Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

CPAP and pitting edema (fluid retention)
#11
(07-12-2012, 12:11 AM)ScottBerglin Wrote: Hey, Zonk, thanks for the past writings and the link...very informative.
If I read the link correctly, it suggests a low correlation between CPAP use and Urinary response....what's your summary?
thanks,
Scott
Hi scott - I don,t know anything about the topic .....just copied the thread from our old forum in response to question by a board member.

Post Reply Post Reply
#12
I sleep in a recliner. I find that which recliner I sleep in makes a big difference in edema. When visiting my Dad, I would get edema really bad in one recliner at his house, but not in a different recliner in his house. I presume it has to do with restricting blood or other fluid flow in my legs.

Sleeping position, pillows under the legs, etc. might make a difference.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
Post Reply Post Reply
#13
Fluid retention
Source: betterhealth - (vic gov au)
Summary
Fluid retention (oedema) occurs when fluid isn't removed from the body tissues, including the skin. Causes include the body's reaction to hot weather, a high salt intake, and the hormones associated with the menstrual cycle. Symptoms include swelling of body parts such as feet, hands and ankles, a feeling of stiffness or aching and weight fluctuations. Drinking lots of water will actually help fluid retention. Fluid retention may be a sign of disease, including kidney disease, heart failure, chronic lung disease, arthritis or an allergic reaction.

Fluid regularly leaks into body tissues from the blood. The lymphatic system is a network of tubes throughout the body that drains this fluid (called lymph) from tissues and empties it back into the bloodstream. Fluid retention (oedema) occurs when the fluid isn’t removed from the tissues.

The two broad categories of fluid retention include generalised oedema, when swelling occurs throughout the body, and localised oedema when particular parts of the body are affected.

The wide range of causes includes the body’s reaction to hot weather, a high salt intake, and the hormones associated with the menstrual cycle. However, it’s recommended that you see your doctor rather than self-treat, because oedema can be symptomatic of serious medical conditions such as heart, kidney or liver disease.

Symptoms of fluid retention
Symptoms can include:

Swelling of affected body parts
Feet, ankles and hands are commonly affected
The affected body parts may ache
The joints may feel stiff
Rapid weight gain over a few days or weeks
Unexplained weight fluctuations
When pressed, the skin may hold the indent for a few seconds (pitting oedema)
In other cases, the skin may not indent when pressed (non-pitting oedema).

A wide range of common causes
Some of the many common causes of fluid retention include:

Gravity – standing up for long periods of time allows fluid to ‘pool’ in the tissues of the lower leg.
Hot weather – the body tends to be less efficient at removing fluid from tissues during the summer months.
Burns – including sunburn. The skin retains fluid and swells in response to burn injuries.
Menstrual cycle – some women experience oedema in the two weeks prior to menstruation.
Pregnancy – hormones encourage the body to hold onto excess fluid.
The Pill – oral contraceptives that include oestrogen can trigger fluid retention.
Dietary deficiency – such as insufficient protein or vitamin B1 (thiamine) in the diet.
Medications – certain drugs, including high blood pressure medication (antihypertensives), corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) are known to cause fluid retention.
Chronic venous insufficiency – weakened valves in the veins of the legs fail to efficiently return blood to the heart. The pooling of blood can result in varicose veins.

Medical conditions
Fluid retention may be a symptom of serious underlying conditions, including:

Kidney disease – such as nephrotic syndrome and acute glomerulonephritis
Heart failure – if the heart does not pump effectively, the body compensates in various ways. It starts to retain fluid and increase the volume of blood. This results in congestion of the veins, enlargement of the liver, and the accumulation of fluid in body cavities like the abdominal cavity (ascites) and in subcutaneous tissues, causing swelling (oedema) of the legs
Chronic lung diseases – such as severe emphysema, which put excessive pressure on the heart’s right ventricle, leading to its failure
Liver disease – such as severe cirrhosis that triggers liver failure
Malignant lymphoedema – cancerous tumours that block structures of the lymphatic system, such as the lymph nodes
Thyroid disease – such as hypothyroidism
Arthritis – joints affected by some types of arthritis tend to swell with fluid
Allergic reaction – in susceptible people, the body tends to swell in response to particular allergens: for example, an insect bite. In some cases, the reaction is severe (anaphylaxis) and requires urgent medical attention. This swelling is short-lived rather than ongoing.

