REVIEW   

Minerva Pneumologica 2017 March;56(1):47-58

DOI: 10.23736/S0026-4954.17.01775-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Obesity hypoventilation syndrome: updating a weighty concern

Amanda J. PIPER ^{1, 2}, Olivia A. MCGUINESS ¹ ✉

¹ Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Australia; ² Faculty of Medicine, University of Sydney, Sydney, Australia

Obesity hypoventilation syndrome (OHS) is a common cause of hypercapnic respiratory failure. Early diagnosis and treatment are considered important aspects of care given the significant health, social and financial costs associated with this disorder. Individuals with OHS have higher morbidity and mortality than those with eucapnic obesity. Nevertheless, OHS continues to be overlooked in patients with significant obesity, even when hospitalised. In the past few years, increasing interest in developing screening tools to identify those at risk has arisen. The pathogenesis of OHS is multifactorial, but treatment of sleep disordered breathing with positive airway pressure (PAP) therapy is the mainstay of management, improving daytime respiratory failure in most individuals. The past few years has seen the publication of a number of randomized trials which are shedding light on which forms of PAP provide the most clinically beneficial and cost-effective treatment option for OHS. However, many of the findings are creating new questions. The purpose of this review is to update the latest findings around the diagnosis and management options for increasingly prevalent disorder.

KEY WORDS: Obesity hypoventilation syndrome - Hypercapnia - Continuous positive airway pressure - Sleep apnea syndrome