Sleep Med Psychophysiol.  2015 Jun;22(1):30-34. 10.14401/KASMED.2015.22.1.30.

A Case of Rapidly Developed Obesity Hypoventilation Syndrome in a Patient with Kyphoscoliosis

• Kim MY
• Jeong JS
• Jang YN
• Go SE
• Lee SH
• Moon HS
• Kang HH

• KMID: 2317599
• DOI: http://doi.org/10.14401/KASMED.2015.22.1.30

Abstract

Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.

Keyword

Obesity hypoventilation syndrome; Kyphoscoliosis; Obstructive sleep apnea; Bilevel positive airway pressure

MeSH Terms

Airway Obstruction
Anoxia
Apnea
Blood Gas Analysis
Disorders of Excessive Somnolence
Dyspnea
Emergency Service, Hospital
Female
Humans
Hypercapnia
Hypertension, Pulmonary
Hypoventilation
Middle Aged
Obesity Hypoventilation Syndrome*
Obesity, Morbid
Polysomnography
Pulmonary Heart Disease
Sleep Apnea, Obstructive
Snoring