Hypoventilation syndromes

Last reviewed: 6 Nov 2022
Last updated: 16 Nov 2022

Summary

Definition

History and exam

Other diagnostic factors

  • male sex
  • dyspnea
  • daytime sleepiness
  • morning headache
  • impaired cough
  • repeated lower respiratory tract infections
  • BMI ≥30 kg/m²
  • increased pulmonic component of second heart sound (P2)
  • lower-extremity edema
  • right-sided third heart sound (S3 gallop)
  • left-sided fourth heart sound (S4 gallop)
Other diagnostic factors

Risk factors

  • body mass index (BMI) ≥30 kg/m²
  • restrictive thoracic disorders
  • central nervous system disorders
  • obstructive airway disease
More risk factors

Diagnostic investigations

1st investigations to order

  • arterial blood gas
  • serum bicarbonate
  • pulse oximetry
  • Hct
More 1st investigations to order

Investigations to consider

  • pulmonary function tests
  • respiratory muscle strength
  • CXR
  • polysomnogram
  • echocardiogram
  • TSH
  • PHOX2B gene
More investigations to consider

Treatment algorithm

ACUTE

obesity-hypoventilation syndrome

restrictive thoracic disorders

Cheyne-Stokes respiration

COPD

Contributors

Authors

Samuel Krachman, DO

Professor of Medicine

Division of Pulmonary and Critical Care Medicine

Temple University School of Medicine

Philadelphia

PA

Disclosures

SK is an author of a number of references cited in this topic.

Acknowledgements

Professor Samuel Krachman would like to gratefully acknowledge Dr Gerard Criner, a previous contributor to this topic.

Disclosures

GC declares that he has no competing interests.

Peer reviewers

Matthew Hind, PhD, MRCP

Consultant Physician

Royal Brompton Hospital

Honorary Senior Lecturer

National Heart and Lung Institute

Imperial College

Department of Respiratory Medicine

London

UK

Disclosures

MH declares that he has no competing interests.

Kenneth I. Berger, MD

Associate Professor of Medicine

Physiology and Neuroscience

New York University School of Medicine

New York

NY

Disclosures

KIB declares that he has no competing interests.

  • Differentials

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  • Guidelines

    • Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association
    • Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s
    More Guidelines
  • Patient leaflets

    COPD: what is it?

    COPD: what treatments work?

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