- Pickwickian Syndrome -
a common complication of obesity
The Pickwickian Syndrome is a type of sleep apnea that is associated with extreme obesity. If you are overweight, have problems in breathing, such as hypoventilation, and you have the symptoms of mild or severe obstructive sleep apnea, then you may have this syndrome. This disorder is known for centuries.
During the time of Alexander the Great, there was a leader called Dionysius of Heraclea, who had problems with extreme overweight. He was so fat that he could not eat anymore. In fact, he is reported by historians to have been choked by his own fat.Another example for antic history is Magas, the king of Cyrene, which was also obese and historians said that he was chocked himself to death. This symptoms of pickwickian disorder was described by Dickens in The Posthumous Papers of the Pickwick Club, where a fat boy, Joe, was the person who had this disorder.
What Causes the Pickwickian Syndrome?
There are several factors that comes together to develop this syndrome:- obesity
- sleep apnea
- breathing problems
- lung disease
Some people have a problem with the breathing reflex that allows carbon dioxide to accumulate in their blood. In this way the blood becomes toxic. Obesity may cause shallow breathing by interfering with the work of the breathing muscle. And if the obese person is lying down or sleeping, this abnormal breathing becomes worse. Abnormal breathing in sleep leads to frequent awakenings, apnea episodes, excessive daytime sleepiness, weight gain. And the result is obesity-hypoventilation syndrome, or the pickwickian disorder.
What are the side effects of the Pickwickian Syndrome ?
Here are the most common side effects and complications that results from this breathing disorder:- restless sleep
- excessive daytime sleepiness
- Loss of interest in sex
- hypertension
- stroke
- arrhythmias
- heart enlargement
- heart failure
- secondary polycythemia (excessive red blood cells caused by low oxygen)
- sudden death
What are the treatments ?
Therapy of pickwickian disorder consists mainly of
weight loss
combined with CPAP. There are cases where CPAP is not able to eliminate sleep apnea and low blood oxygen level, so a temporary tracheostomy may be used. If you want to know more about
tracheostomy you can click here.
It is very important to know that weight loss is very effective in reducing the symptoms of this syndrome. The more weight is lost, the more likely it is that the person's breathing will improve. Sleep apnea can be treated this way, but you should maintain your weight loss program after the treatment, or this disorder can return. Weight loss surgery, or
gastric bypass,
is very effective in treating pickwickian syndrome, reducing sleep apnea to the lowest level. However, weight loss surgery is not a simple operation, and should be considered the last alternative in your treatment.
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