Treatment options for obesity hypoventilation syndrome

Recommended treatment options for patients with respiratory difficulties related to obesity hypoventilation syndrome (OHS) include:

  1. A controlled weight loss program;1 and
  2. Nocturnal positive airway pressure, that is, noninvasive ventilation (NIV).2

Weight loss

Because weight is a major cause of OHS, the first step in treating patients suspected of OHS is weight loss. Losing weight is not only likely to improve their general health, but can also improve their alveolar ventilation [PaCO2] and arterial oxygen tension [PaO2].3

As well as following a weight loss program, patients should undergo:

  • Arterial blood gases testing
  • Pulmonary function testing
  • A polysomnography (PSG)
  • Chest radiographs

Noninvasive ventilation (NIV)

The main goals of treatment for OHS patients are as follows:

  • Normalize arterial carbon dioxide tension (PaCO2 45 mm Hg)
  • Prevent hypoxemia during sleep and wakefulness
  • Prevent erythrocytosis, pulmonary hypertension, and respiratory failure
  • Relieve hypersomnia and altered mentation

Treatment with NIV helps to achieve these goals, and has been widely observed to be the ideal treatment for OHS.2

ResMed’s NIV solution

ResMed’s intelligent Volume-Assured Pressure Support (iVAPS) is a unique technology featured in the S9 VPAP ST-A (hyperlink to product page) and the Stellar Series (hyperlink to product page) devices.  This new therapy mode adjusts to a patient’s respiratory rate, targets alveolar ventilation and automatically adjusts pressure support as needed to accommodate each pateint’s unique needs, even as their disease state progresses.

iVAPS  is available in the following ResMed devices used to treat OHS:


  • 01

    Piper JP, Grunstein RR. Obesity hypoventilation syndrome. (2011) Am J Respir Crit Care Med 183:292-298

  • 02

    Storre JH, Seuthe B, Fiechter R, Milioglou S, Dreher M, Sorichter S, Windisch W. Average volume-assured pressure support in obesity hypoventilation: A randomised crossover trial. Chest.2006 Sep 130(3): 815-21

  • 03

    3 Zavorsky GS, Hoffman SL. Pulmonary gas exchange in the morbidly obese. Obes Rev 2008 9:326–339

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