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48-469: OHS may refer to: Medicine [ edit ] Obesity hypoventilation syndrome Occipital horn syndrome Other [ edit ] Occupational safety and health Occupational Health Science , a scholarly journal published by the Society for Occupational Health Psychology Oh's , a brand of cereals Oracle HTTP Server Over head system ,

96-675: A need-blind admissions process for both domestic and international students, with its commitment to ensuring that both continuing and newly admitted students can attend, regardless of their financial situation. In the 2023-2024 school year, Stanford OHS allocated over $ 2.5 million in financial aid and Malone Scholarships. This substantial financial aid effort resulted in more than half of the beneficiaries receiving financial aid awards covering 75% or more of their tuition costs, whether they were enrolled full-time, part-time, or in single courses. The range of financial aid awards varies from 10% to 100% of tuition costs. These awards are determined based on

144-522: A condition characterized by snoring , brief episodes of apnea (cessation of breathing) during the night, interrupted sleep and excessive daytime sleepiness . In OHS, sleepiness may be worsened by elevated blood levels of carbon dioxide , which causes drowsiness ("CO 2 narcosis"). Other symptoms present in both conditions are depression , and hypertension (high blood pressure) which is difficult to control with medication . The high carbon dioxide can also cause headaches , which tend to be worsening in

192-557: A lower BMI as a result of physical characteristics. It is anticipated that rates of OHS will rise as the prevalence of obesity rises. This may also explain why OHS is more commonly reported in the United States , where obesity is more common than in other countries. The discovery of obesity hypoventilation syndrome is generally attributed to the authors of a 1956 report of a professional poker player who, after gaining weight, became somnolent and fatigued and prone to fall asleep during

240-413: A lower pressure during expiration (breathing out). If this too is ineffective in increasing oxygen levels, the addition of oxygen therapy may be necessary. As a last resort, tracheostomy may be necessary; this involves making a surgical opening in the trachea to bypass obesity-related airway obstruction in the neck. This may be combined with mechanical ventilation with an assisted breathing device through

288-423: A machine that delivers a continuous positive pressure to the airways and preventing the collapse of soft tissues in the throat during breathing; it is administered through a mask on either the mouth and nose together or if that is not tolerated on the nose only (nasal CPAP). This relieves the features of obstructive sleep apnea and is often sufficient to remove the resultant accumulation of carbon dioxide. The pressure

336-3363: A power supply scheme for bumper cars Organizations [ edit ] Ochsner Health System Office of Homeland Security , Office of the Executive Branch of the United States, precursor to the Department of Homeland Security Ohio Historical Society Oklahoma Historical Society Ontario Handweavers & Spinners Oregon Historical Society Organ Historical Society , in Villanova, Pennsylvania, United States Ottawa Humane Society Oxford Harmonic Society High schools [ edit ] Various countries Orange High School (disambiguation) , various schools of this name Olympic High School (disambiguation) , various schools of this name Canada Oromocto High School , in Oromocto, New Brunswick New Zealand Onehunga High School , in Auckland United Kingdom Oriel High School , in Crawley, West Sussex, England Oxford High School , in Oxford, Oxfordshire, England United States Oakland High School , in Oakland, California Oakmont High School , in Antelope, California Oakton High School , in Vienna, Virginia Oceanside High School , in Oceanside, California Odessa High School (New York) , in Odessa, New York Odessa High School , in Odessa, Texas Odessa High School (Washington) , in Odessa, Washington Ogden High School (Utah) , in Ogden, Utah Olympian High School , in San Diego County, California Olympic High School , in Charlotte, North Carolina Opelika High School , in Opelika, Alabama Orem High School , in Orem, Utah Orion High School , in Orion, Illinois Osborne High School , in Marietta, Georgia Ottawa Senior High School , in Ottawa, Kansas Ottumwa High School , in Ottumwa, Iowa Stanford Online High School , online school based in Redwood City, California Oswego High School , in Oswego Illinois Oswego High School , in Oswego, New York Topics referred to by

