Medscape is available in 5 Language Editions – Choose your Edition here.


Hypoventilation Syndromes Differential Diagnoses

  • Author: Jazeela Fayyaz, DO; Chief Editor: Ryland P Byrd, Jr, MD  more...
Updated: Feb 25, 2015
Contributor Information and Disclosures

Jazeela Fayyaz, DO Pulmonologist, Department of Pulmonology, Unity Hospital

Jazeela Fayyaz, DO is a member of the following medical societies: American College of Physicians, American Thoracic Society

Disclosure: Nothing to disclose.


Klaus-Dieter Lessnau, MD, FCCP Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Ryland P Byrd, Jr, MD Professor of Medicine, Division of Pulmonary Disease and Critical Care Medicine, James H Quillen College of Medicine, East Tennessee State University

Ryland P Byrd, Jr, MD is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.


Ryland P Byrd Jr, MD Professor, Department of Internal Medicine, Division of Pulmonary Medicine and Critical Care Medicine, Program Director of Pulmonary Diseases and Critical Care Medicine Fellowship, East Tennessee State University, James H Quillen College of Medicine; Medical Director of Respiratory Therapy, James H Quillen Veterans Affairs Medical Center

Ryland P Byrd Jr, MD is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Nothing to disclose.

Jackie A Hayes, MD, FCCP Clinical Assistant Professor of Medicine, University of Texas Health Science Center at San Antonio; Chief, Pulmonary and Critical Care Medicine, Department of Medicine, Brooke Army Medical Center

Jackie A. Hayes, MD, FCCP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Sat Sharma, MD, FRCPC Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital

Sat Sharma, MD, FRCPC, FACP, FCCP, DABSM is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

  1. Piper AJ, Yee BJ. Hypoventilation syndromes. Compr Physiol. 2014 Oct 1. 4(4):1639-76. [Medline].

  2. Mokhlesi B, Tulaimat A. Recent advances in obesity hypoventilation syndrome. Chest. 2007 Oct. 132(4):1322-36. [Medline].

  3. Paschoal IA, Villalba Wde O, Pereira MC. Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment. J Bras Pneumol. 2007 Feb. 33(1):81-92. [Medline].

  4. Lesser DJ, Ward SL, Kun SS, Keens TG. Congenital hypoventilation syndromes. Semin Respir Crit Care Med. 2009 Jun. 30(3):339-47. [Medline].

  5. Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: Pathophysiology and treatment. Chest. 2007 Feb. 131(2):595-607. [Medline]. [Full Text].

  6. Balachandran JS, Masa JF, Mokhlesi B. Obesity Hypoventilation Syndrome Epidemiology and Diagnosis. Sleep Med Clin. 2014 Sep. 9(3):341-347. [Medline]. [Full Text].

  7. Piper AJ, Grunstein RR. Current perspectives on the obesity hypoventilation syndrome. Curr Opin Pulm Med. 2007 Nov. 13(6):490-6. [Medline].

  8. Mokhlesi B, Tulaimat A, Faibussowitsch I, Wang Y, Evans AT. Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea. Sleep Breath. 2007 Jun. 11(2):117-24. [Medline].

  9. Powers MA. The obesity hypoventilation syndrome. Respir Care. 2008 Dec. 53(12):1723-30. [Medline].

  10. Weitzenblum E, Kessler R, Canuet M, Chaouat A. [Obesity-hypoventilation syndrome]. Rev Mal Respir. 2008 Apr. 25(4):391-403. [Medline].

  11. Alawami M, Mustafa A, Whyte K, Alkhater M, Bhikoo Z, Pemberton J. Echocardiographic and Electrocardiographic findings in Patients with Obesity Hypoventilation Syndrome. Intern Med J. 2014 Nov 5. [Medline].

  12. [Guideline] Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005 Apr 1. 28(4):499-521. [Medline].

  13. Chen ML, Turkel SB, Jacobson JR, Keens TG. Alcohol use in congenital central hypoventilation syndrome. Pediatr Pulmonol. 2006 Mar. 41(3):283-5. [Medline].

  14. Ozsancak A, D'Ambrosio C, Hill NS. Nocturnal noninvasive ventilation. Chest. 2008 May. 133(5):1275-86. [Medline].

  15. [Guideline] Kushida CA, Littner MR, Hirshkowitz M, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep. 2006 Mar 1. 29(3):375-80. [Medline].

  16. [Guideline] Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. National Guidelines Clearinghouse. 2008.

  17. Combs D, Shetty S, Parthasarathy S. Advances in Positive Airway Pressure Treatment Modalities for Hypoventilation Syndromes. Sleep Med Clin. 2014 Sep. 9(3):315-325. [Medline]. [Full Text].

  18. Banerjee D, Yee BJ, Piper AJ, Zwillich CW, Grunstein RR. Obesity hypoventilation syndrome: hypoxemia during continuous positive airway pressure. Chest. 2007 Jun. 131(6):1678-84. [Medline].

  19. Wijesinghe M, Williams M, Perrin K, Weatherall M, Beasley R. The effect of supplemental oxygen on hypercapnia in subjects with obesity-associated hypoventilation: a randomized, crossover, clinical study. Chest. 2011 May. 139(5):1018-24. [Medline].

  20. Lyons HA, Huang CT. Therapeutic use of progesterone in alveolar hypoventilation associated with obesity. Am J Med. 1968 Jun. 44(6):881-8. [Medline].