Diagnosis of fluid retention
The underlying cause of the oedema must be found before treatment can begin. Diagnostic tests may include:

Physical examination
Medical history
Detailed questioning about the fluid retention, such as when it started, any factors that worsen the swelling and whether it is constant or intermittent
Blood tests
Urine tests
Liver function tests
Kidney function tests
Chest x-ray
Heart function tests, such as electrocardiogram (ECG).

Treatment for fluid retention
Depending on the cause, treatment may include:

A low-salt diet
Diuretics (water pills)
Treatment for the underlying medical condition: for example, hormone replacement (thyroxine) in the case of hypothyroidism
Lifestyle changes in response to the underlying medical condition: for example, avoidance of alcohol if liver disease is the cause
Changes to medication or dosage, if drugs are the cause
Dietary adjustments, if malnutrition is the cause
Ongoing medical supervision
Aids such as support stockings.

Self-care options
Mild fluid retention can be helped in the following ways:
Reduce the amount of salt in your diet; for instance, don’t add salt during the cooking process and stop salting your meals at the table. Avoid foods like potato chips and salted peanuts. Be wary of processed foods such as manufactured meats, which tend to contain ‘hidden’ salt.
Vitamin B6 (pyridoxine) is thought to help in cases of mild fluid retention. Good sources of vitamin B6 include brown rice and red meat.
Vitamin B5 (pantothenic acid), calcium and vitamin D help the body to excrete excess fluids. Include fresh fruits and low-fat dairy foods in your daily diet.
Supplements may help in the case of fluid retention caused by the menstrual cycle: for example calcium, magnesium, manganese, evening primrose oil and chaste tree.
Herbal diuretics include dandelion leaf, corn silk and horsetail.
Make sure to discuss the use of supplements with your doctor or health care professional, particularly if you are on any type of medication.
Drink plenty of water. It may sound contradictory, but a well-hydrated body is less likely to retain fluid.
Cut back on dehydrating drinks such as tea, coffee and alcohol.
Cranberry juice has a mild diuretic action.
Lie down with your legs higher than your head, when possible.
Exercise regularly.
Wear support stockings.

Where to get help
Your doctor
Pharmacist

Things to remember
The two broad categories of fluid retention include generalised oedema, when swelling occurs throughout the body, and localised oedema when particular parts of the body are affected.
Always see your doctor, because oedema can be symptomatic of serious medical conditions such as heart, kidney or liver disease.
Self-care options for mild fluid retention include a low-salt diet, supplements and drinking plenty of water.
Post Reply Post Reply


#14
holy old thread resurrection, batman ^_^

I was researching any link between cpap and water retention, since I have been experiencing a marked increase in water retention since beginning cpap which as not gotten better after 3 months. I found cpap caused an increased thoracic pressure which in turn increased renal vascular resistance - resulting in lower kidney output and therefore water retention.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC29011/ (as mentioned previously in this thread)

and
http://www.ncbi.nlm.nih.gov/pubmed/9510662 indicating that bi-level did not interfere with cardiac hemodynamics

I raised my EPR from 2 to 3 to see if I could realize some benefit from it with respect to the water retention, and I have to say that after one night the results are promising.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Post Reply Post Reply
#15
your not kidding. I have wondered about magnesium of late, and finding literature that it can be of great help. So, I am checking my own consumption, and trying to ensure my calcium to magnesium ratio is optimum. ironically, I had just a few days ago found that pressing my thumb against my fleshy lower palm, upon release left a persistent depression. I interpreted this as a sign of dehydration. Well, I think now that I am wrong. It may actually be edema.

I changed my CPAP treatment about a month ago, to have IPAP and EPAP be the same. I am therefore on auto-titrating CPAP.

I'll have to keep an eye on this...

Thanks for the repeat and publication lookup!

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#16
(10-21-2012, 06:24 PM)zonk Wrote: Fluid retention
Things to remember
The two broad categories on fluid retention include generalised oedema, when swelling occurs throughout the body, and localised oedema when particular parts of the body are affected.
Always see your doctor, because oedema can be symptomatic of serious medical conditions such as heart, kidney or liver disease.
Self-care options for mild fluid retention include a low-salt diet, supplements and drinking plenty of water.

