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Obesity hypoventilation syndrome

Pierpaolo Baiamonte, Emilia Mazzuca, Claudia I Gruttad'Auria, Alessandra Castrogiovanni, Claudia Marino, Davide Lo Nardo, Marco Basile, Margherita Algeri, Salvatore Battaglia, Oreste Marrone, Andrea Gagliardo, Maria R Bonsignore
Continuous positive airway pressure (CPAP) is the first-choice treatment for obstructive sleep-disordered breathing. Automatic bilevel ventilation can be used to treat obstructive sleep-disordered breathing when CPAP is ineffective, but clinical experience is still limited. To assess the outcome of titration with CPAP and automatic bilevel ventilation, the charts of 356 outpatients (obstructive sleep apnea, n = 242; chronic obstructive pulmonary disease + obstructive sleep apnea overlap, n = 80; obesity hypoventilation syndrome [OHS], n = 34; 103 females) treated for obstructive sleep-disordered breathing from January 2014 to April 2017 were reviewed...
March 12, 2018: Journal of Sleep Research
Adam M Hyde, Robert G McMurray, Frank A Chavoya, Daniela A Rubin
PURPOSE: Prader-Willi syndrome (PWS) is a genetic neurobehavioral disorder presenting hypothalamic dysfunction and adiposity. At rest, PWS exhibits hypoventilation with hypercapnia. We characterized ventilatory responses in children with PWS during exercise. METHODS: Participants were children aged 7-12 years with PWS (n = 8) and without PWS with normal weight (NW; n = 9, body mass index ≤ 85th percentile) or obesity (n = 9, body mass index ≥ 95th percentile)...
February 27, 2018: Pediatric Exercise Science
Angelo Onofri, Maxime Patout, Georgios Kaltsakas, Elodie Lhuillier, Sitali Mushemi-Blake, Gill Arbane, Martino F Pengo, Philip Marino, Joerg Steier
Background: Chronic hypercapnic respiratory failure (HRF) in obesity hypoventilation syndrome (OHS) is commonly treated using non-invasive ventilation (NIV). We hypothesised that treatment of OHS would improve neural respiratory drive index (NRDI) and cardiac function. Methods: Fourteen patients (8 females) with OHS, who were admitted for initiation of domiciliary NIV, were prospectively studied. Patients had (mean ± SD): age (53±10 years), body mass index (BMI) (50...
January 2018: Journal of Thoracic Disease
Geak Poh Tan, Nigel McArdle, Satvinder Singh Dhaliwal, Jane Douglas, Clare Siobhan Rea, Bhajan Singh
Home mechanical ventilation (HMV) is used in a wide range of disorders associated with chronic hypoventilation. We describe the patterns of use, survival and predictors of death in Western Australia. We identified 240 consecutive patients (60% male; mean age 58 years and body mass index 31 kg m-2) referred for HMV between 2005 and 2010. The patients were grouped into four categories: motor neurone disorders (MND; 39%), pulmonary disease (PULM; 25%, mainly chronic obstructive pulmonary disease), non-MND neuromuscular and chest wall disorders (NMCW; 21%) and the obesity hypoventilation syndrome (OHS; 15%)...
January 1, 2018: Chronic Respiratory Disease
Najib T Ayas, Cheryl R Laratta, John M Coleman, Anthony G Doufas, Matthias Eikermann, Peter C Gay, Daniel J Gottlieb, Indira Gurubhagavatula, David R Hillman, Roop Kaw, Atul Malhotra, Babak Mokhlesi, Timothy I Morgenthaler, Sairam Parthasarathy, Satya Krishna Ramachandran, Kingman P Strohl, Patrick J Strollo, Michael J Twery, Phyllis C Zee, Frances F Chung
The purpose of this workshop was to identify knowledge gaps in the perioperative management of obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS). A single-day meeting was held at the American Thoracic Society Conference in May, 2016, with representation from many specialties, including anesthesiology, perioperative medicine, sleep, and respiratory medicine. Further research is urgently needed as we look to improve health outcomes for these patients and reduce health care costs. There is currently insufficient evidence to guide screening and optimization of OSA and OHS in the perioperative setting to achieve these objectives...
