{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:21:34Z","timestamp":1787016094625,"version":"build-2736575974"},"reference-count":72,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Obesity\u2010related respiratory failure is increasingly common but remains under\u2010diagnosed and under\u2010treated. There are several clinical phenotypes reported, including severe obstructive sleep apnoea (OSA), isolated nocturnal hypoventilation with or without severe OSA and OSA complicating chronic obstructive pulmonary disease (COPD). The presence of hypercapnic respiratory failure is associated with poor clinical outcomes in each of these groups. While weight loss is a core aim of management, this is often unachievable, and treatment of sleep\u2010disordered breathing with positive airway pressure (PAP) therapy is the mainstay of clinical practice. Although there are few long\u2010term clinical efficacy trials, the lack of equipoise would prevent the utilization of an untreated control group. The current data support the use of PAP therapy to improve respiratory failure and is associated with improvements in health\u2010related quality of life, reduced healthcare utilization and reduced mortality. Both continuous PAP (CPAP) and non\u2010invasive ventilation (NIV) appear safe and effective in patients with obesity\u2010related respiratory failure and OSA, with or without COPD, and the current evidence would not support a single therapy choice in all patients. There are no studies of CPAP in patients with isolated nocturnal hypoventilation, and NIV would be the current recommendation in this patient group. Whichever starting therapy is used, titration should be performed to correct sleep\u2010disordered breathing and reverse chronic respiratory failure, with consideration of step\u2010down of the treatment based on a clinical re\u2010evaluation. In contrast, failure to reach physiological and clinical treatment targets should lead to the consideration of treatment escalation.<\/jats:p>","DOI":"10.1111\/resp.13588","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T19:48:42Z","timestamp":1558640922000},"page":"952-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Non\u2010invasive ventilation for obese patients with chronic respiratory failure: Are two pressures always better than one?"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1500-611X","authenticated-orcid":false,"given":"Patrick B.","family":"Murphy","sequence":"first","affiliation":[{"name":"Lane Fox Respiratory Service Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"},{"name":"Centre for Human and Applied Physiological Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4883-0084","authenticated-orcid":false,"given":"Eui\u2010Sik","family":"Suh","sequence":"additional","affiliation":[{"name":"Lane Fox Respiratory Service Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"},{"name":"Centre for Human and Applied Physiological Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hart","sequence":"additional","affiliation":[{"name":"Lane Fox Respiratory Service Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"},{"name":"Centre for Human and Applied Physiological Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO. Obesity and overweight.2018. [Accessed 26 Sept 2018.] Available from URL:http:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00043-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.667"},{"key":"e_1_2_9_5_1","first-page":"1347","article-title":"Obesity hypoventilation syndrome: a state\u2010of\u2010the\u2010art review","volume":"55","author":"Mokhlesi B","year":"2010","journal-title":"Respir. Care"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000527"},{"key":"e_1_2_9_7_1","first-page":"236","article-title":"Chronic obstructive pulmonary disease and obstructive sleep apnoea\u2010the overlap syndrome","volume":"8","author":"McNicholas WT","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-0626"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.105.2.434"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1983.128.1.177"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.081315"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.4.1102"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200412-1631SO"},{"key":"e_1_2_9_14_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications","author":"Iber C","year":"2007"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.37.11.840"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1961.16.1.15"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1981.51.3.557"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01082.2001"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00502.2005"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104957"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205148"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)91171-3"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000195504"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.5.9809025"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.81.2.716"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.1.75"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602013340503"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.5.1334"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204389"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00959-2016"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.02.647"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2005.10.033"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.556746"},{"key":"e_1_2_9_34_1","first-page":"A354","article-title":"Long term positive airway pressure effectiveness in obesity hypoventilation syndrome. Pickwick Study results","volume":"52","author":"Quiroga MAS","year":"2018","journal-title":"Eur. Respir. J."},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-201081"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.4451"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)00017-X"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200912-1869OC"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208501"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2006.11.005"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-2896(03)75388-5"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07445-7"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00043306"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta13040"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-2531"},{"key":"e_1_2_9_46_1","doi-asserted-by":"crossref","unstructured":"MasaJF CorralJ AlonsoML OrdaxE TroncosoMF GonzalezM Lopez\u2010MartinezS MarinJM MartiS Diaz\u2010CambrilesTet al.;Spanish Sleep Network. Efficacy of different treatment alternatives for obesity hypoventilation syndrome. Pickwick study.Am. J. Respir. Crit. Care Med.2015;192:86\u201395.","DOI":"10.1164\/rccm.201410-1900OC"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12131"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.3.815"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2848"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.03.013"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208559"},{"key":"e_1_2_9_52_1","first-page":"A4780","article-title":"Home mechanical ventilation (HMV): setup and outcome in Europe","volume":"46","author":"Patout M","year":"2015","journal-title":"Eur. Respir. J."},{"key":"e_1_2_9_53_1","unstructured":"CorralJ MogollonMV Sanchez\u2010QuirogaMA Gomez de TerrerosJ RomeroA Alonso\u2010AlvarezML Gomez\u2010GarciaT GonzalezM Lopez\u2010MartinezS deLucasPet al.;Spanish Sleep Network. Echocardiographic changes with non\u2010invasive ventilation and CPAP in obesity hypoventilation syndrome.Thorax2018;73:361\u20138."},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbr.2016.01.012"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0391-9"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1159\/000368615"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00004311"},{"key":"e_1_2_9_58_1","first-page":"389","article-title":"Self\u2010reported sleep quality and acute exacerbations of chronic obstructive pulmonary disease","volume":"10","author":"Geiger\u2010Brown J","year":"2015","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1159\/000235619"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00085804"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/21548331.2016.1134268"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2916"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70153-5"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-14-66"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198010303031804"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204993"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-014-9614-5"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1986.134.5.920"},{"key":"e_1_2_9_69_1","first-page":"275","article-title":"Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?","volume":"8","author":"Faria AC","year":"2015","journal-title":"Int. J. Gen. Med."},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/948717"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/31.1.141"},{"key":"e_1_2_9_72_1","article-title":"Polysomnography versus limited respiratory monitoring and nurse\u2010led titration to optimise non\u2010invasive ventilation set\u2010up: a pilot randomised clinical trial","author":"Patout M","year":"2018","journal-title":"Thorax"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00205714"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fresp.13588","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.13588","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/resp.13588","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.13588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T20:39:26Z","timestamp":1694205566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.13588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,23]]},"references-count":72,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/resp.13588"],"URL":"https:\/\/doi.org\/10.1111\/resp.13588","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,23]]},"assertion":[{"value":"2019-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}