384-447: A reasonable screening test. If this is elevated (27 mmol/L or higher), blood gasses should be measured. To distinguish various subtypes, polysomnography is required. This usually requires brief admission to a hospital with a specialized sleep medicine department where a number of different measurements are conducted while the subject is asleep; this includes electroencephalography (electronic registration of electrical activity in

432-409: A restricted admission status. Tuition costs at Stanford OHS vary by enrollment level each year. For the 2024–2025 school year, tuition at Stanford OHS is hold at $ 5,970 for single course enrollment, $ 17,910 for part-time enrollment (2–3 courses), and $ 29,850 for full-time enrollment (4–5 courses). Financial aid is available, and awarded to students based on financial need. Stanford OHS operates on

480-484: A third of all people with OHS. It is not fully understood why some obese people develop obesity hypoventilation syndrome while others do not. It is likely that it is the result of an interplay of various processes. Firstly, work of breathing is increased as adipose tissue restricts the normal movement of the chest muscles and makes the chest wall less compliant , the diaphragm moves less effectively, respiratory muscles are fatigued more easily, and airflow in and out of

528-613: A week depending on the course. At Stanford OHS, students are placed in course levels by their individual ability, not by grade level. Each student's schedule is individualized, allowing them to be challenged in every subject. Usually, classes have a mix of students in different grade levels. The four courses offered in the Core sequence cover subjects in science, history of science, political theory, and philosophy. The four-year interdisciplinary Core sequence focuses on critical thinking, and oral and written argumentation. Placement in these courses

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576-407: A wide variety of university-level courses, often at the post-AP level, but ceased to offer AP courses starting in the 2024–25 school year. In seminar courses, web-based video conferencing technology is employed. Concurrent video feeds enable each student to see their classmates and instructors during the seminar, maximizing interaction and engagement. Seminar classes are usually hosted once or twice

624-537: Is OHS primarily due to "sleep hypoventilation syndrome"; this requires a rise of CO 2 levels by 10 mmHg (1.3 kPa) after sleep compared to awake measurements and overnight drops in oxygen levels without simultaneous apnea or hypopnea. Overall, 90% of all people with OHS fall into the first category, and 10% in the second. In people with stable OHS, the most important treatment is weight loss —by diet, through exercise , with medication, or sometimes weight loss surgery (bariatric surgery). This has been shown to improve

672-435: Is again uncertain. While many people with obesity hypoventilation syndrome are cared for on an outpatient basis, some deteriorate suddenly and when admitted to the hospital may show severe abnormalities such as markedly deranged blood acidity (pH<7.25) or depressed level of consciousness due to very high carbon dioxide levels. On occasions, admission to an intensive care unit with intubation and mechanical ventilation

720-539: Is an online independent school located within Stanford University for academically talented students worldwide. It operates as a six-year school, serving students in grades 7–12. The current Head of School is Tomohiro Hoshi. Stanford OHS was formerly a part of the wider offerings of the Education Program for Gifted Youth (EPGY), a collection of gifted education programs within Stanford University . With

768-578: Is associated with a reduced quality of life , and people with the condition incur increased healthcare costs, largely due to hospital admissions including observation and treatment on intensive care units . OHS often occurs together with several other disabling medical conditions, such as asthma (in 18–24%) and type 2 diabetes (in 30–32%). Its main complication of heart failure affects 21–32% of patients. Those with abnormalities severe enough to warrant treatment have an increased risk of death reported to be 23% over 18 months and 46% over 50 months. This risk

816-492: Is correlated with grade level, but not restricted for students who place higher. Placement in the Core sequence typically follows the students' placement in English courses due to the strong writing components of each Core course. Core courses for 7th and 8th grade are optional, while core courses for 9th, 10th, 11th, and 12th grade are required for a Stanford OHS diploma. Stanford OHS offers three levels of enrollment, determined by

