수면정신생리

수면정신생리 (22권1호 30-34)

A Case of Rapidly Developed Obesity Hypoventilation Syndrome in a Patient with Kyphoscoliosis

척추후측만증 환자에서 급속히 진행된 비만성 저환기 증후군 1례

Kim, Min Young;Jeong, Jee Sun;Jang, Yu Na;Go, Se-eun;Lee, Sang Haak;Moon, Hwa Sik;Kang, Hyeon Hui;

Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;Department of Internal medicine, College of Medicine, St. Paul''s Hospital, The Catholic University of Korea;

DOI : http://dx.doi.org/10.14401/KASMED.2015.22.1.30

Abstract

Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.

Keywords

Obesity hypoventilation syndrome;Kyphoscoliosis;Obstructive sleep apnea;Bilevel positive airway pressure;