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Obesity hypoventilation syndrome (OHS)

Definition

Obesity hypoventilation syndrome (OHS) occurs when a very obese person does not breathe enough oxygen while sleeping.

Alternative Names

Pickwickian syndrome

Causes

The exact cause of OHS in unknown. Most (but not all) patients with the syndrome have a form of sleep apnea.

OHS is believed to result from both a defect in the brain's control over breathing and excessive weight (due to obesity) against the chest wall, which makes it hard for a person to take a deep breath. As a result, the blood has too much carbon dioxide and not enough oxygen. (See respiratory acidosis). Patients with OHS have chronic fatigue due to sleep loss, poor sleep quality, and chronic hypoxia.

Morbid (massive or excessive) obesity is the main risk factor.

Symptoms

The main symptoms of OHS are due to sleep deprivation, and include:

Excessive daytime sleepiness
Falling asleep at inappropriate times during the day
Increased risk for accidents or errors at work
Depression

Symptoms of chronic hypoxia (low blood oxygen level) can also occur, such as shortness of breath or fatigue after minimal physical effort.

Exams and Tests

Persons with OHS are usually extremely overweight. Physical signs that suggest OHS include:

Cyanosis (bluish coloration of the lips, fingers, toes, or skin)
Signs of right-side heart failure (cor pulmonale ) such as swollen legs or feet, shortness of breath, or feeling fatigued after little exertion.

Tests done to confirm the diagnosis include:

Sleep study
Pulmonary function
Arterial blood gas

The presence of high carbon dioxide (CO₂) levels in the blood when a person is awake helps distinguish OHS from obstructive sleep apnea.

Treatment

The treatment involves mechanical ventilation to help the person breath. Options include:

Non-invasive mechanical ventilation (BiPAP or other modes) through a mask that fits tightly over the nose or nose and mouth
Mechanical ventilation through a tracheostomy (an incision in the neck)

Other therapies are aimed at weight loss, which may lead to reversal of the OHS.

Support Groups

Support groups may help patients with OHS, or their family members, adjust to the lifestyle changes that are required for successful treatment. In addition, support groups may provide information about new treatments that are developed.

Outlook (Prognosis)

When treated, OHS has a good prognosis. Untreated, it can lead to serious heart and blood vessel complications, severe disability or death.

Possible Complications

Complications of OHS include complications of excessive sleepiness, such as:

Increased risk for accidents
Depression, agitation, irritability
Sexual dysfunction

OHS may also include cardiovascular complications, such as

Hypertension
Cor pulmonale (right heart failure)

When to Contact a Medical Professional

Call your health care provider if you experience excessive daytime sleepiness, or any other symptoms that suggest OHS.

Prevention

Maintain a healthy weight and avoid obesity.

Murray J, Nadel J. Textbook of Respiratory Medicine. 3^rd ed. Philadelphia, Pa: W.B. Saunders Company; 2000:2326-2328.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby, Inc; 2004:221-223.

