Sleep apnea/Obesity hypoventilation syndrome "Pickwickian syndrom" : Part 1
- Daytime sleepiness
- Non-restorative sleep
- Witnessed apneas by bed partner
- Awakening with choking
- Nocturnal restlessness
- Insomnia with frequent awakenings
- Lack of concentration
- Cognitive deficits
- Changes in mood
- Morning headaches
- Vivid, strange, or threatening dreams
- Gastroesophageal reflux
- Obesity
- Large neck circumference
- Systemic hypertension
- Hypercapnia
- Cardiovascular disease
- Cerebrovascular disease
- Cardiac dysrhythmias
- Narrow or "crowded" airway
- Pulmonary hypertension
- Cor pulmonale
- Polycythemia
- Obesity (BMI be >30 kg/m2)
- Arterial blood (special blood draw) showing high CO2 (hypoventilation)
- A different cause of the hypoventilation cannot be identified
- Thyroid function tests to look for hypothyroidism
- Pulmonary function tests, to look for evidence that COPD or a restrictive disease.
- A chest radiograph to look for lung disease, chest wall disease, signs of diaphragm paralysis, and cardiomegaly (enlarged heart).
Published September 23, 2011
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