title: Obesity hypoventilation syndrome: from sleep-disordered breathing to systemic comorbidities and the need to offer combined treatment strategies.
abstract: Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥ 30 kg/m(2)), daytime hypercapnia (partial arterial carbon dioxide concentration ≥45 mm Hg) and sleep-disordered breathing after ruling out other disorders that may cause alveolar hypoventilation. Through the prism of the International Classification of Functioning, OHS is a chronic condition associated with respiratory, metabolic, hormonal and cardiovascular impairments, leading to a decrease in daily life activities, a lack of social participation and high risk of hospitalization and death. Despite its severity, OHS is largely underdiagnosed and the health-related costs are higher than those of apnoeic or obese eucapnic patients. The present review discusses the definition, epidemiology, physiopathology and treatment modalities of OHS. Although nocturnal positive airway pressure therapies represent first-line treatment and are effective in improving patient outcomes, there is a need to offer combined treatment strategies and to assess the effect of multimodal therapeutic strategies on morbidity and mortality.
authors: Research and Development Department AGIR à dom, Meylan, France. j.borel@agiradom.com
authors: Jean-Christian
authors: JC
authors: Borel
authors: Anne-Laure
authors: AL
authors: Borel
authors: Denis
authors: D
authors: Monneret
authors: Renaud
authors: R
authors: Tamisier
authors: Patrick
authors: P
authors: Levy
authors: Jean-Louis
authors: JL
authors: Pepin
mesh_terms: D001835:Body Weight / Q000502:physiology; D045422:Continuous Positive Airway Pressure; D006304:Health Status; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D010845:Obesity Hypoventilation Syndrome / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017286:Polysomnography; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D015431:Weight Loss / Q000502:physiology