Obesity-Hypoventilation Syndrome: Increased Risk of Death over Sleep Apnea Syndrome |
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| Authors: | Olalla Castro-A?ón Luis A. Pérez de Llano Sandra De la Fuente Sánchez Rafael Golpe Lidia Méndez Marote Julián Castro-Castro Arturo González Quintela |
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| Affiliation: | 1Respiratory Division and Sleep Disorders Unit, Lucus Augusti University Hospital, Galician Health Service, Lugo, Spain;2Lucus Augusti University Hospital, Galician Health Service, Lugo, Spain;3Galician Health Service, Lugo, Spain;4Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain;Weill Cornell Medical College Qatar, QATAR |
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| Abstract: | AimTo study whether mortality and cardiovascular morbidity differ in non-invasive ventilation (NIV)-treated patients with severe obesity-hypoventilation syndrome (OHS) as compared with CPAP-treated patients with obstructive sleep apnea syndrome (OSAS), and to identify independent predictors of mortality in OHS.ResultsThree hundred and thirty subjects (110 patients with OHS and 220 patients with OSAS) were studied. Mean follow-up time was 7±4 years. The five year mortality rates were 15.5% in OHS cohort and 4.5% in OSAS cohort (p< 0.05). Patients with OHS had a 2-fold increase (OR 2; 95% CI: 1.11–3.60) in the risk of mortality and 1.86 fold (OR 1.86; 95% CI: 1.14–3.04) increased risk of having a cardiovascular event. Diabetes, baseline diurnal SaO2 < 83%, EPAP < 7 cmH2O after titration and adherence to NIV < 4 hours independently predicted mortality in OHS.ConclusionMortality of severe OHS is high and substantially worse than that of OSAS. Severe OHS should be considered a systemic disease that encompasses respiratory, metabolic and cardiovascular components that require a multimodal therapeutic approach. |
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