Obesity Hypoventilation Syndrome: Symptoms and Treatment

 
Dr. Akhilesh Singh, New Delhi, India.
 
Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some obese people. In OHS, poor breathing results in too much carbon dioxide and too little oxygen in the blood.
The cause of OHS isn’t fully known. Researchers think that several factors may work together to cause the disorder.
Many people who have OHS also have obstructive sleep apnea. Obstructive sleep apnea is a common disorder in which the airway collapses or is blocked during sleep. This causes pauses in breathing or shallow breaths while you sleep.
Obstructive sleep apnea disrupts your sleep and causes you to feel very tired during the day.
Doctors treat OHS in a number of ways. One way is with positive airway pressure (PAP) machines, which are used during sleep.
PAP therapy uses mild air pressure to keep your airways open.
Other treatments for OHS include ventilator  support and medicines.
 OHS occurs with obesity, so your doctor will likely recommend weight loss as part of your treatment plan. Successful weight loss often involves setting goals and making lifestyle changes, such as following a healthy diet and being physically active.
Who Is at Risk for Obesity Hypoventilation Syndrome?
People who are obese are at risk for obesity hypoventilation syndrome (OHS). “Obesity” refers to having too much body fat. People who are obese have body weight that’s greater than what is considered healthy for a certain height.
The most useful measure of obesity is body mass index (BMI). BMI is calculated from your height and weight. In adults, a BMI of 30 or more is considered obese.
If you are obese, you’re at greater risk for OHS if your BMI is 40 or higher. You’re also at greater risk if most of your excess weight is around your waist, rather than at your hips. This is referred to as “abdominal obesity.”
OHS tends to occur more often in men than women. At the time of diagnosis, most people are 40 to 60 years old.
Signs and Symptoms of Obesity Hypoventilation Syndrome?
Many of the signs and symptoms of obesity hypoventilation syndrome (OHS) are the same as those of obstructive sleep apnea. This is because many people who have OHS also have obstructive sleep apnea.
One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses.
Other symptoms include:
•           Daytime sleepiness
•           Morning headaches
•           Memory, learning, or concentration problems
•           Feeling irritable or depressed, or having mood swings or personality changes
You also may have rapid, shallow breathing. During a physical exam, your doctor might hear abnormal heart sounds while listening to your heart with a stethoscope. He or she also might notice that the opening to your throat is small and your neck is larger than normal.
Complications of Obesity Hypoventilation Syndrome
When left untreated, OHS can cause serious problems, such as:
•           Leg edema, which is swelling in the legs caused by fluid in the body’s tissues.
•           Pulmonary hypertension, which is increased pressure in the pulmonary arteries. These arteries carry blood from your heartto your lungs to pick up oxygen.
•           Cor pulmonale, which is failure of the right side of the heart.
•           Secondary erythrocytosis, which is a condition in which the body makes too many red blood cells.
How Is Obesity Hypoventilation Syndrome Treated?
Treatments for obesity hypoventilation syndrome (OHS) include breathing support, weight loss, and medicines.
The goals of treating OHS may include:
•           Supporting and aiding your breathing
•           Achieving major weight loss
•           Treating underlying and related conditions
How Can Obesity Hypoventilation Syndrome Be Prevented?
You can prevent obesity hypoventilation syndrome (OHS) by maintaining a healthy weight. However, not everyone who is obese develops OHS. Researchers don’t fully know why only some people who are obese develop the condition.
Adopting healthy habits can help you maintain a healthy weight. Many lifestyle habits begin during childhood. So, it’s important to make following a healthy lifestyle a family goal.
A healthy diet is an important part of a healthy lifestyle. A healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, eggs, poultry without skin, seafood, nuts, seeds, beans, and peas.
A healthy diet is low in sodium (salt), added sugars, solid fats, and refined grains. Solid fats are saturated fat and trans fatty acids. Refined grains come from processing whole grains, which results in a loss of nutrients (such as dietary fiber). Examples of refined grains include white rice and white bread.
Singh is a healthcare facilitator based in New Delhi, India.