Abstract
Rationale: Obesity hypoventilation syndrome (OHS) incidence may be increasing with the obesity epidemic. Despite extensive noninvasive ventilation (NIV) and continuous positive airway pressure (CPAP) use, information regarding efficacy is limited.
Objectives: We performed a large multicenter randomized controlled study to determine the comparative efficacy of NIV, CPAP, and lifestyle modification (control group).
Methods: Sequentially screened OHS patients with severe sleep apnea were randomized into the above-mentioned groups for a two-month follow-up. Arterial blood gases parameters, clinical symptoms, health-related quality-of-life assessments, polysomnography, spirometry, six-minute walk distance (6-MWD), dropouts, compliance, and side effects were evaluated. Statistical analysis was performed using intention-to-treat analysis, although adjustments for CPAP and NIV compliance were also analyzed.
Results: 221 patients were randomized. NIV yielded the greatest improvement in PaCO2 and bicarbonate, with significant differences relative to the control. In the CPAP group, PaCO2 improvement was significantly different than in the control group only after CPAP compliance adjustment. Clinical symptoms and polysomnographic parameters improved similarly with NIV and CPAP relative to the control. However, the spirometry and 6-MWD results improved more with NIV than CPAP. Dropouts were similar between groups, and compliance and secondary effects were similar between NIV and CPAP.
- Copyright ©ERS 2015
