Diagnosis
Diagnosis of OHS-3 criteria
BMI>30
Daytime Hypercapnia (PaCO2>45)
Exclusion of other causes of hypoventilation/sleep disordered breathing
1837, Charles Dickenson referred to a character named BLANK who was overweight with a rosy complexion, snored, struggled to breathe and felt constantly drowsy
JOE
What does AHI stand for in sleep studies?
Apnea-Hypopnea Index
OHS occurs at a higher or lower BMI range in the Asian population
lower BMI :(
What does CPAP stand for?
Continuous Positive Airway Pressure
Patients with eucapnic OSAHS, most OHS patients often present with signs of *** such as dyspnea, facial redness, cyanosis, jugular engorgement, LE edema.
What is cor pulmonale?
Another name for OHS/Obesity Hypoventilation Syndrome?
Pickwick syndrome/Pickwickian syndrome
Severe OSA is classified with an AHI of greater than what number?
30 events/hour
Name all 8 components of STOPBANG
Snoring, Tiredness, observed apnea, HTN, BMI>35, Age>50, Neck circumference>40 and male gender
What percentage of patients show improvement in OHS with CPAP therapy?
80%
Per the American Academy of Sleep Medicine, OHS is defined as the presence of PaCO2 of greater than [A] mmHg for over [B ]minutes or an increase in PaCO2 by greater than [C ]mmHg during sleep, in comparison to a PaCO2 more significant than 50 mmHg for more than 10 minutes in the awake supine value
A-PaCo2>55
B-10 minutes
C-10mmHg
Name the sleep stage most associated with central hypoventilation in OHS.
REM Sleep
Phlebotomy should only be considered in patients exhibiting hematocrit levels exceeding ***% and symptomatic hyperviscosity
65%
Name the therapy used when CPAP is ineffective in OHS treatment.
Bi-level Positive Airway Pressure - BiPAP
In comparison to obese individuals without hypoventilation, patients with OHS are at a higher risk of these 3 cardiac conditions
1. Heart failure 2.Angina pectoris 3. Cor pulmonale
In 1983, this physician’s invention of positive pressure equipment provided a new treatment option for OHS, reducing the need for tracheostomy.
Who is Sullivan?
This invention in 1983 significantly advanced the treatment of OHS.
Positive pressure equipment
These two respiratory stimulants, have been studied for their effects on improving hypercapnia and hypoxemia in OHS, but can also have side effects like promoting upper airway collapse.
What are medroxyprogesterone acetate and acetazolamide?
What is the minimum saturation level requiring oxygen supplementation in OHS?
Below 88%
Per the article what is the definitive diagnostic test for OHS?
Measuring PCO2 levels through arterial blood gas analysis (without supplemental oxygen).
The initial clinical documentation of the efficacy of positive pressure devices like CPAP in treating sleep-disordered breathing was made in this year.
1982
Name the six subtypes of hypoventilation disorders as per the International Classification of Sleep Disorders
OHS, congenital alveolar hypoventilation due to late hypothalamic dysfunction, idiopathic alveolar hypoventilation, hypoventilation during sleep associ- ated with substances or medications, and hypoventilation during sleep due to other diseases
How does acetazolamide help treat OHS?
Acetazolamide prevents the conversion of carbon dioxide to bicarbonate, which lowers pH in the brain and increases central ventilatory drive and minute ventilation
Name the therapy combining volume and pressure control in OHS treatment.
Average Volume-Assured Pressure Support - AVAPS