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 apnoea (OSA), and increased risk for stroke, Alzheimer disease, Alzheimer disease-related dementias, Parkinson-disease dementia, and all-cause dementia.[120][121][122][123][124][125]​​​​​

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 intensive care unit admission and need for mechanical ventilation than patients with similar degrees of obesity but without OHS.[126] One study demonstrated higher risk of postoperative respiratory failure and heart failure following elective non-cardiac surgery in patients with OHS with OSA compared with patients with OSA alone.[127]

Appropriate early treatment of OHS is associated with reduced morbidity and mortality.[40][70]​​​​​​[128]​​​

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 non-invasive ventilation, can have a significant effect on survival and quality of life.[49][78][79][80][83]

COPD

While disease severity will eventually predict outcome in patients with COPD, nocturnal non-invasive ventilation has been shown to improve gas exchange, sleep quality, and quality of life in these patients.[109][110][112] In addition, studies have noted improved survival in hypercapnic COPD patients who received non-invasive ventilation with oxygen therapy, compared with oxygen therapy alone.[111][114]

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.[129] While nocturnal non-invasive ventilation has been shown to improve heart function and significantly improve sleep-disordered breathing, its effect on transplant-free survival remains uncertain.[92][93]

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