Re-post or not, this is a great treatise on the problem of fluid retention. Most posters & me are suffering from swollen feet, ankles & legs. This swelling is caused by the lymph (a clear fluid) having been transported to the extremities being unable to return against the force of gravity. The lymphatic system & its interaction with the blood is complex & from what I've read is too complicated to discuss here, but my take on the problem is that it is caused by lack of exercise, a sedentary job, or long periods of sitting such as in a car or aircraft, or possibly other existing medical conditions. IMHO it's not wise to take fluid reducing tablets, or drink diuretic drinks. The best solution it seems to me is compression stockings. Not just any compression stocking, but properly prescribed graduated garments that have greater compression pressure at the ankle & decreasing compression pressure toward the knee (or thigh in full length garments). These garments can be quite expensive especially the German "Jobst" which can cost around AU$70. I wear my stockings most every day & my lower legs hardly swell at all now. I wear an inexpensive brand, "Netex" which costs less than $10 from the US. If anyone is interested I can give them the location. Netex outperforms and is more durable than most other brands. Also drink plenty of water. To check your hydration level, pinch the skin of the back of your hand. If the skin immediately returns, your hydration is ok, but it the pinch remains, you need to drink more water. Stick with it & good luck!
[Image: signature.png]Keep on breathin'
Post Reply Post Reply


#17
well I pinch and it returns. I feel better than I felt in 10 years. i'll keep drinking and hope people can report how this condition reverses if it does. before too long I will be speaking with my GP.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#18
(02-22-2015, 02:01 PM)DariaVader Wrote: holy old thread resurrection, batman ^_^

I was researching any link between cpap and water retention, since I have been experiencing a marked increase in water retention since beginning cpap which as not gotten better after 3 months. I found cpap caused an increased thoracic pressure which in turn increased renal vascular resistance - resulting in lower kidney output and therefore water retention.
<link removed> (as mentioned previously in this thread)

and
<link removed> indicating that bi-level did not interfere with cardiac hemodynamics

I raised my EPR from 2 to 3 to see if I could realize some benefit from it with respect to the water retention, and I have to say that after one night the results are promising.

I know this is an old thread but I'm wondering what your prolonged experience has been with EPR setting #3. I'm experiencing edema that continues to get worse since starting CPAP. Based on this thread I checked my machine and found that my EPR setting was off. I turned it on to setting #3 and am hopeful I'll see results.
Post Reply Post Reply
#19
The EPR setting helps, unless my pressure raises for other reasons, in which case it is not enough. I am seriously considering bilevel, and will be discussing it at my next appointment - which will be with a new doc, hopefully next month. My old doc left the practice for greener pastures somewhere... I really hope the new one is as amenable to the idea as he was.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Post Reply Post Reply


#20
(07-11-2012, 11:11 PM)zonk Wrote: The effect of continuous positive airway pressure (CPAP) on renal vascular resistance: the influence of renal denervation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC29011/

There are a number of other studies which must be interpreted by someone with a medical background. Note, many of these studies have small sample sizes and some suggest correlation as causation. So be careful reading the raw literature and applying it to your situation.

If you Google the keywords "pubmed cpap edema" without quotes, you will find a number of medical studies that provide links between cpap and edema to some degree or another.

In the final analysis, you need a multidisciplinary approach involving a cardiologist, pulmonologist, and a nephrologist to investigate, diagnose, and treat your condition. It could be positional, it could be related to physiology, it could be related to your diet, drugs, or over-the-counter supplements (let us not forget to tell our doctors about the supplements when discussing drugs), or a combination of factors involving a CPAP.

You may wish to ask about blood thinners and DVT preventatives if you are going to constrict blood vessels in your legs.

I wish you luck on your investigation.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  New to CPAP, Issue with Peripheral Edema Beelotus 5 467 12-19-2016, 11:13 PM
Last Post: Beej
Grin CPAP and water retention? Dooley 9 6,996 12-18-2016, 07:10 PM
Last Post: Beelotus
  CO2 Retention - ASV (ComSAS) niammus 4 1,111 12-24-2015, 08:27 PM
Last Post: archangle
  Weight Gain From Water Retention Louis R. 54 5,651 09-12-2015, 11:37 PM
Last Post: Louis R.
  Edema and apnea surferdude2 13 3,466 05-01-2015, 06:15 PM
Last Post: woozie38

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.