Obesity Hypoventilation Syndrome

The development of hypercapnic respiratory failure due to obesity alone—called the obesity hypoventilation syndrome—is associated with high morbidity and mortality. Yet, it is also a disorder which is commonly misdiagnosed or overlooked even by experienced clinicians. As a consequence, people with obesity hypoventilation experience frequent hospitalizations, poor quality of life, and social deprivation not only compared to the general population but also to those with eucapnic obesity. Factors contributing to this disorder are complex and extend beyond obesity itself. Effective treatment of sleep disordered breathing reverses daytime hypercapnia and improves symptoms in the majority of patients. However, even when therapy is instituted, mortality exceeds that seen in patients with obstructive sleep apnea alone, usually related to cardiovascular disease. Consequently, long-term management of obesity hypoventilation needs to address not just hypoventilation but also the obesity aspects of this disorder.