{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T20:13:03Z","timestamp":1762114383716,"version":"build-2065373602"},"reference-count":55,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Obesity hypoventilation syndrome (OHS) is defined by the combination of obesity (body mass index [BMI] \u226530\u2009kg\/m2), sleep-disordered breathing, and daytime hypercapnia (arterial carbon dioxide tension [PaCO2] \u226545\u2009mm Hg at sea level) during wakefulness occurring in the absence of an alternative neuromuscular, mechanical, or metabolic explanation for hypoventilation. Patients with OHS can be classified by phenotypes depending on whether or not they have obstructive respiratory events: hypoventilation and no or not significant obstructive sleep apnea (OSA) and hypoventilation and significant OSA; we also add a third phenotype, which is the hospitalized patient with acute-on-chronic respiratory failure. We describe the mid- and long-term outcomes with and without positive airway pressure (PAP) by these three phenotypes.<\/jats:p>","DOI":"10.1055\/a-2591-5583","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T18:56:47Z","timestamp":1745261807000},"page":"202-212","source":"Crossref","is-referenced-by-count":2,"title":["Phenotypes of Obesity Hypoventilation Syndrome: Characteristics and Outcomes"],"prefix":"10.1055","volume":"46","author":[{"given":"Juan F.","family":"Masa-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Emeritus Pulmonologist in San Pedro de Alc\u00e1ntara Hospital, C\u00e1ceres, Spain"},{"name":"Academic Numerary of the Royal Academy of Medicine in Salamanca University, Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor R.","family":"Ram\u00edrez-Molina","sequence":"additional","affiliation":[{"name":"Department of Pulmonologist and Somnologist Attached to Hospital H+ Quer\u00e9taro, Quer\u00e9taro, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia","family":"De Dios-Calama","sequence":"additional","affiliation":[{"name":"Department of Pulmonologist in the Pulmonary Service San Pedro de Alc\u00e1ntara Hospital, C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1513\/pats.200708-122MG","article-title":"Assessment and management of patients with obesity hypoventilation syndrome","volume":"5","author":"B Mokhlesi","year":"2008","journal-title":"Proc Am Thorac Soc"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1164\/rccm.201410-1900OC","article-title":"Efficacy of different treatment alternatives for obesity hypoventilation syndrome. Pickwick study","volume":"192","author":"J F Masa","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.pulmoe.2020.05.012","article-title":"Effectiveness of different treatments in obesity hypoventilation syndrome","volume":"26","author":"V R Ram\u00edrez Molina","year":"2020","journal-title":"Pulmonology"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"1600959","DOI":"10.1183\/13993003.00959-2016","article-title":"Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep","volume":"49","author":"W Randerath","year":"2017","journal-title":"Eur Respir J"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1136\/thoraxjnl-2019-214403","article-title":"Positive airway pressure in obesity hypoventilation syndrome: is it worth it?","volume":"75","author":"A Piper","year":"2020","journal-title":"Thorax"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1002\/osp4.27","article-title":"The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort","volume":"2","author":"P E Marik","year":"2016","journal-title":"Obes Sci Pract"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1080\/15412555.2017.1317730","article-title":"Non-invasive positive airway pressure in obesity hypoventilation syndrome and chronic obstructive pulmonary disease: present and future perspectives","volume":"14","author":"V R Ram\u00edrez-Molina","year":"2017","journal-title":"COPD"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.chest.2020.03.068","article-title":"Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe OSA: the Pickwick randomized controlled trial","volume":"158","author":"J F Masa","year":"2020","journal-title":"Chest"},{"issue":"151","key":"ref9","doi-asserted-by":"crossref","first-page":"180097","DOI":"10.1183\/16000617.0097-2018","article-title":"Obesity hypoventilation syndrome","volume":"28","author":"J F Masa","year":"2019","journal-title":"Eur Respir Rev"},{"volume-title":"Obesity-Hypoventilation Syndrome","author":"M H Antoine","key":"ref10"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1164\/rccm.201008-1280CI","article-title":"Obesity