Overweight and Obesity Obesity Hypoventilation Syndrome

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Obesity hypoventilation syndrome, also known as Pickwickian syndrome, is a breathing disorder that affects some people who have been diagnosed with obesity. Normally, you exhale carbon dioxide, a by-product of breaking down food for energy. Obesity hypoventilation syndrome causes you to have too much carbon dioxide and too little oxygen in your blood. Without treatment, it can lead to serious and even life-threatening health problems.

Having overweight or obesity increases your risk of developing obesity hypoventilation syndrome. Most people who have obesity hypoventilation syndrome also have sleep apnea.

It is not clear why obesity hypoventilation syndrome affects some people who have obesity and not others. Extra fat on your neck, chest, or across your abdomen can make it difficult to breathe deeply and may produce hormones that affect your body’s breathing patterns. You may also have a problem with the way your brain controls your breathing.

Common symptoms include:

• Breathlessness
• Daytime sluggishness or sleepiness, especially if you also have sleep apnea
• Dizziness
• Fatigue, or extreme tiredness
• Headaches

In addition to the above symptoms, you or a loved one may notice you often snore loudly, choke or gasp, or have trouble breathing at night. Your symptoms may get worse over time.

If your healthcare provider suspects that you have obesity hypoventilation syndrome, they will:

• Perform a physical exam
• Measure your weight and height
• Calculate your body mass index (BMI)
• Measure your waist and neck circumference

Additional tests might include lung tests to measure the amount of oxygen in your body or how well your lungs are working. You may also need a sleep study if your provider thinks you may have sleep apnea.

If you are diagnosed with obesity hypoventilation syndrome, your provider may recommend healthy lifestyle changes, such as getting to and maintaining a healthy weight and being physically active. You may also need a continuous positive airway pressure (CPAP) machine or other breathing device at night to help keep your airways open and increase blood oxygen levels. Other treatments may include weight-loss surgery or medicines.

If you have been prescribed a CPAP machine, use it as instructed and continue with your provider’s recommended healthy lifestyle changes to prevent complications. Tell your provider about new symptoms, such as swelling around your ankles, chest pain, lightheadedness, or wheezing. Talk to your provider if you will be flying or need surgery, because these situations can increase your risk for serious complications.