Syndrome of the Week

The obesity hypoventilation syndrome, also known as Pickwickian syndrome, is the combination of obesity (body mass index above 30 kg/m2), falling oxygen levels in blood (hypoxia) during sleep and increasing carbon dioxide levels (hypercapnia); this is the result of hypoventilation (excessively slow or shallow breathing) during sleep. Obstructive sleep apnea is often but not necessarily present.

It may cause dyspnea (difficulty breathing), poor sleep with daytime tiredness, leg swelling and various other symptoms. The main treatments are weight loss and nocturnal ventilation (with CPAP or related methods). The exact cause is unknown.

The condition was first described in 1956 in a patient who, after gaining weight, became somnolent and fatigued and prone to fall asleep during the day, as well as developing edema of the legs suggesting heart failure.

The authors coined the newly described condition "Pickwickian syndrome" after the character Joe from Dickens' The Posthumous Papers of the Pickwick Club (1837), who was markedly obese and tended to fall asleep uncontrollably during the day.