hypoventilation syndrome: mechanisms and management","volume":"183","author":"A J Piper","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"issue":"03","key":"ref12","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1164\/rccm.201905-1071ST","article-title":"Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society clinical practice guideline","volume":"200","author":"B Mokhlesi","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1152\/japplphysiol.01082.2001","article-title":"Postevent ventilation as a function of CO(2) load during respiratory events in obstructive sleep apnea","volume":"93","author":"K I Berger","year":"1985","journal-title":"J Appl Physiol"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1378\/chest.10-2531","article-title":"Noninvasive ventilation in mild obesity hypoventilation syndrome: a randomized controlled trial","volume":"141","author":"J C Borel","year":"2012","journal-title":"Chest"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1513\/AnnalsATS.201912-887OC","article-title":"The effect of hospital discharge with empiric noninvasive ventilation on mortality in hospitalized patients with obesity hypoventilation syndrome. An individual patient data meta-analysis","volume":"17","author":"B Mokhlesi","year":"2020","journal-title":"Ann Am Thorac Soc"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.cmet.2018.03.001","article-title":"Mechanisms of action and therapeutic application of glucagon-like peptide-1","volume":"27","author":"D J Drucker","year":"2018","journal-title":"Cell Metab"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00125-023-05906-7","article-title":"The expanding incretin universe: from basic biology to clinical translation","volume":"66","author":"D J Drucker","year":"2023","journal-title":"Diabetologia"},{"issue":"09","key":"ref18","doi-asserted-by":"crossref","first-page":"e2433326","DOI":"10.1001\/jamanetworkopen.2024.33326","article-title":"One-year weight reduction with semaglutide or liraglutide in clinical practice","volume":"7","author":"H Gasoyan","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"09","key":"ref19","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1001\/jamainternmed.2024.2525","article-title":"Semaglutide vs tirzepatide for weight loss in adults with overweight or obesity","volume":"184","author":"P J Rodriguez","year":"2024","journal-title":"JAMA Intern Med"},{"issue":"24","key":"ref20","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and cardiovascular outcomes in obesity without diabetes","volume":"389","author":"A M Lincoff","year":"2023","journal-title":"N Engl J Med"},{"key":"ref21","first-page":"17","article-title":"Risk of major adverse cardiovascular events and all-cause mortality under treatment with GLP-1 RAs or the dual GIP\/GLP-1 receptor agonist tirzepatide in overweight or obese adults without diabetes: a systematic review and meta-analysis","volume":"17","author":"M-I Stefanou","year":"2024","journal-title":"Ther Adv Neurol Disord"},{"issue":"13","key":"ref22","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1056\/NEJMoa2404881","article-title":"Tirzepatide for the treatment of obstructive sleep apnea and obesity","volume":"391","author":"A Malhotra","year":"2024","journal-title":"N Engl J Med"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1513\/AnnalsATS.202309-821OC","article-title":"Continuous positive airway pressure but not GLP1-mediated weight loss improves early cardiovascular disease in obstructive sleep apnea: a randomized proof-of-concept study","volume":"21","author":"C O'Donnell","year":"2024","journal-title":"Ann Am Thorac Soc"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1007\/s11325-022-02768-y","article-title":"Efficacy and safety of liraglutide in patients with type 2 diabetes mellitus and severe obstructive sleep apnea","volume":"27","author":"W Jiang","year":"2023","journal-title":"Sleep Breath"},{"issue":"08","key":"ref25","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1038\/ijo.2016.52","article-title":"Effect of liraglutide 3.0\u2009mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial","volume":"40","author":"A Blackman","year":"2016","journal-title":"Int J Obes (Lond)"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1164\/arrd.1983.128.1.177","article-title":"Remission of severe obesity-hypoventilation syndrome after short-term treatment during sleep with nasal continuous positive airway pressure","volume":"128","author":"C