures, helps decrease the degree of these complications.
Ultimately, sleep becomes less fragmented and this improves excessive daytime sleepiness. This results in an improved quality of life, which is the goal of any successful medical treatment.
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.Chouri-Pontarollo, Net al. “Impaired objective daytime vigilance in obesity-hypoventilation syndrome: impact of noninvasive ventilation.“Chest2007;131:148.Conway, Wet al. “Adverse effects of tracheostomy for sleep apnea.“JAMA1981;246:347.Perez de Llano, LAet al. “Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome.“Chest2005;128:587.Scrima, Let al. “Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action.“Sleep1982;5:318.Sugerman, Het al. “Long-term effects of gastric surgery for treating respiratory insufficiency of obesity.“Am J Clin Nutr1992;55:597S.
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.Chouri-Pontarollo, Net al. “Impaired objective daytime vigilance in obesity-hypoventilation syndrome: impact of noninvasive ventilation.“Chest2007;131:148.Conway, Wet al. “Adverse effects of tracheostomy for sleep apnea.“JAMA1981;246:347.Perez de Llano, LAet al. “Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome.“Chest2005;128:587.Scrima, Let al. “Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action.“Sleep1982;5:318.Sugerman, Het al. “Long-term effects of gastric surgery for treating respiratory insufficiency of obesity.“Am J Clin Nutr1992;55:597S.
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.
Chouri-Pontarollo, Net al. “Impaired objective daytime vigilance in obesity-hypoventilation syndrome: impact of noninvasive ventilation.“Chest2007;131:148.Conway, Wet al. “Adverse effects of tracheostomy for sleep apnea.“JAMA1981;246:347.Perez de Llano, LAet al. “Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome.“Chest2005;128:587.Scrima, Let al. “Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action.“Sleep1982;5:318.Sugerman, Het al. “Long-term effects of gastric surgery for treating respiratory insufficiency of obesity.“Am J Clin Nutr1992;55:597S.
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