A Trial of Rehabilitation in Obesity Hypoventilation Syndrome (OHS)
A Trial of Rehabilitation in Obesity Hypoventilation Syndrome (OHS)
Obesity is an escalating problem in the UK and a proportion of these patients have a
 condition known as Obesity Hypoventilation Syndrome (OHS). This syndrome is associated with
 symptoms of breathlessness, reduction in exercise capacity, fatigue and headaches. Previous
 research has shown that patients with this condition tend to use healthcare services more
 frequently and are often at risk of other diseases such as diabetes mellitus and high blood
 pressure. Currently, the mainstay of treatment is noninvasive ventilation (NIV), this is a
 mask ventilator that patients use overnight to improve oxygen levels and remove carbon
 dioxide (the waste gas of breathing), however this does not fully treat the underlying
 problem. The research group has shown that NIV helps improve activity and contributes to
 weight loss in this group of patients. The aim of this research will be to investigate the
 effect of an exercise and nutrition programme in addition to NIV on weight loss and activity
 levels compared to NIV alone.
Inclusion Criteria:

 -  Diagnosis of OHS

 -  Age >18

 -  BMI > 30 kg/m2

 -  Chronic hypercapnia , daytime PaCO2 >6kPa

 -  FEV1/FVC ≥70%

 -  Evidence of sleep disordered breathing on overnight studies

 -  Tolerated NIV > 4hrs on 1st night during initiation of NIV

 Exclusion Criteria:

 -  Hypercapnic respiratory failure secondary to an identifiable cause other than OHS.

 -  Age <18

 -  Respiratory acidosis (pH <7.35)

 -  Wheelchair/bedbound patients

 -  Cognitive impairment which would prevent the subject from complying with trial
 protocol

 -  Unstable coronary artery syndrome

 -  Patients postintubation or decannulation following treatment requiring acute
 hypercapnic respiratory failure

 -  Patients undergoing renal replacement therapy

 -  Critical peripheral vascular disease

 -  Disabling locomotor disability preventing participation in exercises involved in the
 rehabilitation programme

 -  Pregnancy

 -  Bariatric surgery planned within 3 months