Keywords
Abstract
Background: Obesity Hypoventilation Syndrome (OHS) is a complex respiratory disorder characterized by obesity (BMI ≥30 kg/m²), chronic alveolar hypoventilation, and sleep-disordered breathing, often accompanied by metabolic and psychological comorbidities. Depression is one of the most prevalent mental health issues among individuals with OHS, exacerbating disease burden and reducing quality of life. Physical activity has been shown to improve both physiological and psychological outcomes in obese and chronically ill populations; however, limited data exist regarding its association with depression in patients suffering from OHS.
Objective: To determine the association between the level of physical activity and the degree of depression among patients with Obesity Hypoventilation Syndrome.
Methodology: This analytical cross-sectional study was conducted in the Pulmonology Department of Lady Reading Hospital, Peshawar, over six months (January–June 2024). A total of 197 clinically diagnosed OHS patients aged 25–65 years were recruited through non-probability convenient sampling. The International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels, the Patient Health Questionnaire-9 (PHQ-9) to evaluate depression, and Body Mass Index (BMI) was calculated for obesity classification. Data were analyzed using SPSS v23. Chi-square and regression analyses were applied to explore the association between physical activity and depression.
Results: Among 197 participants, females constituted 61.4% and males 38.6%, with a mean age of 45.6 ± 10.3 years. Most participants (45.2%) reported low physical activity levels, and 28.9% had moderately severe depression. The Chi-square test revealed a statistically significant association between lower physical activity levels and higher depression severity (p < 0.001). Regression analysis confirmed that decreased physical activity independently predicted higher PHQ-9 scores after adjusting for age, gender, and BMI.
Conclusion: The study demonstrated a strong negative association between physical activity and depression among patients with Obesity Hypoventilation Syndrome. Incorporating tailored exercise programs into rehabilitation and management plans may mitigate depressive symptoms, enhance functional capacity, and improve overall quality of life in OHS patients.
References
1. Andrade, R., et al., Impact of treating obesity hypoventilation syndrome on body mass index. Pulmonology, 2023.
2. Brown, L.K., Hypoventilation syndromes. Clinics in chest medicine, 2010. 31(2): p. 249-270.
3. Zheng, Y., et al., Cardiovascular disease in obesity hypoventilation syndrome–A review of potential mechanisms and effects of therapy. Sleep Medicine Reviews, 2021. 60: p. 101530.
4. Fadl, A.A., et al., Overview on Pediatric Obesity Hypoventilation Syndrome. Saudi Medical Horizons Journal, 2023. 3(3): p. 110-117.
5. Vu, E.L., et al., Cerebral autoregulation during orthostatic challenge in congenital central hypoventilation syndrome. American journal of respiratory and critical care medicine, 2022. 205(3): p. 340-349.
6. Duan, D. and J.C. Jun, Obesity, Metabolic Syndrome, and Sleep Disorders, in Metabolic Syndrome: A Comprehensive Textbook. 2024, Springer. p. 639-658.
7. Vanek, J., et al., Obstructive sleep apnea, depression and cognitive impairment. Sleep medicine, 2020. 72: p. 50-58.
8. Mokhlesi, B., et al., Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society clinical practice guideline. American journal of respiratory and critical care medicine, 2019. 200(3): p. e6-e24.
9. Joshi, J.M. and R.N. Bharmal, Obesity hypoventilation syndrome: new insights in diagnosis and management. Indian Journal of Sleep Medicine, 2020. 15(1): p. 9-14.
10. Athayde, R.A.B.d., et al., Obesity hypoventilation syndrome: a current review. Jornal Brasileiro de Pneumologia, 2018. 44: p. 510-518.
11. Tzitzili, E., et al., Diagnosis and Evaluation of Upper Airway Disorders in Noninvasive Ventilator Support: Endoscopy Evaluation, in Upper Airway Disorders and Noninvasive Mechanical Ventilation: Rationale and Approaches. 2023, Springer. p. 371-378.
12. Bouloukaki, I., et al., 0516 LONG TERM EFFECTS OF COMPLIANCE WITH POSITIVE AIRWAY PRESSURE (PAP) THERAPY IN PATIENTS WITH OBESITY HYPOVENTILATION SYNDROME (OHS). Sleep, 2017. 40: p. A192.
13. Zheng, Y., et al., P065 A Comparison of Two Obesity Related Hypoventilation Disorders–Impact on Sleep, Quality of Life and Neurocognitive Outcomes and the Effects of PAP Therapy. Sleep Advances: A Journal of the Sleep Research Society, 2023. 4(Suppl 1): p. A59.
14. Argun Baris, S., et al., The effect of positive airway pressure therapy on neurocognitive functions, depression and anxiety in obesity hypoventilation syndrome. Multidisciplinary Respiratory Medicine, 2016. 11: p. 1-11.
15. d Genta, P.R., Obesity hypoventilation syndrome: a current review. 2018.
16. Athayde, R.A.B.d., et al., Obesity hypoventilation syndrome: a current review. Jornal Brasileiro de Pneumologia, 2018. 44(06): p. 510-518.
17. Agossou, M., et al., Factors associated with the efficiency of home non-invasive ventilation in patients with obesity-hypoventilation syndrome in Martinique. Journal of Clinical Medicine, 2023. 12(10): p. 3381.
18. Andrade, R., et al., Impact of treating obesity hypoventilation syndrome on body mass index. Pulmonology, 2025. 31(1): p. 2416816.
19. BaHammam, A.S., et al., Prevalence of hypothyroidism in a large sample of patients with obesity hypoventilation syndrome. Nature and Science of Sleep, 2020: p. 649-659.
20. Bishara, J., T.G. Keens, and I.A. Perez, The genetics of congenital central hypoventilation syndrome: clinical implications. The Application of Clinical Genetics, 2018: p. 135-144.
21. Zheng, Y., et al., A comparison of two obesity-related hypoventilation disorders: Impact on sleep, quality of life and neurocognitive outcomes and the effects of positive airway pressure therapy. Sleep Advances, 2024. 5(1): p. zpae016.
22. Zheng, Y., et al., P065 A Comparison of Two Obesity Related Hypoventilation Disorders–Impact on Sleep, Quality of Life and Neurocognitive Outcomes and the Effects of PAP Therapy. SLEEP Advances, 2023. 4: p. A59.
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