Obesity Hypoventilation Syndrome: A Systematic Review

Background: The accurate incidence of obesity-hypoventilation syndromes (OHS) in the general population remains unknown. OHS arises from an intricate interaction among sleep-disordered breathing, depauperate respiratory drive, obesity-related respiratory, metabolic, hormonal and cardiovascular impairments, and leading to a reduction in daily life activities. Currently, OHS information is extremely limited in the clinical and diagnostic predictors, and anesthesiology literature. This review will examine the epidemiology, clinical characteristics, and prevalence of OHS in different countries, and treatment available treatment modalities. Methods: A comprehensive literature search was conducted to identify studies focused on OHS through databases, including Google Scholar, PubMed, Medline, Scopus, Embase, Cochrane Library and Web of science. The articles in English published in index above were selected for the review. Data were extracted on the clinical outcome, prevalence and diagnosis features, epidemiology, and treatments. Results: Available data in this review article suggest that the high incidence of OHS, noninvasive ventilation (NIV) and continuous positive airway pressure therapy (CPAP) treatments were more effective than lifestyle modification with respect to the improvements in clinical symptoms, although bi-level PAP exhibited slightly greater respiratory functional improvements than CPAP with long-term treatment. Conclusion: NIV and CPAP therapies are the mainstay of treatment but the best approach for those who do not respond to this modality is unknown and may include a combination of PAP therapy and pharmacotherapy with respiratory stimulants or tracheostomy, with or without nocturnal ventilation.