  21. Morrison DA, Goldman AL. Oral progesterone treatment in chronic obstructive lung disease: failure of voluntary hyperventilation to predict response. Thorax. 1986 Aug. 41(8):616-9. [Medline]. [Full Text].

  22. Johnson W, DeMaria E. Surgical treatment of obesity. Curr Treat Options Gastroenterol. 2006 Apr. 9(2):167-74. [Medline].

  23. Taira T, Takeda N, Itoh K, Oikawa A, Hori T. Phrenic nerve stimulation for diaphragm pacing with a spinal cord stimulator: technical note. Surg Neurol. 2003 Feb. 59(2):128-32; discussion 132. [Medline].

  24. Chen ML, Tablizo MA, Kun S, Keens TG. Diaphragm pacers as a treatment for congenital central hypoventilation syndrome. Expert Rev Med Devices. 2005 Sep. 2(5):577-85. [Medline].

  25. Chakrabarti B, Angus RM. Ventilatory failure on acute take. Clin Med. 2005 Nov-Dec. 5(6):630-4. [Medline].

  26. Adnet F, Plaisance P, Borron SW, Levy A, Payen D. Prolonged severe hypercapnia complicating near fatal asthma in a 35-year-old woman. Intensive Care Med. 1998 Dec. 24(12):1335-8. [Medline].

  27. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999 Aug 1. 22(5):667-89. [Medline].

  28. BaHammam A, Syed S, Al-Mughairy A. Sleep-related breathing disorders in obese patients presenting with acute respiratory failure. Respir Med. 2005 Jun. 99(6):718-25. [Medline].

  29. Caruana-Montaldo B, Gleeson K, Zwillich CW. The control of breathing in clinical practice. Chest. 2000 Jan. 117(1):205-25. [Medline].

  30. Culebras A. Sleep disorders and neuromuscular disease. Semin Neurol. 2005 Mar. 25(1):33-8. [Medline].

  31. De Troyer A, Borenstein S, Cordier R. Analysis of lung volume restriction in patients with respiratory muscle weakness. Thorax. 1980 Aug. 35(8):603-10. [Medline]. [Full Text].

  32. Hoo GW, Hakimian N, Santiago SM. Hypercapnic respiratory failure in COPD patients: response to therapy. Chest. 2000 Jan. 117(1):169-77. [Medline].

  33. Kassirer JP, Madias NE. Respiratory acid-base disorders. Hosp Pract. 1980 Dec. 15(12):57-9, 65-71. [Medline].

  34. Kessler R, Chaouat A, Schinkewitch P, et al. The obesity-hypoventilation syndrome revisited: a prospective study of 34 consecutive cases. Chest. 2001 Aug. 120(2):369-76. [Medline].

  35. Krachman S, Criner GJ. Hypoventilation syndromes. Clin Chest Med. 1998 Mar. 19(1):139-55. [Medline].

  36. Langevin B, Petitjean T, Philit F, Robert D. Nocturnal hypoventilation in chronic respiratory failure (CRF) due to neuromuscular disease. Sleep. 2000 Jun 15. 23 Suppl 4:S204-8. [Medline].

  37. Masa JF, Celli BR, Riesco JA, et al. The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation. Chest. 2001 Apr. 119(4):1102-7. [Medline].

  38. Nixon GM, Brouillette RT. Sleep and breathing in Prader-Willi syndrome. Pediatr Pulmonol. 2002 Sep. 34(3):209-17. [Medline].

  39. O'Donoghue FJ, Catcheside PG, Ellis EE, et al. Sleep hypoventilation in hypercapnic chronic obstructive pulmonary disease: prevalence and associated factors. Eur Respir J. 2003 Jun. 21(6):977-84. [Medline].

  40. Olson AL, Zwillich C. The obesity hypoventilation syndrome. Am J Med. 2005 Sep. 118(9):948-56. [Medline].

  41. Perez de Llano LA, Golpe R, Ortiz Piquer M, Veres Racamonde A, Vazquez Caruncho M, Caballero Muinelos O. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome. Chest. 2005 Aug. 128(2):587-94. [Medline].

  42. Perrin C, D'Ambrosio C, White A, Hill NS. Sleep in restrictive and neuromuscular respiratory disorders. Semin Respir Crit Care Med. 2005 Feb. 26(1):117-30. [Medline].

  43. Plant PK, Owen JL, Elliott MW. One year period prevalence study of respiratory acidosis in acute exacerbations of COPD: implications for the provision of non-invasive ventilation and oxygen administration. Thorax. 2000 Jul. 55(7):550-4. [Medline].

  44. Poulain M, Doucet M, Major GC, Drapeau V, Series F, Boulet LP. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. CMAJ. 2006 Apr 25. 174(9):1293-9. [Medline].

  45. Schlichtig R, Grogono AW, Severinghaus JW. Current status of acid-base quantitation in physiology and medicine. Anesth Clin North Am. 1998. 16 (1):211-33.

  46. Tuggey JM, Elliott MW. Titration of non-invasive positive pressure ventilation in chronic respiratory failure. Respir Med. 2006 Jul. 100(7):1262-9. [Medline].

  47. Ward S, Chatwin M, Heather S, Simonds AK. Randomised controlled trial of non-invasive ventilation (NIV) for nocturnal hypoventilation in neuromuscular and chest wall disease patients with daytime normocapnia. Thorax. 2005 Dec. 60(12):1019-24. [Medline].

  48. Weitzenblum E, Chaouat A. Sleep and chronic obstructive pulmonary disease. Sleep Med Rev. 2004 Aug. 8(4):281-94. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.