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Typical mistypes for Obesity hypoventilation syndrome (OHS)
ibesity hypoventilation syndrome (ohs), kbesity hypoventilation syndrome (ohs), lbesity hypoventilation syndrome (ohs), pbesity hypoventilation syndrome (ohs), 0besity hypoventilation syndrome (ohs), 9besity hypoventilation syndrome (ohs), ovesity hypoventilation syndrome (ohs), onesity hypoventilation syndrome (ohs), ohesity hypoventilation syndrome (ohs), ogesity hypoventilation syndrome (ohs), obwsity hypoventilation syndrome (ohs), obssity hypoventilation syndrome (ohs), obdsity hypoventilation syndrome (ohs), obrsity hypoventilation syndrome (ohs), ob4sity hypoventilation syndrome (ohs), ob3sity hypoventilation syndrome (ohs), obeaity hypoventilation syndrome (ohs), obezity hypoventilation syndrome (ohs), obexity hypoventilation syndrome (ohs), obedity hypoventilation syndrome (ohs), obeeity hypoventilation syndrome (ohs), obewity hypoventilation syndrome (ohs), obesuty hypoventilation syndrome (ohs), obesjty hypoventilation syndrome (ohs), obeskty hypoventilation syndrome (ohs), obesoty hypoventilation syndrome (ohs), obes9ty hypoventilation syndrome (ohs), obes8ty hypoventilation syndrome (ohs), obesiry hypoventilation syndrome (ohs), obesify hypoventilation syndrome (ohs), obesigy hypoventilation syndrome (ohs), obesiyy hypoventilation syndrome (ohs), obesi6y hypoventilation syndrome (ohs), obesi5y hypoventilation syndrome (ohs), obesitt hypoventilation syndrome (ohs), obesitg hypoventilation syndrome (ohs), obesith hypoventilation syndrome (ohs), obesitu hypoventilation syndrome (ohs), obesit7 hypoventilation syndrome (ohs), obesit6 hypoventilation syndrome (ohs), obesity gypoventilation syndrome (ohs), obesity bypoventilation syndrome (ohs), obesity nypoventilation syndrome (ohs), obesity jypoventilation syndrome (ohs), obesity uypoventilation syndrome (ohs), obesity yypoventilation syndrome (ohs), obesity htpoventilation syndrome (ohs), obesity hgpoventilation syndrome (ohs), obesity hhpoventilation syndrome (ohs), obesity hupoventilation syndrome (ohs), obesity h7poventilation syndrome (ohs), obesity h6poventilation syndrome (ohs), obesity hyooventilation syndrome (ohs), obesity hyloventilation syndrome (ohs), obesity hy-oventilation syndrome (ohs), obesity hy0oventilation syndrome (ohs), obesity hypiventilation syndrome (ohs), obesity hypkventilation syndrome (ohs), obesity hyplventilation syndrome (ohs), obesity hyppventilation syndrome (ohs), obesity hyp0ventilation syndrome (ohs), obesity hyp9ventilation syndrome (ohs), obesity hypocentilation syndrome (ohs), obesity hypobentilation syndrome (ohs), obesity hypogentilation syndrome (ohs), obesity hypofentilation syndrome (ohs), obesity hypovwntilation syndrome (ohs), obesity hypovsntilation syndrome (ohs), obesity hypovdntilation syndrome (ohs), obesity hypovrntilation syndrome (ohs), obesity hypov4ntilation syndrome (ohs), obesity hypov3ntilation syndrome (ohs), obesity hypovebtilation syndrome (ohs), obesity hypovemtilation syndrome (ohs), obesity hypovejtilation syndrome (ohs), obesity hypovehtilation syndrome (ohs), obesity hypovenrilation syndrome (ohs), obesity hypovenfilation syndrome (ohs), obesity hypovengilation syndrome (ohs), obesity hypovenyilation syndrome (ohs), obesity hypoven6ilation syndrome (ohs), obesity hypoven5ilation syndrome (ohs), obesity hypoventulation syndrome (ohs), obesity hypoventjlation syndrome (ohs), obesity hypoventklation syndrome (ohs), obesity hypoventolation syndrome (ohs), obesity hypovent9lation syndrome (ohs), obesity hypovent8lation syndrome (ohs), obesity hypoventikation syndrome (ohs), obesity hypoventipation syndrome (ohs), obesity hypoventioation syndrome (ohs), obesity hypoventilztion syndrome (ohs), obesity hypoventilstion syndrome (ohs), obesity hypoventilwtion syndrome (ohs), obesity hypoventilqtion syndrome (ohs), obesity hypoventilarion syndrome (ohs), obesity hypoventilafion syndrome (ohs), obesity hypoventilagion syndrome (ohs), obesity hypoventilayion syndrome (ohs), obesity hypoventila6ion syndrome (ohs), 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obesity hypoventilation shndrome (ohs), obesity hypoventilation sundrome (ohs), obesity hypoventilation s7ndrome (ohs), obesity hypoventilation s6ndrome (ohs), obesity hypoventilation sybdrome (ohs), obesity hypoventilation symdrome (ohs), obesity hypoventilation syjdrome (ohs), obesity hypoventilation syhdrome (ohs), obesity hypoventilation synsrome (ohs), obesity hypoventilation synxrome (ohs), obesity hypoventilation syncrome (ohs), obesity hypoventilation synfrome (ohs), obesity hypoventilation synrrome (ohs), obesity hypoventilation synerome (ohs), obesity hypoventilation syndeome (ohs), obesity hypoventilation synddome (ohs), obesity hypoventilation syndfome (ohs), obesity hypoventilation syndtome (ohs), obesity hypoventilation synd5ome (ohs), obesity