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. history 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 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 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).