Pickwickian Syndrome

What is Pickwickian Syndrome?

Pickwickian syndrome is an obesity-related hypoventilation condition combined with sleep apnea. Pickwickian syndrome usually presents with high levels of carbon dioxide and low levels of oxygen in your blood and body. People with this condition experience difficulty breathing when they sleep, which can lead to a series of related health problems. Pickwickian syndrome is also known as obesity hypoventilation syndrome.

Signs & Symptoms

Pickwickian syndrome results in symptoms related to fatigue, energy, and mental health.

Pickwickian syndrome symptoms include:

  • Fatigue—You feel tired, sleepy, and generally experience low energy.
  • Mental health issues—Depression is linked to this condition.
  • Snoring—You may snore at night.
  • Discolored appendages—The tips of your fingers and toes might look bluish.
  • Swelling—Swollen feet or legs are common side effects.
  • Sleep disturbances—You may have trouble sleeping because your condition repeatedly wakes you up at night.
  • Trouble breathing—The low levels of oxygen in your blood can cause you to feel shortness of breath.
  • Headaches—You may feel frequent headaches during the day or night.

Risk Factors

The most common risk factor for Pickwickian syndrome is obesity.

Other risk factors:

  • Gender—Males develop the condition slightly more than females.
  • Age—Individuals between the age of 42 and 61 are at the highest risk.
  • Other health conditions—People with sleep apnea or other breathing disorders are at an increased risk for Pickwickian disease.


Pickwickian syndrome is an obesity disorder that affects the respiratory system. People with this disorder have a reduced capacity to process carbon dioxide, which can accumulate in your body. The direct cause of Pickwickian syndrome is unknown.

Potential Pickwickian syndrome causes:

  • Respiratory issues
  • Excess hormones
  • Neurological defects


Your doctor will make a Pickwickian syndrome diagnosis after performing a medical exam, testing your lung function, observing your sleep habits, conducting imaging tests, and analyzing the levels of oxygen and carbon dioxide in your blood.

Medical Examination

Obesity hypoventilation syndrome diagnosis starts with a routine appointment with your doctor. They will investigate your medical history and current symptoms. They will also perform a physical exam, paying close attention to your weight and other signs of the disease.

Lung Function Tests

In order to check how well your lungs function, your doctor may order a lung function test. This is also called a pulmonary function test. This test will measure how much air you can breathe in and out, as well as how quickly you can breathe. Your doctor may also perform a pulse oximetry test to measure the oxygen present in your blood. The results of these tests will help your doctor determine the severity of your Pickwickian syndrome.

Lab Tests

Your doctor may also order blood tests to check the levels of oxygen and carbon dioxide in your blood. This will help them rule out other conditions that often mimic Pickwickian syndrome.

Imaging Tests

Imaging tests, such as a chest X-ray or computed tomography (CT) scan, can assist doctors in evaluating your lungs and heart. These tests help rule out other possible causes of your symptoms.

Sleep Studies

In order to confirm a Pickwickian syndrome diagnosis, your doctor may also order a sleep study. Sleep studies include daytime or overnight monitoring of your sleep patterns, breathing, and oxygen levels.

These tests will help determine if you have trouble breathing during sleep, which is a common symptom of Pickwickian syndrome.


Pickwickian syndrome treatment varies by severity, cause, and patient health profile. There are non-surgical and surgical treatment options.

Nonsurgical Treatment

Your doctor might suggest a breathing apparatus called a positive airway pressure (PAP) machine to prevent sleep apnea and the resulting oxygen deprivation.

If you experience sleep apnea, you might need a machine that delivers air pressure through a mask while you sleep. The most common type is called continuous positive airway pressure (CPAP). It keeps your airway open so that you can breathe throughout the night.

Your doctor may also prescribe medication to stimulate your respiratory system. Along with medication, lifestyle changes to exercise and nutrition often help reduce the symptoms of Pickwickian syndrome.

Surgical Treatment

If you do not respond to other treatments, another option is bariatric surgery. This type of surgery is generally only recommended for people who are severely obese and have not been able to lose weight with other methods.

Bariatric surgery often involves reducing the size and shape of your stomach. The surgery helps you feel full sooner, prevent absorption, and allow food to bypass part of your small intestine.


The most effective way to prevent Pickwickian syndrome is weight loss and weight management.

Pickwickian syndrome prevention methods:

  • Avoid obesity
  • Exercise regularly
  • Increase activity
  • Eat a healthy diet

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