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Obesity Hypoventilation Syndrome. Obesity hypoventilation syndrome has been noted for centuries, yet we still are trying to uncover the exact mechanisms behind the disease and best treatment modalities for patients afflicted by the condition. The syndrome, which results in symptoms based on a diverse spectrum of interactions between obesity, ventilatory drive, and sleep's impact on respiration, has been shown to worsen morbidity and mortality far beyond that of more typical sleep-disordered breathing. In this article, the authors discuss current knowledge and research about the epidemiology, pathophysiology, and clinical features, along with treatment considerations of obesity hypoventilation syndrome.