What Is Sleep-Related Hypoventilation?

Table of ContentsView AllTable of ContentsWhat Is It?Types and Their CausesSymptomsDiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

What Is It?

Types and Their Causes

Symptoms

Diagnosis

Treatment

Sleep-relatedhypoventilationis breathing that is not sufficient during sleep. Breathing is either too shallow or too slow. Sleep-related hypoventilation is a category of disorders that have different underlying causes.

Overall, these disorders lead to an increase ofcarbon dioxidein the blood. This can potentially cause symptoms that include poor sleep quality, excessive daytime sleepiness, and morning headaches.However, some patients with these disorders do not have any symptoms. Learn more about this group of disorders in this article.

What Is Sleep-Related Hypoventilation?

Sleep-related hypoventilation is one of four categories of sleep-related breathing disorders. The others areobstructive sleep apneas, central sleep apnea syndromes, and sleep-related hypoxemia disorder.

Sleep-Related Hypoventilation DisordersThe six sleep-related hypoventilation disorders include:Obesity hypoventilation syndrome (OHS)Congenital central alveolar hypoventilation syndrome (CCHS)Late-onset central hypoventilation with hypothalamic dysfunctionIdiopathic central alveolar hypoventilationSleep-related hypoventilation due to a medication or substanceSleep-related hypoventilation due to a medical disorder

Sleep-Related Hypoventilation Disorders

The six sleep-related hypoventilation disorders include:Obesity hypoventilation syndrome (OHS)Congenital central alveolar hypoventilation syndrome (CCHS)Late-onset central hypoventilation with hypothalamic dysfunctionIdiopathic central alveolar hypoventilationSleep-related hypoventilation due to a medication or substanceSleep-related hypoventilation due to a medical disorder

The six sleep-related hypoventilation disorders include:

Types of Sleep Disorders: Know the Symptoms

The six subtypes of sleep-related hypoventilation all have different mechanisms causing hypoventilation, or insufficient breathing. Most sleep-related hypoventilation cases are made up of either obesity hypoventilation syndrome or sleep-related hypoventilation due to a medication or medical condition. The other types are rarer.

Obesity Hypoventilation Syndrome (OHS)

OHS is present in some peoplewith obesity, and it causes poor breathing leading to an increase in carbon dioxide in the blood. The specific cause of OHS is unknown, but experts believe it is due to both a defect in the brain and its control on breathing and excess weight on the chest that makes it difficult for the muscles to allow for proper breaths.

Treatment of Obesity Hypoventilation Syndrome

Sleep-Related Hypoventilation Due to a Medication or Substance

How Alcohol Affects Sleep Apnea

Sleep-Related Hypoventilation Due to a Medical Disorder

This is diagnosed when patients have diseases of the lung tissue, airways, pulmonary blood vessels, or neurological or musculoskeletal disorders.

Congenital Central Alveolar Hypoventilation Syndrome (CCHS)

CCHS often is first detected in adulthood, occasionally being discovered after general anesthesia causes respiratory failure or severe respiratory illness, or after taking medications that cause a decrease in respiration.

Late-Onset Central Hypoventilation with Hypothalamic Dysfunction

This disorder is related to the central control of breathing, which takes place within the central nervous system (which consists of the brain and spinal cord). This disorder causes hypoventilation during sleep. When patients have this disorder, they must have two of the following:

Idiopathic Central Alveolar Hypoventilation

Idiopathic central alveolar hypoventilation is diagnosed when other diseases, including other sleep-related hypoventilation disorders, are ruled out. The term idiopathic typically refers to an unknown cause. As such, there are still many questions related to this disorder that do not have answers.

While there are different causes of sleep-related hypoventilation, the buildup of carbon dioxide, calledhypercapnia, can cause several symptoms including:

Other consequences of chronic hypercapnia and hypoxemia (low oxygen blood levels) include pulmonary hypertension (high blood pressure affecting the lungs and heart) and heart enlargement and dysfunction. A physical exam might show excess fluid and laboratory tests may reveal elevated bicarbonate and polycythemia, which is increased red blood cells.

Why Is Too Many Red Blood Cells a Problem?

What Does a Sleep Study Measure?Polysomnography is a sleep study that records certain bodily functions and movements as you sleep or try to sleep. It records:Airflow in and out of your lungs as you breatheEffort and rate of breathingLevel of oxygen in your bloodBody positionBrain waves, as shown on an electroencephalogram (EEG)Muscle activityEye movementsHeart rate

What Does a Sleep Study Measure?

Polysomnography is a sleep study that records certain bodily functions and movements as you sleep or try to sleep. It records:Airflow in and out of your lungs as you breatheEffort and rate of breathingLevel of oxygen in your bloodBody positionBrain waves, as shown on an electroencephalogram (EEG)Muscle activityEye movementsHeart rate

Polysomnography is a sleep study that records certain bodily functions and movements as you sleep or try to sleep. It records:

Carbon dioxide levels are measured through either a blood sample from an artery in the wrist or continuous monitoring of carbon dioxide levels exhaled while breathing.

7 Diagnostic Tests for Sleep Disorders

Treatment for sleep-related hypoventilation typically involves positive airway pressure (PAP) therapy using continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV). They both provide oxygen through a mask worn when a person is asleep.

