Polysomnography with continuous nocturnal carbon dioxide monitoring is the gold standard for the evaluation of patients suspected of having obesity hypoventilation syndrome (OHS).
How is obesity hypoventilation diagnosed?
The traditional criteria for OHS diagnosis include the presence of daytime alveolar hypoventilation (awake, sea-level, arterial PCO2>45 mm Hg) among patients with BMI ≥30 kg/m2 in the absence of other causes of hypoventilation, and incorporating finger pulse oximetry and serum bicarbonate screening will likely aid in …
What are the signs and symptoms of hypoventilation?
What are the symptoms of Hypoventilatory Syndrome?
- Laboured breathing (Dyspnoea) during activity.
- Increased levels of anxiety.
- Disturbed sleep and sleep apnoea.
- Laboured breathing even during periods of inactivity.
- Persistent sleepiness throughout the daytime, prolonged sleep at night.
How is Pickwickian syndrome diagnosed?
To diagnose you with the condition, your doctor will first do a physical exam to check for signs of Pickwickian syndrome. Your doctor may also take a blood sample to check how much oxygen and carbon dioxide is in your blood.
What is the treatment for obesity hypoventilation syndrome?
The mainstay of treatment in OHS is to provide breathing support, often through the use of continuous positive airway pressure (CPAP) or bilevel. These devices generate a pressurized flow of air that can keep the upper airway from collapsing during sleep.
How is hypoventilation treated?
Bronchodilators, such as beta agonists (eg, albuterol, salmeterol), anticholinergic agents (eg, ipratropium bromide), and methylxanthines (eg, theophylline), are helpful in treating patients with obstructive lung disease and severe bronchospasm.
What causes hypoventilation syndrome?
Central hypoventilation syndrome is caused by certain receptors in the brain failing to recognize changes in carbon dioxide levels during sleep, leading to a low breathing rate and low blood concentration of oxygen.
What happens if hypoventilation is left untreated?
If left untreated, hypoventilation can cause life-threatening complications, including death. Respiratory depression occurring from a drug overdose can lead to respiratory arrest. This is when breathing completely stops, which is potentially fatal.
How do you test for hypoventilation?
Tests that may be done include:
- Measuring levels of oxygen and carbon dioxide in the blood (arterial blood gases)
- Chest x-ray or CT scan.
- Hematocrit and hemoglobin blood tests tests to check oxygen carrying ability of red blood cells.
- Lung function tests.
- Overnight oxygen level measurements (oximetry)
- Blood gases.
How do you identify hypoventilation?
Symptoms of hyperventilation
- Feeling anxious, nervous, or tense.
- Frequent sighing or yawning.
- Feeling that you can’t get enough air (air hunger) or need to sit up to breathe.
- A pounding and racing heartbeat.
- Problems with balance, lightheadedness, or vertigo.
- Numbness or tingling in the hands, feet, or around the mouth.
How do you treat Pickwickian syndrome?
The most common treatment for the breathing issues that come along with Pickwickian syndrome is positive airway pressure (PAP) therapy. Your doctor may recommend this type of treatment in the form of a continuous PAP (or CPAP) machine.
What is Ondine curse?
Ondine’s curse — or, more officially, central hypoventilation syndrome — is an often fatal respiratory disorder that occurs during sleep. Typically the disorder is congenital, but in some cases can be developed later in life, especially when the patient has also had a severe injury to the brain or brain stem.
Does obesity affect oxygen levels?
Obesity affects lung function and diminishes oxygen exchange.
Is obesity hypoventilation syndrome reversible?
Lesson of the month 1: Obesity hypoventilation (Pickwickian) syndrome: a reversible cause of severe pulmonary hypertension.
Does obesity reduce lung capacity?
Although obesity significantly reduces functional residual capacity (FRC) and expiratory reserve volume (ERV) [15, 24, 25], it has very little effect on residual volume (RV) and total lung capacity (TLC).
How does obesity affect breathing?
Obesity causes mechanical compression of the diaphragm, lungs, and chest cavity, which can lead to restrictive pulmonary damage. Furthermore, excess fat decreases total respiratory system compliance, increases pulmonary resistance, and reduces respiratory muscle strength.