Obesity-related breathing disorders: "State of the Art"

Obesity-related breathing disorders include obstructive sleep apnea, sleep-related alveolar hypoventilation, and full-blown obesity hypoventilation syndrome. The pathophysiology is based on obesity-related changes of the respiratory system, with upper-airway collapsibility, reduced thoracic compliance, increased intrinsic positive end-expiratory pressure, increased ventilation-perfusion mismatch, and reduced carbon dioxide sensitivity. There is a close correlation with metabolic and cardiovascular diseases such as heart failure, coronary heart disease, and pulmonary hypertension. Depending on the pathophysiological accentuation, continuous and bilevel positive pressure are established therapy-methods.