scholarly journals Positive Pressure for Obesity Hypoventilation Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Arijit Chanda ◽  
Jeff S. Kwon ◽  
Armand John Wolff ◽  
Constantine A. Manthous
Keyword(s):  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Positive Pressure ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Pickwickian Syndrome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation ◽  
Term Management

Obesity is increasing world-wide; obesity hypoventilation syndrome (OHS), formerly Pickwickian syndrome, has increased in parallel. Despite its prevalence, OHS has not been studied well, but there is abundant evidence that it is tightly linked with sleep-disordered breathing, most commonly obstructive sleep apnea. This article reviews the pathophysiology of OHS as well as the literature regarding the benefits of treating this disorder with positive airway pressure. We also emphasize that while positive pressure treatments may temporize cardiopulmonary disease progression, simultaneous pursuit of weight reduction is central to long-term management of this condition.

scholarly journals Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea

Thorax ◽  
2020 ◽  
Vol 75 (6) ◽  
pp. 459-467 ◽  
Author(s):  
Juan F Masa ◽  
Babak Mokhlesi ◽  
Iván Benítez ◽  
Francisco Javier Gómez de Terreros Caro ◽  
M-Ángeles Sánchez-Quiroga ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Primary Outcome ◽  
Cost Effective ◽  
Sleep Apnoea ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
The Mean ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

BackgroundObesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities.ObjectivesWe performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure.MethodsHospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed.ResultsIn total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91–3.14) years for NIV group and 3.00 (2.92–3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups.ConclusionCPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA.Trial registration numberNCT01405976

scholarly journals Obesity hypoventilation syndrome

2019 ◽  
Vol 28 (151) ◽  
pp. 180097 ◽  
Author(s):  
Juan F. Masa ◽  
Jean-Louis Pépin ◽  
Jean-Christian Borel ◽  
Babak Mokhlesi ◽  
Patrick B. Murphy ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Obesity Hypoventilation Syndrome ◽  
Hypercapnic Respiratory Failure ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation ◽  
Disordered Breathing

Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥30 kg·m−2), daytime hypercapnia (arterial carbon dioxide tension ≥45 mmHg) and sleep disordered breathing, after ruling out other disorders that may cause alveolar hypoventilation. OHS prevalence has been estimated to be ∼0.4% of the adult population. OHS is typically diagnosed during an episode of acute-on-chronic hypercapnic respiratory failure or when symptoms lead to pulmonary or sleep consultation in stable conditions. The diagnosis is firmly established after arterial blood gases and a sleep study. The presence of daytime hypercapnia is explained by several co-existing mechanisms such as obesity-related changes in the respiratory system, alterations in respiratory drive and breathing abnormalities during sleep. The most frequent comorbidities are metabolic and cardiovascular, mainly heart failure, coronary disease and pulmonary hypertension. Both continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) improve clinical symptoms, quality of life, gas exchange, and sleep disordered breathing. CPAP is considered the first-line treatment modality for OHS phenotype with concomitant severe obstructive sleep apnoea, whereas NIV is preferred in the minority of OHS patients with hypoventilation during sleep with no or milder forms of obstructive sleep apnoea (approximately <30% of OHS patients). Acute-on-chronic hypercapnic respiratory failure is habitually treated with NIV. Appropriate management of comorbidities including medications and rehabilitation programmes are key issues for improving prognosis.

Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

2020 ◽  
Author(s):  
Mª Ángeles Sanchez Quiroga ◽  
Juan Fernando Masa Jiménez ◽  
Ivan Benitez ◽  
Javier Gómez De Terreros ◽  
Jaime Corral ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Noninvasive Ventilation ◽  
Sleep Apnoea ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

scholarly journals 0516 LONG TERM EFFECTS OF COMPLIANCE WITH POSITIVE AIRWAY PRESSURE (PAP) THERAPY IN PATIENTS WITH OBESITY HYPOVENTILATION SYNDROME (OHS)

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A192-A192
Author(s):  
I Bouloukaki ◽  
C Mermigkis ◽  
C Protopapadakis ◽  
M Markakis ◽  
M Bolaki ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Long Term Effects ◽  
Obesity Hypoventilation Syndrome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Long-Term Outcome of Noninvasive Positive Pressure Ventilation for Obesity Hypoventilation Syndrome

CHEST Journal ◽  
2010 ◽  
Vol 138 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Pascaline Priou ◽  
Jean-François Hamel ◽  
Christine Person ◽  
Nicole Meslier ◽  
Jean-Louis Racineux ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Obesity Hypoventilation Syndrome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

The Pickwick randomized clinical trial: long-term positive airway pressure therapy in obesity hypoventilation syndrome

2019 ◽  
Author(s):  
Mª Ángeles Sanchez Quiroga ◽  
Juan Fernando Masa Jiménez ◽  
Babak Mokhlesi ◽  
Ivan Benítez ◽  
Francisco Javier Gómez De Terreros ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Obesity Hypoventilation Syndrome ◽  
Pressure Therapy ◽  
Positive Airway Pressure Therapy ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation
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