E Sullivan","year":"1983","journal-title":"Am Rev Respir Dis"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1378\/chest.07-0027","article-title":"Recent advances in obesity hypoventilation syndrome","volume":"132","author":"B Mokhlesi","year":"2007","journal-title":"Chest"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"e52006","DOI":"10.1371\/journal.pone.0052006","article-title":"Comorbidities and mortality in hypercapnic obese under domiciliary noninvasive ventilation","volume":"8","author":"J C Borel","year":"2013","journal-title":"PLoS One"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1378\/chest.120.2.377","article-title":"The use of health-care resources in obesity-hypoventilation syndrome","volume":"120","author":"G Berg","year":"2001","journal-title":"Chest"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"103","DOI":"10.5664\/jcsm.2398","article-title":"Morbidity prior to a diagnosis of sleep-disordered breathing: a controlled national study","volume":"9","author":"P Jennum","year":"2013","journal-title":"J Clin Sleep Med"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.chest.2016.02.647","article-title":"Protective cardiovascular effect of sleep apnea severity in obesity hypoventilation syndrome","volume":"150","author":"J F Masa","year":"2016","journal-title":"Chest"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jsmc.2024.02.009","article-title":"Obstructive sleep apnea, obesity hypoventilation syndrome, and pulmonary hypertension: a state-of-the-art review","volume":"19","author":"S Bjork","year":"2024","journal-title":"Sleep Med Clin"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.amjmed.2003.08.022","article-title":"Obesity-associated hypoventilation in hospitalized patients: prevalence, effects, and outcome","volume":"116","author":"S Nowbar","year":"2004","journal-title":"Am J Med"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/j.1365-2796.2007.01765.x","article-title":"Mortality and prognostic factors in patients with obesity-hypoventilation syndrome undergoing noninvasive ventilation","volume":"261","author":"S Budweiser","year":"2007","journal-title":"J Intern Med"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"101530","DOI":"10.1016\/j.smrv.2021.101530","article-title":"Cardiovascular disease in obesity hypoventilation syndrome\u2014a review of potential mechanisms and effects of therapy","volume":"60","author":"Y Zheng","year":"2021","journal-title":"Sleep Med Rev"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.chest.2016.02.659","article-title":"Reduced cardiovascular morbidity in obesity-hypoventilation syndrome: an ischemic preconditioning protective effect?","volume":"150","author":"L Lavie","year":"2016","journal-title":"Chest"},{"issue":"10","key":"ref37","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1136\/thoraxjnl-2016-208501","article-title":"Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea","volume":"71","author":"J F Masa","year":"2016","journal-title":"Thorax"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2147\/NSS.S369316","article-title":"Results of CPAP titration and short-term adherence rates in patients with obesity hypoventilation syndrome and mild\/moderate obstructive sleep apnea","volume":"14","author":"A S BaHammam","year":"2022","journal-title":"Nat Sci Sleep"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1378\/chest.09-2472","article-title":"Long-term outcome of noninvasive positive pressure ventilation for obesity hypoventilation syndrome","volume":"138","author":"P Priou","year":"2010","journal-title":"Chest"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1378\/chest.120.2.369","article-title":"The obesity-hypoventilation syndrome revisited: a prospective study of 34 consecutive cases","volume":"120","author":"R Kessler","year":"2001","journal-title":"Chest"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1016\/S0140-6736(18)32978-7","article-title":"Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial","volume":"393","author":"J F Masa","year":"2019","journal-title":"Lancet"},{"issue":"05","key":"ref42","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1136\/thx.2007.081315","article-title":"Randomised trial of CPAP vs bilevel support in the treatment of obesity hypoventilation syndrome without severe nocturnal desaturation","volume":"63","author":"A J Piper","year":"2008","journal-title":"Thorax"},{"issue":"07","key":"ref43","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1111\/resp.12131","article-title":"Continuous