Verywell / Joules Garcia

With CPAP, the air is at a constant pressure both when breathing in and breathing out. The commonly used form of NIV isBiPAP, which is bi-level PAP. This provides higher pressure when breathing in and lower pressure when breathing out.

Treatment will be determined on the underlying cause of the sleep-related hypoventilation, as well as the levels of carbon dioxide present in the blood.

A Word From Verywell

Sleep is essential for everybody. It affects your ability to function and live your life. However, sometimes you may notice difficulty sleeping or still feeling tired during the day. Many of the sleep-related disorders are treatable, and if you have concerns about your sleep quality, share them with your doctor.

Sleep-related hypoventilation can lead to complications, so it is important for your doctor to determine if you have this condition. A doctor will be able to perform an assessment and determine a diagnosis and treatment plan for you if necessary.

7 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.Böing S, Randerath WJ.Chronic hypoventilation syndromes and sleep-related hypoventilation.Journal of Thoracic Disease. 2015;7(8). doi:10.3978/j.issn.2072-1439.2015.06.10Sateia MJ.International classification of sleep disorders-third edition.Chest. 2014;146(5):1387-1394. doi:10.1378/chest.14-0970Foldvary-Schaefer NR, Waters TE.Sleep-disordered breathing.Continuum: Lifelong Learning in Neurology. 2017;23(4):1093-1116. doi:10.1212/01.CON.0000522245.13784.f6MedlinePlus.Obesity hypoventilation syndrome (OHS).Simonds AK, De Becker W, European Respiratory Society. ERS Handbook: Respiratory Sleep Medicine. European Respiratory Society; 2012.Mayer G, Arzt M, Braumann B, et al.German s3 guideline nonrestorative sleep/sleep disorders, chapter “sleep-related breathing disorders in adults,” short version: german sleep society.Somnologie. 2017;21(4):290-301. doi:10.1007/s11818-017-0136-2MedlinePlus.Polysomnography.

7 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.Böing S, Randerath WJ.Chronic hypoventilation syndromes and sleep-related hypoventilation.Journal of Thoracic Disease. 2015;7(8). doi:10.3978/j.issn.2072-1439.2015.06.10Sateia MJ.International classification of sleep disorders-third edition.Chest. 2014;146(5):1387-1394. doi:10.1378/chest.14-0970Foldvary-Schaefer NR, Waters TE.Sleep-disordered breathing.Continuum: Lifelong Learning in Neurology. 2017;23(4):1093-1116. doi:10.1212/01.CON.0000522245.13784.f6MedlinePlus.Obesity hypoventilation syndrome (OHS).Simonds AK, De Becker W, European Respiratory Society. ERS Handbook: Respiratory Sleep Medicine. European Respiratory Society; 2012.Mayer G, Arzt M, Braumann B, et al.German s3 guideline nonrestorative sleep/sleep disorders, chapter “sleep-related breathing disorders in adults,” short version: german sleep society.Somnologie. 2017;21(4):290-301. doi:10.1007/s11818-017-0136-2MedlinePlus.Polysomnography.

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.

Böing S, Randerath WJ.Chronic hypoventilation syndromes and sleep-related hypoventilation.Journal of Thoracic Disease. 2015;7(8). doi:10.3978/j.issn.2072-1439.2015.06.10Sateia MJ.International classification of sleep disorders-third edition.Chest. 2014;146(5):1387-1394. doi:10.1378/chest.14-0970Foldvary-Schaefer NR, Waters TE.Sleep-disordered breathing.Continuum: Lifelong Learning in Neurology. 2017;23(4):1093-1116. doi:10.1212/01.CON.0000522245.13784.f6MedlinePlus.Obesity hypoventilation syndrome (OHS).Simonds AK, De Becker W, European Respiratory Society. ERS Handbook: Respiratory Sleep Medicine. European Respiratory Society; 2012.Mayer G, Arzt M, Braumann B, et al.German s3 guideline nonrestorative sleep/sleep disorders, chapter “sleep-related breathing disorders in adults,” short version: german sleep society.Somnologie. 2017;21(4):290-301. doi:10.1007/s11818-017-0136-2MedlinePlus.Polysomnography.

Böing S, Randerath WJ.Chronic hypoventilation syndromes and sleep-related hypoventilation.Journal of Thoracic Disease. 2015;7(8). doi:10.3978/j.issn.2072-1439.2015.06.10

Sateia MJ.International classification of sleep disorders-third edition.Chest. 2014;146(5):1387-1394. doi:10.1378/chest.14-0970

Foldvary-Schaefer NR, Waters TE.Sleep-disordered breathing.Continuum: Lifelong Learning in Neurology. 2017;23(4):1093-1116. doi:10.1212/01.CON.0000522245.13784.f6

MedlinePlus.Obesity hypoventilation syndrome (OHS).

Simonds AK, De Becker W, European Respiratory Society. ERS Handbook: Respiratory Sleep Medicine. European Respiratory Society; 2012.

Mayer G, Arzt M, Braumann B, et al.German s3 guideline nonrestorative sleep/sleep disorders, chapter “sleep-related breathing disorders in adults,” short version: german sleep society.Somnologie. 2017;21(4):290-301. doi:10.1007/s11818-017-0136-2

MedlinePlus.Polysomnography.

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