864-495: Is different from Wikidata All article disambiguation pages All disambiguation pages Obesity hypoventilation syndrome Obesity hypoventilation syndrome is defined as the combination of obesity and an increased blood carbon dioxide level during the day that is not attributable to another cause of excessively slow or shallow breathing . The most effective treatment is weight loss , but this may require bariatric surgery to achieve. Weight loss of 25 to 30%

912-463: Is increased until the obstructive symptoms (snoring and periods of apnea) have disappeared. CPAP alone is effective in more than 50% of people with OHS. In some occasions, the oxygen levels are persistently too low ( oxygen saturations below 90%). In that case, the hypoventilation itself may be improved by switching from CPAP treatment to an alternate device that delivers "bi-level" positive pressure: higher pressure during inspiration (breathing in) and

960-419: Is known as full admission. Students can also elect to select their preferred enrollment level in their application. All enrolled students receive an official transcript for courses taken at the school regardless of their enrollment level, and are welcome to participate in student life activities online and in-person. However, college counseling is only available to full-time students. Admission at Stanford OHS

1008-567: Is less able to remove blood from the veins. When this is the case, raised hydrostatic pressure leads to accumulation of fluid in the skin (edema), and in more severe cases the liver and the abdominal cavity. The chronically low oxygen levels in the blood also lead to increased release of erythropoietin and the activation of erythropoeisis , the production of red blood cells . This results in polycythemia , abnormally increased numbers of circulating red blood cells and an elevated hematocrit . Formal criteria for diagnosis of OHS are: If OHS

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1056-412: Is necessary. Otherwise, "bi-level" positive airway pressure (see the next section) is commonly used to stabilize the patient, followed by conventional treatment. Positive airway pressure , initially in the form of continuous positive airway pressure (CPAP), is a useful treatment for obesity hypoventilation syndrome, particularly when obstructive sleep apnea coexists. CPAP requires the use during sleep of

1104-411: Is rare for graduating seniors (full-time 12th grade students) to be admitted while intending to graduate that year. Applicants for full-time 12th grade are typically asked to consider repeating 11th grade to satisfy Stanford OHS graduation requirements. Applicants to 12th grade for part-time or single course enrollment are not subject to graduation requirements at Stanford OHS, and so may be admitted under

1152-441: Is reduced to less than 10% in those receiving treatment with PAP. Treatment also reduces the need for hospital admissions and reduces healthcare costs. The exact prevalence of obesity hypoventilation syndrome is unknown, and it is thought that many people with symptoms of OHS have not been diagnosed. About a third of all people with morbid obesity (a body mass index exceeding 40 kg/m ) have elevated carbon dioxide levels in

1200-467: Is reduced. Furthermore, episodes of nighttime acidosis (e.g. due to sleep apnea) lead to compensation by the kidneys with retention of the alkali bicarbonate . This normalizes the acidity of the blood. However, bicarbonate stays around in the bloodstream for longer, and further episodes of hypercapnia lead to relatively mild acidosis and reduced ventilatory response in a vicious circle . Low oxygen levels lead to hypoxic pulmonary vasoconstriction ,

1248-436: Is selective. As of the 2024–25 school year, the application requires prior academic records, two essays, five short questions, two recommendation forms, one sample of a student's analytical writing, a parent questionnaire, and various other information. Submitting a standardized test score is optional for all applicants. Students can apply to any or all of the three enrollment levels, and all applicants are considered for each of

1296-486: Is suspected, various tests are required for its confirmation. The most important initial test is the demonstration of elevated carbon dioxide in the blood. This requires an arterial blood gas determination, which involves taking a blood sample from an artery , usually the radial artery . Given that it would be complicated to perform this test on every patient with sleep-related breathing problems, some suggest that measuring bicarbonate levels in normal (venous) blood would be

1344-414: Is usually required to resolve the disorder. The other first-line treatment is non-invasive positive airway pressure (PAP), usually in the form of continuous positive airway pressure (CPAP) at night. The disease was known initially in the 1950s, as "Pickwickian syndrome" in reference to a Dickensian character. Most people with obesity hypoventilation syndrome have concurrent obstructive sleep apnea ,