positive airway pressure in clinically stable patients with mild-to-moderate obesity hypoventilation syndrome and obstructive sleep apnoea","volume":"18","author":"N Salord","year":"2013","journal-title":"Respirology"},{"issue":"11","key":"ref44","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.5664\/jcsm.8712","article-title":"CPAP titration failure is not equivalent to long-term CPAP treatment failure in patients with obesity hypoventilation syndrome: a case series","volume":"16","author":"A C Lastra","year":"2020","journal-title":"J Clin Sleep Med"},{"issue":"08","key":"ref45","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/j.1440-1843.2012.02252.x","article-title":"Haemodynamic effects of non-invasive ventilation in patients with obesity-hypoventilation syndrome","volume":"17","author":"O Castro-A\u00f1\u00f3n","year":"2012","journal-title":"Respirology"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1164\/rccm.201906-1122OC","article-title":"Echocardiographic changes with positive airway pressure therapy in obesity hypoventilation syndrome","volume":"201","author":"J F Masa","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"e0117808","DOI":"10.1371\/journal.pone.0117808","article-title":"Obesity-hypoventilation syndrome: increased risk of death over sleep apnea syndrome","volume":"10","author":"O Castro-A\u00f1\u00f3n","year":"2015","journal-title":"PLoS One"},{"issue":"05","key":"ref48","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1136\/thoraxjnl-2016-208559","article-title":"A randomised controlled trial of CPAP versus non-invasive ventilation for initial treatment of obesity hypoventilation syndrome","volume":"72","author":"M E Howard","year":"2017","journal-title":"Thorax"},{"issue":"02","key":"ref49","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s11325-020-02177-z","article-title":"Long-term effectiveness of CPAP in patients with severe obesity-hypoventilation syndrome","volume":"25","author":"L P de Llano","year":"2021","journal-title":"Sleep Breath"},{"issue":"03","key":"ref50","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.arbres.2021.05.019","article-title":"Effectiveness of CPAP vs. noninvasive ventilation based on disease severity in obesity hypoventilation syndrome and concomitant severe obstructive sleep apnea","volume":"58","author":"J F Masa","year":"2022","journal-title":"Arch Bronconeumol"},{"issue":"04","key":"ref51","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1136\/thoraxjnl-2017-210642","article-title":"Echocardiographic changes with non-invasive ventilation and CPAP in obesity hypoventilation syndrome","volume":"73","author":"J Corral","year":"2018","journal-title":"Thorax"},{"issue":"06","key":"ref52","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1136\/thoraxjnl-2019-213622","article-title":"Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea","volume":"75","author":"J F Masa","year":"2020","journal-title":"Thorax"},{"issue":"07","key":"ref53","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1136\/thx.2010.143958","article-title":"Health, social and economical consequences of sleep-disordered breathing: a controlled national study","volume":"66","author":"P Jennum","year":"2011","journal-title":"Thorax"},{"issue":"12","key":"ref54","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1164\/rccm.201206-1101OC","article-title":"Noninvasive ventilation in acute hypercapnic respiratory failure caused by obesity hypoventilation syndrome and chronic obstructive pulmonary disease","volume":"186","author":"A Carrillo","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"544A","DOI":"10.1378\/chest.1784265","article-title":"Results of noninvasive ventilation in obese patients with acute respiratory","volume":"145","author":"C Romero","year":"2014","journal-title":"Chest"}],"container-title":["Seminars in Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2591-5583.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T22:32:53Z","timestamp":1754087573000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2591-5583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":55,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,8,1]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2591-5583","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1069-3424","1098-9048"],"issn-type":[{"type":"print","value":"1069-3424"},{"type":"electronic","value":"1098-9048"}],"subject":[],"published-other":{"date-parts":[[2025,4,21]]},"published":{"date-parts":[[2025,4]]}}}