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Edema and apnea
#1
I suspect edema (Oedema) may play a part in apnea. I am not sure if it is strictly an indirect effect or whether it may have a role in exacerbating apnea to the point where it reaches the level for diagnosis and treatment. I think it is often a marker for diagnostic purposes, especially in cases of long standing apnea. Those cases where edema is present in long standing apnea may well be due other conditions that apnea has caused rather than being caused directly by apnea.

Do any of you have symptoms of edema especially in, but not limited to, your facial area? Did you have those symptoms before you were diagnosed with apnea? Did your sleep doctor check you for edema during his diagnosis? Do you think edema can affect apnea unfavorably? Is it possible that a low sodium diet would be of any value in treating apnea, whether directly of indirectly?

In my case, I had never noticed any symptoms of edema until I started having apnea trouble. I can't say which came first so just thought to ask if anyone else has had the same experience and paid better attention. I have had a thorough medical exam to rule out any heart and circulatory problems and liver function that are the usual causes of edema so it would seem to be idiopathic. I hate that term since it may mean I have something that has no known cause and likely has no know cure, unless it goes away by itself.
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#2
I have edema, lymphedema to be exact, and I was diagnosed with sleep apnea about the same time as the lymphedema. I wish I knew if having one influences the other. I've also tried the low sodium thing because I also have hypertension. When I religiously follow "low sodium", my electrolytes get out of balance and the edema becomes more noticeable. My doctor says he doesn't know why I have lymphedema, but thinks that sleep apnea might get a little better if I lost weight.
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#3
I had edema in my legs in February 2014 and that took me to the hospital. They checked me out and found no pronounced heart trouble and gave me furosamide and a referral to an internal medicine specialist at the hospital. When I saw him he pretty well immediately suggested it was highly likely I had sleep apnea. It took about six months after that go go through the specialists and the sleep studies and I finally started titration on a Resperonics system which finally led to purchasing the Resmed through my Blue Cross insurance, which paid the whole shot, no deductible. I am in Canada but medicare in British Columbia apparently won't pay the shot so thank goodness my union negotiated us a good private package. Medicare did at least pay for the hospital and specialist visits and the sleep study.

The edema is gone, but it was gone before I started on APAP.

I suspect my edema was caused by a weakened ticker due to long standing sleep apnea. Fortunately it was a fairly mild case.
Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#4
i suffer from edema, and have had issues with it since my teens at least. Mine seems to be related to insulin resistance --- avoiding carbs and sugar makes more difference for me than avoiding salt does. I retain water in my face, hands, abdomen, legs.... recently i began wearing compression socks and my calves reduced by 2.5 inches in 2 days, and ankles by 1.5 to a svelte 8.5"

Incidentally, I found articles that correlate increased edema (in those that have it) with higher cpap pressures, and setting EPR to 3 helped with the increased edema I was experiencing at the beginning of treatment.
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
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#5
Edema and sleep apnea are well documented but usually in terms of swelling of the feet and hands. Not much--if I recall correctly--in terms of facial swelling.

I am sedentary (I don't walk much) and in the summer heat, my ankles and calves swell up right nice like. I have to be careful when I travel as well, especially plane travel. I really swell up then. My chair tilts back fairly far and when my ankles start to get fluffy, I tilt back and raise my feet. That seems to help.

But I never get a puffy face that I know of. I'll watch that and see.
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#6
(04-29-2015, 11:07 PM)GrammaBear Wrote: I have edema, lymphedema to be exact, and I was diagnosed with sleep apnea about the same time as the lymphedema. I wish I knew if having one influences the other. I've also tried the low sodium thing because I also have hypertension. When I religiously follow "low sodium", my electrolytes get out of balance and the edema becomes more noticeable. My doctor says he doesn't know why I have lymphedema, but thinks that sleep apnea might get a little better if I lost weight.

Sodium is the primary anion in the fluid outside cells. Potassium is primary within cells. When Na+ falls out of the normal range, the cells swell.

The first place a doc will look for edema is in the feet near the ankle. The doc presses with a thumb and releases; if it leaves a dent, it's called pitting edema. It is most often secondary to cardiac conditions; but can be secondary to diabetes, certain medications like CCBs, or venous insufficiency.

Meds that are vasodilators contribute to edema. People with edema are often given a diuretic like Lasix.
[Image: 1F4m9Ift.jpg]
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#7
It just makes sense that any swelling of the cells would aggravate apnea. If not, why not? Are soft palate cells immune to such swelling?

I have also heard that corticosteroids have been known to cause edema. Edema seems to have so many possible causes that it often ruled idiopathic and untreated until something worse happens.
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#8
(04-29-2015, 10:16 PM)surferdude2 Wrote: ...some questions below...

Do any of you have symptoms of edema especially in, but not limited to, your facial area?
Yes. And redness/flushing. But not in other areas.

Did you have those symptoms before you were diagnosed with apnea?
Yes. But I was diagnosed late...

Did your sleep doctor check you for edema during his diagnosis?
No.

Do you think edema can affect apnea unfavorably?
Seems like. Anything that puts extra pressure (or takes up extra space) probably has an effect.

Is it possible that a low sodium diet would be of any value in treating apnea, whether directly of indirectly?
That is a good question. (a variation on low sodium is balanced sodium/potassium/magnesium)

I can't say which came first...
Same here.

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#9
my pitting edema was noticeable after I was treated. I do not remember every noticing it before diagnosis. It seems only confined to legs, calves, ankles on both right and left.

I was on APAP treatment for about 10 weeks before I switched to only moderate pressure CPAP with a range of 6.0 to 13.5. I had a 90% pressure of 8.1. After this, I noticed the swelling. But the treatment was really comfortable, so continued for 5 weeks.

I saw some improvement, but not for long. Things that helped were - (1) elevation of the legs for 15 minutes seemed to relieve for about an hour (2) exercising like more brisk walking versus casual walk reduced the edema slightly (3) increased water intake no real effect (4) oops forgot in original post... acupressure reflexology basic pressure points specific for edema - which also aided in relieving symptoms for several minutes and was actually therapeutic from both calming and slight relief of symptoms.

So, I switched back to APAP 6.5 to 10.5 for a month, no progress and 90% up to 10.3. Changed to 7.0 to 12.0 for 16 days, no progress on edema and 90% up to 11.2. Changed to 5.0 to 11.0, no progress, and 90% is 10.2.

DONE using dual level! I am going back to CPAP! Last 3 nights Auto CPAP 5.0 to 11.0, same exhale as inhale, feel better. 90% is 11.0, but AHI is better.

Nobody else I've read has gotten rid of pitting edema. If they are out there, can you point to them?

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.
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#10
I've never had edema, but this is an interesting topic that I'm going to research more.
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