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How Is Obesity Hypoventilation Syndrome Treated?

Treatments for obesity hypoventilation syndrome (OHS) include breathing support, weight loss, and medicines.

The goals of treating OHS may include:

  • Supporting and aiding your breathing
  • Achieving major weight loss
  • Treating underlying and related conditions

Breathing Support

Positive Airway Pressure

Treatment for OHS often involves a machine that provides positive airway pressure (PAP) while you sleep.

PAP therapy uses mild air pressure to keep your airways open. This treatment can help your body better maintain the carbon dioxide and oxygen levels in your blood. PAP therapy also can help relieve daytime sleepiness.

Your doctor might recommend CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure). CPAP provides continuous mild air pressure to keep your airways open. BiPAP works almost the same, but it changes the air pressure while you breathe in and out.

The machines have three main parts:

  • A mask or other device that fits over your nose or your nose and mouth. Straps keep the mask in place while you're wearing it.
  • A tube that connects the mask to the machine's motor.
  • A motor that blows air into the tube.

Some machines have other features, such as heated humidifiers. The machines are small, lightweight, and fairly quiet. The noise they make is soft and rhythmic.

Some people who have OHS receive extra oxygen as part of their PAP treatment. However, oxygen therapy alone isn't recommended as a treatment for OHS.

PAP therapy also is used to treat obstructive sleep apnea. Many people who have OHS also have this common condition.

If your doctor prescribes PAP therapy, you'll work with someone from a home equipment provider to select a CPAP or BiPAP machine. The home equipment provider will help you pick a machine based on your prescription and the features that meet your needs.

Ventilator Support

If you have severe OHS that requires treatment in a hospital, you might be put on a ventilator. A ventilator is a machine that supports breathing. This machine:

  • Gets oxygen into your lungs
  • Removes carbon dioxide from your body
  • Helps you breathe easier

A ventilator blows air, or air with extra oxygen, into the airways through a breathing tube. One end of the tube is inserted into your windpipe, and the other end is hooked to the ventilator.

Usually, the breathing tube is put into your nose or mouth and then moved down into your throat. A tube placed like this is called an endotracheal (en-do-TRA-ke-al) tube. Endotracheal tubes are used only in a hospital setting.

Sometimes the breathing tube is placed through a surgically made hole called a tracheostomy (TRA-ke-OS-toe-me). The hole goes through the front of your neck and into your windpipe.

The procedure to make a tracheostomy usually is done in an operating room. You'll be given medicine so you won't feel any pain. The tracheostomy allows you to be on a ventilator in the hospital, in a long-term care facility, or at home.

Talk with your doctor about how long you'll need ventilator support and whether you can receive treatment at home.

For more information about ventilator support, go to the Health Topics  Ventilator/Ventilator Support article.

Weight Loss

Your doctor will likely recommend weight loss as part of your treatment plan. Successful weight loss often involves setting goals and making lifestyle changes. For example, eating fewer calories and being physically active can help you lose weight.

Medicines and weight-loss surgery might be an option if lifestyle changes aren't enough. Your doctor will advise you on the best weight-loss treatment for you.

For more information about weight loss, go to the treatment section of the Health Topics Overweight and Obesity article.


Your doctor may prescribe medicines to treat OHS (although this treatment is less common than others).

Your doctor also may advise you to avoid certain substances and medicines that can worsen OHS. Examples include alcohol, sedatives, and narcotics. They can interfere with how well your body is able to maintain normal carbon dioxide and oxygen levels.

If you're having surgery, make sure you tell your surgeon and health care team that you have OHS. Some medicines routinely used for surgery can worsen your condition.

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Updated: January 27, 2012