1392-558: The Malone Family Foundation of Englewood, Colorado, was well received and the Foundation requested a full proposal. Over Summer 2005, Ravaglia fleshed out his ideas into a full-blown design for an online school for gifted students. In January 2006, EPGY received a substantial gift from the Foundation to help develop the school. Formally called "The Education Program for Gifted Youth Online High School at Stanford University," it

1440-490: The 1960s, various further discoveries were made that led to the distinction between obstructive sleep apnea and sleep hypoventilation. The term "Pickwickian syndrome" has fallen out of favor because it does not distinguish obesity hypoventilation syndrome and sleep apnea as separate disorders (which may coexist). Stanford Online High School Stanford Online High School , also known as Stanford OHS , SOHS , or OHS and formerly known as EPGY Online High School ,

1488-494: The blood). Under normal circumstances, central chemoreceptors in the brain stem detect the acidity, and respond by increasing the respiratory rate ; in OHS, this "ventilatory response" is blunted. The blunted ventilatory response is attributed to several factors. Obese people tend to have raised levels of the hormone leptin , which is secreted by adipose tissue and under normal circumstances increases ventilation. In OHS, this effect

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1536-561: The blood. When examining groups of people with obstructive sleep apnea, researchers have found that 10–20% of them meet the criteria for OHS as well. The risk of OHS is much higher in those with more severe obesity, i.e. a body mass index (BMI) of 40 kg/m or higher. It is twice as common in men compared to women. The average age at diagnosis is 52. American Black people are more likely to be obese than American whites, and are therefore more likely to develop OHS, but obese Asians are more likely than people of other ethnicities to have OHS at

1584-551: The brain), electrocardiography (same for electrical activity in the heart), pulse oximetry (measurement of oxygen levels) and often other modalities. Blood tests are also recommended for the identification of hypothyroidism and polycythemia . To distinguish between OHS and various other lung diseases that can cause similar symptoms, medical imaging of the lungs (such as a chest X-ray or CT/CAT scan ), spirometry , electrocardiography and echocardiography may be performed. Echo- and electrocardiography may also show strain on

1632-459: The day, as well as developing edema of the legs suggesting heart failure . The authors coined the condition "Pickwickian syndrome" after the character Joe from Dickens' The Posthumous Papers of the Pickwick Club (1837), who was markedly obese and tended to fall asleep uncontrollably during the day. This report, however, was preceded by other descriptions of hypoventilation in obesity. In

1680-773: The first online school to become accredited by the California Association of Independent Schools (CAIS). In 2022, Stanford OHS is granted membership to the Council of International Schools (CIS). Until the 2014–15 school year, Stanford OHS used Saba Centra in order to host its classes. However, in for the 2014–15 school year, it switched to Adobe Connect and has used the platform ever since. Stanford OHS uses Canvas as its Learning Management System . Stanford OHS offers classes in nine major subjects: Core, English, Humanities, History, Languages, Math, Computer Science, Economics, and Science. The school distinguishes itself by offering

1728-489: The lung is impaired by excessive tissue in the head and neck area. Hence, people with obesity need to expend more energy to breathe effectively. These factors together lead to sleep-disordered breathing and inadequate removal of carbon dioxide from the circulation and hence hypercapnia; given that carbon dioxide in aqueous solution combines with water to form an acid (CO 2 [g] + H 2 O[l] + excess H 2 O[l] --> H 2 CO 3 [aq]), this causes acidosis (increased acidity of

1776-431: The morning. The low oxygen level leads to physiologic constriction of the pulmonary arteries to correct ventilation-perfusion mismatching, which puts excessive strain on the right side of the heart. When this leads to right sided heart failure, it is known as cor pulmonale . Symptoms of this disorder occur because the heart has difficulty pumping blood from the body through the lungs. Fluid may, therefore, accumulate in

