Prognosis

The natural course for patients with disorders associated with hypoventilation syndromes varies depending on the underlying cause.

Observational data suggest an association between sleep-disordered breathing, especially obstructive sleep apnea (OSA), and increased risk for stroke, Alzheimer disease, Alzheimer disease-related dementias, Parkinson disease dementia, and all-cause dementia.[122][123][124][125][126][127]​​​​​​

Obesity hypoventilation syndrome (OHS)

If left untreated, patients with mild OHS have a lower quality of life, increased somnolence, and more severe pulmonary hypertension compared with patients with OSA. Patients with OHS have a higher rate of ICU admission and need for mechanical ventilation than patients with similar degrees of obesity but without OHS.[128] One study demonstrated higher risk of postoperative respiratory failure and heart failure following elective noncardiac surgery in patients with OHS with OSA compared with patients with OSA alone.[129]

Appropriate early treatment of OHS is associated with reduced morbidity and mortality.[40]​​[71]​​​​[130]​​​

Restrictive thoracic disorders

In many patients with hypoventilation syndrome due to neuromuscular disease, disease progression will eventually affect outcome. However, therapeutic interventions, such as nocturnal noninvasive ventilation, can have a significant effect on survival and quality of life.[50][79][80][81][84]

COPD

While disease severity will eventually predict outcome in patients with COPD, nocturnal noninvasive ventilation has been shown to improve gas exchange, sleep quality, and quality of life in these patients.[110][111][113] In addition, studies have noted improved survival in hypercapnic COPD patients who received noninvasive ventilation with oxygen therapy, compared with oxygen therapy alone.[112][115]

Cheyne-Stokes respiration (CSR)

It has been demonstrated that in patients with congestive heart failure, mortality is higher in those with CSR than in those without CSR, despite a similar degree of heart failure.[131] While nocturnal noninvasive ventilation has been shown to improve heart function and significantly improve sleep-disordered breathing, its effect on transplant-free survival remains uncertain.[93][94]

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