February 2018: Annals of the American Thoracic Society
Léonore Schopfer, Lena Groenendijk, Jean-Paul Janssens, Alain Bigin Younossian, Laurence Vignaux
Non-invasive ventilation (NIV) is recognized as first line therapy in acute hypercapnic respiratory failure and chronic alveolar hypoventilation caused by several diseases (restrictive thoracic disorders, neuromuscular disease and obesity-hypoventilation syndrome). In Switzerland and other European countries, long-term NIV has also been applied in hypercapnic patients with chronic obstructive pulmonary disease (COPD). However, only recently has conclusive evidence showing benefits of long-term NIV become available...
January 31, 2018: Revue Médicale Suisse
Ernesto Díaz-Domínguez, Martín Rosas-Peralta, Luis Efrén Santos-Martínez, Nielzer Armando Rodríguez-Almendros, José Antonio Magaña-Serrano, Gilberto Pérez-Rodríguez
The obesity hypoventilation syndrome (OHS) refers to the combination of obesity, daytime hypercapnia and sleep-disordered breathing. Obesity has risen to epidemic proportions in the last three decades in the United States, Mexico and Europe. The OHS is associated with obstructive sleep apnea syndrome in 30%. Without treatment, mortality is 46% at 50 months. So in this paper we analyze the OHS, obesity and pulmonary hypertension, the pathophysiology, clinical presentation and diagnosis as well as the treatment, which is aimed at the correction of sleep-disordered breathing and hypoxemia; although there is little experience with the use of specific pulmonary vasodilator drugs...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
Andras Sikter, Zoltan Rihmer, Roberto de Guevara
The authors seek to find new connections between recent results of biology and older theories. This paper aims to assemble the jigsaw puzzle. The theoretical background of the hypothesis was described in the previous issue of the journal (Sikter et al. 2017a). Human stress response often coexists with persistent hypocapnia or hypercapnia - developing via psychosomatic pathomechanism - which can lead to mental and psychosomatic illnesses. Chronic hypocapnia mainly generates hyperarousal disorders which may be reversible for an extended time, however, vicious cycles may start when hypoxia and/or severe somatic diseases are simultaneously present (commonly in the elderly), which conditions often end with death without medical help...
September 2017: Neuropsychopharmacologia Hungarica
Donato Lacedonia, Giovanna Elisiana Carpagnano, Giulia Patricelli, Mauro Carone, Crescenzio Gallo, Incoronata Caccavo, Roberto Sabato, Annarita Depalo, Maria Aliani, Alberto Capozzolo, Maria Pia Foschino Barbaro
INTRODUCTION: Sleep-disordered breathing causes a burden to the sufferer, the health care system and the society. Most studies have focused on obstructive sleep apnea (OSA); however, the prevalence of comorbidities in patients affected by overlap syndrome (OS) and obesity hypoventilation syndrome (OHS) has not been carefully evaluated. STUDY OBJECTIVES: The principal aim of this study was to identify the presence of comorbidities in patients suffering from OSA, OS, OHS and the differences in three groups of patients...
December 11, 2017: Clinical Respiratory Journal
C D Turnbull, S H Wang, A R Manuel, B T Keenan, A G McIntyre, R J Schwab, J R Stradling
PURPOSE: Obesity is associated with both obstructive sleep apnea (OSA) and obesity hypoventilation. Differences in adipose tissue distribution are thought to underlie the development of both OSA and hypoventilation. We explored the relationships between the distribution of upper airway, neck, chest, abdominal and muscle fat in very obese individuals. METHODS: We conducted a cross-sectional cohort study of individuals presenting to a tertiary sleep clinic or for assessment for bariatric surgery...
December 2, 2017: Sleep & Breathing, Schlaf & Atmung
Frazer Warricker, Zafir Islam, Benoy N Shah
Obesity hypoventilation syndrome (OHS) is a condition in which an individual with a body mass index >30 kg/m2 develops daytime alveolar hypoventilation (defined as a resting PaCO2 >45 mmHg) that cannot be attributed to other pathologies. It is a condition with increasing prevalence and rising cost to healthcare systems worldwide. Right heart failure and pulmonary hypertension are well-known complications of this syndrome. Here, we present the case of a female patient with OHS who presented to our centre with severe pulmonary hypertension, which resolved with appropriate treatment...