1824-420: The number of courses a student is enrolled in each academic year. The three options are known as full-time for students taking 4–5 courses, part-time for students taking 2–3 courses, and single course for students taking 1 course (or 2 semester-long courses). Students may be only be offered certain enrollment options, which is known as restricted admission, or may be offered all types of enrollment options, which

1872-481: The opening. People who fail first-line treatments or have very severe, life-threatening disease may sometimes be treated with tracheotomy , which is a reversible procedure. Treatments without proven benefit, and concern for harm, include oxygen alone or respiratory stimulant medications. Medroxyprogesterone acetate , a progestin , and acetazolamide are both associated with an increased risk of thrombosis and are not recommended. Obesity hypoventilation syndrome

1920-505: The restructuring of the program into Stanford Pre-Collegiate Studies, Stanford OHS became fully independent in its administration from the other components of the program. Stanford OHS is accredited through the Western Association of Schools and Colleges. In April 2005, EPGY Executive Director Raymond Ravaglia proposed the idea of expanding its online course offerings into a full-fledged online school. This informal proposal, made to

1968-535: The right side of the heart caused by OHS, and spirometry may show a restrictive pattern related to obesity. Obesity hypoventilation syndrome is a form of sleep disordered breathing . Two subtypes are recognized, depending on the nature of disordered breathing detected on further investigations. The first is OHS in the context of obstructive sleep apnea; this is confirmed by the occurrence of 5 or more episodes of apnea, hypopnea or respiratory-related arousals per hour (high apnea-hypopnea index ) during sleep. The second

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2016-455: The same term [REDACTED] This disambiguation page lists articles associated with the title OHS . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=OHS&oldid=1216394151 " Categories : Disambiguation pages Educational institution disambiguation pages Hidden categories: Short description

2064-589: The school was approved as an online education provider by the University of California and the California State University systems. Ninth grade was added for the 2008–09 academic year, and with the 2009–10 school year, supported by an additional gift from the Malone Family Foundation, it was able to add a middle-school component for students in grades 7–8. In January 2015, Stanford OHS became

2112-475: The skin of the legs in the form of edema (swelling), and in the abdominal cavity in the form of ascites ; decreased exercise tolerance and exertional chest pain may occur. On physical examination , characteristic findings are the presence of a raised jugular venous pressure , a palpable parasternal heave, a heart murmur due to blood leaking through the tricuspid valve , hepatomegaly (an enlarged liver), ascites and leg edema. Cor pulmonale occurs in about

2160-463: The symptoms of OHS and resolution of the high carbon dioxide levels. Weight loss may take a long time and is not always successful. If the symptoms are significant, nighttime positive airway pressure (PAP) treatment is tried; this involves the use of a machine to assist with breathing. PAP exists in various forms, and the ideal strategy is uncertain. Some medications have been tried to stimulate breathing or correct underlying abnormalities; their benefit

2208-400: The three enrollment levels. The application process is the same for each applicant regardless of desired enrollment or grade level. Applicants to grades 7–8 (middle school) follow the same application process and requirements as those applying to grades 9–12 (high school). Stanford OHS does not admit students mid-year, and only admits students to the start of each academic year in the fall. It

2256-427: The tightening of small blood vessels in the lung to create an optimal distribution of blood through the lung. Persistently low oxygen levels causing chronic vasoconstriction leads to increased pressure on the pulmonary artery ( pulmonary hypertension ), which in turn puts strain on the right ventricle , the part of the heart that pumps blood to the lungs. The right ventricle undergoes remodeling , becomes distended and

2304-491: Was typically referred to as "EPGY OHS," "Stanford EPGY OHS," or simply "OHS." The school was officially established on September 7, 2006, with students in grades 10–12. The school accepted thirty students for its inaugural year and projected an eventual enrollment of up to 600 full-time equivalent students. In 2006, Stanford OHS received official accreditation from the Western Association of Schools and Colleges . In 2008,

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