What is Obesity Hypoventilation Syndrome?

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  • Written By: Andy Josiah
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 16 October 2019
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Obesity hypoventilation syndrome (OHS) is a condition that commonly affects overweight people, characterized by slow or hollow breathing that consequently causes lowered oxygen and increased carbon dioxide in the blood. The condition is also known as Pickwickian syndrome. The alternative term originated in the 1950s—the same decade that the condition was discovered—when a report revealing the growing lethargy of a weight-gaining professional poker player drew comparisons with a character in the 1837 Charles Dickens book The Posthumous Papers of the Pickwick Club.

The poker-player report, published in 1956, was far from the first one on excessively slow or hollow breathing, which is known by the medical term hypoventilation. It was, however, the first time the medical community distinguished between hypoventilation and sleep apnea, with the latter describing pauses in breathing when a person is sleeping. This discernment resulted in OHS being split into two subtypes: one which is characterized by sleep apnea, or temporary cessation of breathing, and the other which does not feature such interruptions but is still marked by inadequate breathing. Physicians can set obesity hypoventilation syndrome apart from sleep apnea by detecting the higher levels of carbon dioxide in the blood of the patient when wide awake.


Besides sleep apnea, other symptoms of obesity hypoventilation syndrome may include drowsiness or sleepiness during the daytime, depression and hypertension, or high blood pressure. In more extreme cases, patients may have shortness of breath, headaches, and right-side heart strain, or cor pulmonale. Complications of the disease include increased accident risk or sexual dysfunction.

The risk of getting obesity hypoventilation syndrome increases with the accumulation of weight, since it is believed that added weight restricts the chest wall from allowing deeper breaths. With such an interruption in the circulatory system, the result is blood that has little oxygen but excessive carbon dioxide. Moreover, most OHS patients have sleep apnea. The exact cause of the obesity hypoventilation syndrome, however, is still a mystery.

The best way to avoid contracting obesity hypoventilation syndrome is prevention by maintaining a healthy weight. Still, those with OHS can seek treatment from physicians, who can recommend a respiratory ventilation device called a continuous positive airway pressure (CPAP) machine. Left untreated, obesity hypoventilation syndrome can lead to more serious problems such as heart and blood vessel damage.


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