December 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
Thomas Rossor, Ming Lim, Kirandeep VanDenEshof, Paul Gringras
Type 1 narcolepsy (NT1) is a chronic primary disorder of hypersomnolence characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. NT1 is linked to hypothalamic hypocretin deficiency, strongly associated with Human Leukocyte Antigen (HLA) marker DQB1*06:02 and of probable autoimmune origin. NT1 is usually associated with increased rates of overweight and obesity, and sometimes with increases in overnight blood pressure and increased rates of hypoventilation with raised CO2 levels overnight...
January 2018: European Journal of Paediatric Neurology: EJPN
Chaoling Liu, Mao-Sheng Chen, Hui Yu
Obstructive Sleep Apnea and Obesity Hypoventilation Syndrome are two similar diseases. Obstructive Sleep Apnea has been receiving more and more attention while the diagnostic rate of Obesity Hypoventilation Syndrome is not high. Few studies directly evaluated the relationship between them. We systematically analyzed the relevance of the two diseases. MEDLINE® , EMBASE® and the Cochrane Library were carried out to find studies until May 2017. Pooled mean difference and 95% confidence interval were calculated to evaluate the value of clinical and physiologic variables in the prediction of Obesity Hypoventilation Syndrome...
November 3, 2017: Oncotarget
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
February 2018: Current Opinion in Anaesthesiology
Jaime Corral, Maria Victoria Mogollon, M-Ángeles Sánchez-Quiroga, Javier Gómez de Terreros, Auxiliadora Romero, Candela Caballero, Joaquin Teran-Santos, María L Alonso-Álvarez, Teresa Gómez-García, Mónica González, Soledad López-Martínez, Pilar de Lucas, José M Marin, Odile Romero, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Roberto M Lang, Babak Mokhlesi, Juan F Masa
RATIONALE: Despite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomised trials have assessed the impact of non-invasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography. OBJECTIVES: We performed a secondary analysis of the data from the largest multicentre randomised controlled trial of OHS (Pickwick project, n=221) to determine the comparative efficacy of 2 months of NIV (n=71), CPAP (n=80) and lifestyle modification (control group, n=70) on structural and functional echocardiographic changes...
November 16, 2017: Thorax
Z Y Zhang, H H Lu, Q W Li, P Lin
No abstract text is available yet for this article.
November 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Janine Pilcher, Michael Richards, Leonie Eastlake, Steven J McKinstry, George Bardsley, Sarah Jefferies, Irene Braithwaite, Mark Weatherall, Richard Beasley
OBJECTIVE: To compare the effects on transcutaneous carbon dioxide tension (Ptco2) of high concentration and titrated oxygen therapy in medical inpatients with morbid obesity who were not selected for a pre-existing diagnosis of obesity hypoventilation syndrome. DESIGN: A randomised, crossover trial undertaken between February and September 2015. SETTING: Internal medicine service, Wellington Regional Hospital, New Zealand. PARTICIPANTS: 22 adult inpatients, aged 16 years or more, with a body mass index exceeding 40 kg/m<sup>2</sup>...
November 20, 2017: Medical Journal of Australia
Amanda J Piper, Ahmed S BaHammam, Shahrokh Javaheri
The obesity hypoventilation syndrome (OHS) is associated with significant morbidity and increased mortality compared with simple obesity and eucapnic obstructive sleep apnea. Accurate diagnosis and commencement of early and appropriate management is fundamental in reducing the significant personal and societal burdens this disorder poses. Sleep disordered breathing is a major contributor to the developmental of sleep and awake hypercapnia, which characterizes OHS, and is effectively addressed through the use of positive airway pressure (PAP) therapy...
December 2017: Sleep Medicine Clinics
Ana Rodriguez Alvarez, Lidia Méndez Marote, Olalla Castro Añón, Rafael Golpe Gómez, Luis Alejandro Pérez de Llano
No abstract text is available yet for this article.
November 2, 2017: Archivos de Bronconeumología
Antonello Nicolini, Malcom Lemyze, Antonio Esquinas, Cornelius Barlascini, Maurizio A Cavalleri
 Non-invasive ventilation ( NIV ) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades than previously. Unfortunately, NIV can have failure rates ranging from 5% to 50% and patient selection is the key to success. There are particular groups of patients that are more likely to benefit from NIV. For patients with hypoventilation syndrome (OHS) this treatment can be beneficial. This review seeks to evaluate the effectiveness of NIV in acute ARF and determine predictors of NIV failure in morbidly obese patients...
2017: Advances in Respiratory Medicine
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