Obesity Hypoventilation Syndrome – Symptoms & Complications

Obesity hypoventilation syndrome (OHS), known as Pickwickian syndrome, is a medical condition that happens when an individual who is obese (BMI > 30kg/ m2) fail to breathe rapidly or deeply enough due to low blood oxygen when sleeping and also due to increase in level of blood carbon dioxide during the day.

When hypoventilation occurs, the body finds it difficult to remove carbon dioxide. This will cause the lungs to use the oxygen poorly.

There is a difference between hypoventilation and hyperventilation. Hyperventilation is when your breathing is quick, causing the carbon dioxide levels in the blood to lower.

Symptoms Of Hypoventilation

Hypoventilation comes with several signs but not limited to the following:

  • You may feel sleepy or sluggish during the day.
  • You may experience morning headaches
  • You or a loved one may notice you snore loudly often
  • Choke, gasp, or have trouble breathing at night.
  • Swelling of ankles.
  • Waking up feeling restless

Causes Of Obesity Hypoventilation Syndrome

The following are the possible cause of obesity hypoventilation:

  1. Severe obesity (when your BMI>30, it causes the body to do extra work to breath)
  2. Neuromuscular disease (when the muscles that control breathing is weak)
  3. Chronic lung disease (when conditions like COPD and cystic fibrosis that cause the body airways to be blocked).
  4. Chest wall deformities (when the chest walls are deformed, it interferes with the ability to breathe in and out).
  5. Brain injury (this cause interference with the ability of the brain to control some functions like breathing)
  6. Drugs for the central nervous system depressant can cause the respiratory system to slow down, leading to hypoventilation.

How To Diagnose Obesity Hypoventilation Syndrome

When any of the symptoms listed above is noticed, kindly visit your doctor and he may likely order a series of test to be run to determine the cause. The test includes:

  • Lung function test: This is a test that will determine if the lung is functioning effectively.
  • Chest x-ray: This is a test that comes in an image form, showing the chest area and any abnormalities.
  • Sleep study: This test can be used to diagnose if there is any sleep-related disorder.
  • Blood gas test: This is a blood test that checks how stable, acid/base is in your bloodstream. It also checks the amount of carbon dioxide in your body.
  • Pulse oximetry test: This is done using a painless monitor on your finger, which measures the level of oxygen in your bloodstream.
  • Hematocrit and Hemoglobin blood test: This test is used to assess if the number of red blood cells available can carry oxygen through the body.

How To Treat Obesity Hypoventilation Syndrome

When treating OHS, it should include weight loss and treating breathing disorder. Sometimes once you concentrate on weight loss alone, it can correct some other problems such as obstructive sleep apnea.

When medications trigger hyperventilation, when you stop the drug, it can restore your breathing to normal.

Other treatments for OHS include:

  1. Weight loss
  2. BiPAP or CPAP machine can be used to keep your airways open when you’re sleeping,
  3. Oxygen therapy to support your breathing.
  4. Surgery to help correct any chest deformity.
  5. Inhaled medications will open airways and treat any ongoing lung disease.

Can Hypoventilation Cause Complications?

When hypoventilation is not treated, in most cases, it can lead to life-threatening complications, such as death. When hypoventilation occurs due to drug overdose, it can lead to respiratory arrest. This is when breathing stops completely, which is fatal.

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