Post Reply 
CPAP and pitting edema (fluid retention)
Author Message
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #11
RE: CPAP and pitting edema (fluid retention)
(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.
07-18-2012 05:11 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #12
RE: CPAP and pitting edema (fluid retention)
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.
07-20-2012 08:00 PM
Find all posts by this user Post Reply Quote this message in a reply
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #13
RE: CPAP and pitting edema (fluid retention)
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.
10-21-2012 06:24 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #14
RE: CPAP and pitting edema (fluid retention)
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
02-22-2015 02:01 PM
Find all posts by this user Post Reply Quote this message in a reply
quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #15
RE: CPAP and pitting edema (fluid retention)
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.
02-22-2015 06:22 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
woozie38 Offline

Advisory Members

Posts: 248
Joined: Jan 2013

Machine: Fisher & Paykel Icon + Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Integral
CPAP Pressure: 8 to 14
CPAP Software: SleepyHead Other Software

Other Comments: 17 years of CPAP + supp. oxygen @ 3 L/min

Sex: Male
Location: Toowoomba, Queensland Australia

Post: #16
RE: CPAP and pitting edema (fluid retention)
(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'
02-23-2015 05:54 PM
Find all posts by this user Post Reply Quote this message in a reply
quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #17
RE: CPAP and pitting edema (fluid retention)
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.
02-23-2015 06:50 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
nnonix Offline

New Members

Posts: 1
Joined: Jul 2016

Machine: ResMed Airsense10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10
Humidifier: integrated
CPAP Pressure: 11
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: Minnesota, USA

Post: #18
RE: CPAP and pitting edema (fluid retention)
(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.
07-04-2016 02:29 PM
Find all posts by this user Post Reply Quote this message in a reply
DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #19
RE: CPAP and pitting edema (fluid retention)
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
07-04-2016 05:11 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
srlevine1 Offline

Advisory Members

Posts: 225
Joined: Sep 2015

Machine: ResMed Airsense Autoset (S10)
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage Activa LT
Humidifier: Internal to S10
CPAP Pressure: 12-15.6
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Westlake Village, California USA

Post: #20
RE: CPAP and pitting edema (fluid retention)
(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
(This post was last modified: 07-04-2016 05:41 PM by srlevine1.)
07-04-2016 05:37 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  CO2 Retention - ASV (ComSAS) niammus 4 787 12-24-2015 08:27 PM
Last Post: archangle
  Weight Gain From Water Retention Louis R. 54 4,702 09-12-2015 11:37 PM
Last Post: Louis R.
  Edema and apnea surferdude2 13 2,898 05-01-2015 06:15 PM
Last Post: woozie38
Grin CPAP and water retention? Dooley 8 6,237 02-22-2015 06:28 PM
Last Post: quiescence at last

Forum Jump:

Who's Online (Complete List)