hypoventilation synd4ome (ohs), obesity hypoventilation syndrime (ohs), obesity hypoventilation syndrkme (ohs), obesity hypoventilation syndrlme (ohs), obesity hypoventilation syndrpme (ohs), obesity hypoventilation syndr0me (ohs), 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obesity hypoventilation syndrome (ohd), obesity hypoventilation syndrome (ohe), obesity hypoventilation syndrome (ohw), besity hypoventilation syndrome (ohs), oesity hypoventilation syndrome (ohs), obsity hypoventilation syndrome (ohs), obeity hypoventilation syndrome (ohs), obesty hypoventilation syndrome (ohs), obesiy hypoventilation syndrome (ohs), obesit hypoventilation syndrome (ohs), obesityhypoventilation syndrome (ohs), obesity ypoventilation syndrome (ohs), obesity hpoventilation syndrome (ohs), obesity hyoventilation syndrome (ohs), obesity hypventilation syndrome (ohs), obesity hypoentilation syndrome (ohs), obesity hypovntilation syndrome (ohs), obesity hypovetilation syndrome (ohs), obesity hypovenilation syndrome (ohs), obesity hypoventlation syndrome (ohs), obesity hypoventiation syndrome (ohs), obesity hypoventiltion syndrome (ohs), obesity hypoventilaion syndrome (ohs), obesity hypoventilaton syndrome (ohs), obesity hypoventilatin syndrome (ohs), obesity hypoventilatio syndrome (ohs), obesity hypoventilationsyndrome (ohs), obesity hypoventilation yndrome (ohs), obesity hypoventilation sndrome (ohs), obesity hypoventilation sydrome (ohs), obesity hypoventilation synrome (ohs), obesity hypoventilation syndome (ohs), obesity hypoventilation syndrme (ohs), obesity hypoventilation syndroe (ohs), obesity hypoventilation syndrom (ohs), obesity hypoventilation syndrome(ohs), obesity hypoventilation syndrome ohs), obesity hypoventilation syndrome (hs), obesity hypoventilation syndrome (os), obesity hypoventilation syndrome (oh), obesity hypoventilation syndrome (ohs, boesity hypoventilation syndrome (ohs), oebsity hypoventilation syndrome (ohs), obseity hypoventilation syndrome (ohs), obeisty hypoventilation syndrome (ohs), obestiy hypoventilation syndrome (ohs), obesiyt hypoventilation syndrome (ohs), obesit yhypoventilation syndrome (ohs), obesityh ypoventilation syndrome (ohs), obesity yhpoventilation syndrome (ohs), obesity hpyoventilation syndrome (ohs), obesity hyopventilation syndrome (ohs), obesity hypvoentilation syndrome (ohs), obesity hypoevntilation syndrome (ohs), obesity hypovnetilation syndrome (ohs), obesity hypovetnilation syndrome (ohs), obesity hypovenitlation syndrome (ohs), obesity hypoventliation syndrome (ohs), obesity hypoventialtion syndrome (ohs), obesity hypoventiltaion syndrome (ohs), obesity hypoventilaiton syndrome (ohs), obesity hypoventilatoin syndrome (ohs), obesity hypoventilatino syndrome (ohs), obesity hypoventilatio nsyndrome (ohs), obesity hypoventilations yndrome (ohs), obesity hypoventilation ysndrome (ohs), obesity hypoventilation snydrome (ohs), obesity hypoventilation sydnrome (ohs), obesity hypoventilation synrdome (ohs), obesity hypoventilation syndorme (ohs), obesity hypoventilation syndrmoe (ohs), obesity hypoventilation syndroem (ohs), obesity hypoventilation syndrom e(ohs), obesity hypoventilation syndrome( ohs), obesity hypoventilation syndrome o(hs), obesity hypoventilation syndrome (hos), obesity hypoventilation syndrome (osh), obesity hypoventilation syndrome (oh)s, oobesity hypoventilation syndrome (ohs), obbesity hypoventilation syndrome (ohs), obeesity hypoventilation syndrome (ohs), obessity hypoventilation syndrome (ohs), obesiity hypoventilation syndrome (ohs), obesitty hypoventilation syndrome (ohs), obesityy hypoventilation syndrome (ohs), obesity hypoventilation syndrome (ohs), obesity hhypoventilation syndrome (ohs), obesity hyypoventilation syndrome (ohs), obesity hyppoventilation syndrome (ohs), obesity hypooventilation syndrome (ohs), obesity hypovventilation syndrome (ohs), obesity hypoveentilation syndrome (ohs), obesity hypovenntilation syndrome (ohs), obesity hypoventtilation syndrome (ohs), obesity hypoventiilation syndrome (ohs), obesity hypoventillation syndrome (ohs), obesity hypoventilaation syndrome (ohs), obesity hypoventilattion syndrome (ohs), obesity hypoventilatiion syndrome (ohs), obesity hypoventilatioon syndrome (ohs), obesity hypoventilationn syndrome (ohs), obesity hypoventilation syndrome (ohs), obesity hypoventilation ssyndrome (ohs), obesity hypoventilation syyndrome (ohs), obesity hypoventilation synndrome (ohs), obesity hypoventilation synddrome (ohs), obesity hypoventilation syndrrome (ohs), obesity hypoventilation syndroome (ohs), obesity hypoventilation syndromme (ohs), obesity hypoventilation syndromee (ohs), obesity hypoventilation syndrome (ohs), obesity hypoventilation syndrome ((ohs), obesity hypoventilation syndrome (oohs), obesity hypoventilation syndrome (ohhs), obesity hypoventilation syndrome (ohss), obesity hypoventilation syndrome (ohs)), etc.