Resp Care
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Obesity hyoventilation syndrome (OHS) is defined as the triad of obesity, daytime hypoventilation, and sleep-disordered breathing in the absence of an alternative neuromuscular, mechanical or metabolic explanation for hypoventilation. During the last 3 decades the prevalence of extreme obesity has markedly increased in the United States and other countries. With such a global epidemic of obesity, the prevalence of OHS is bound to increase. ⋯ Effective treatment can lead to significant improvement in patient outcomes, underscoring the importance of early diagnosis. This review will include disease definition and epidemiology, clinical characteristics of the syndrome, pathophysiology, and morbidity and mortality associated with it. Lastly, treatment modalities will be discussed in detail.
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Sleep-disordered breathing (mainly obstructive sleep apnea [OSA]) and COPD are among the most common pulmonary diseases, so a great number of patients have both disorders; this "overlap syndrome" causes more severe nocturnal hypoxemia than either disease alone. This common combination of OSA and COPD has important implications for diagnosis, treatment, and outcome. Specifically, patients with COPD and OSA have a substantially greater risk of morbidity and mortality, compared to those with either COPD or OSA alone. ⋯ Many questions remain, however, with regard to disease definition, prognosis, and optimal treatment. Treatment currently consists of continuous positive airway pressure, and oxygen as needed. Noninvasive ventilation may be helpful in overlap syndrome patients, but this has not yet been well studied.