bipap, high pressure, swollen ankles

[Ric]

A friend of mine called this morning to ask if I had ever heard of CPAP/BIPAP therapy causing edema, swollen joints wrists/ankles? He uses a fairly high pressure 17/19, and his doctor suggests it might have something to do with his bipap therapy.

<distant sound of shooting in the dark>

I've not heard of any such sequelae, nor does a search on (swelling/swollen) turn up anything of interest on this forum. Nor can I think of any physiology that would explain it directly. I can imagine that with high pressures and "over-ventilating" one might become mildly "respiratory alkalotic" or hypocapneic, suppressing the ANH/BNH axis, leading to insufficient diuresis, hypernatremia, swelling.... (?)

<more shooting in the dark>

Thought I would share this and see if anyone else has heard of or experienced such or might otherwise explain it ???

THANKS !

-Ric

[GumbyCT]

I can't explain it but I experience the same thing - R ankle edema.

I am also on bipap 18/15. My sleep & primary docs both deny it has anything to do with overinflating my lungs each nite. I am still skeptical since all the testing they have done on me comes back WNL=Within Normal Limits.

Their solutions - Lasix & compression stockings are both band-aid fixes - not solutions or even recognizing what the problem is.

So I would be very interested to see or hear of any theories regarding edema & cpap.

Thanks,
GumbyCT

[ozij]

Hey Ric!
I don't have an answer, but it sure is nice to see you again!
O.

[Ric]

Thanks Oz, long time no typos, I've been sorta preoccupied. Nice to see the board is alive and well and still cranking out good advice. And good to see you too !

-r

[islander]

Last week as I was going through my annual physical, I brought this topic up to my physician as I experience these symtoms. She said in my case, it was because I am on meds. which are to expand my arteries, due to coronary artery disease. She stated these meds caused the arteries to leak or "weep" due to stretching...and gravity explained the result. And she said also since I am "artery deprived" since having a quadruple bypass surgery which required a harvest of my arteries for grafting purposes that tended to exacerbate the problem and rather than increase the use of Lasix (she said my labs made me appear nearly a "raisin" already) that she recommended I use the compression stockings. I have been and I must say they do work even though they are a pain getting on but I notice my feet are not numb as they were before and my ankles and calves are much smaller, too. Incidentally, my pressure is 17cm as well. I do not know if I will get used to wearing these things as I sure am glad to get them off at night....

[larbabe]

Interesting... do any of you have unexplained shortness of breath as well?

[islander]

I do in fact have shortness of breath as well but previously attributed that to my coronary artery disease (CAD) but a recent 64 slice CT Scan indicated early signs of emphysema so now do not know what to think. The shortness of breath is only when exerting myself and quickly disipates upon a brief (30 second) rest. I am today on my 2 year Anniversary since start of CPAP treatment and must say that it must be the best thing I have ever done to improve my quality of life. I used to suffer with migraines nearly every day and have not had one for two years now.

[larbabe]

Maybe there's something to this. I've had edema and exercise induced asthma before, but now I have cankles and get winded just getting dressed. My echo came back normal, so they don't know what it is. Next week I have an appt with the sleep dr. Will have to ask him some questions. I know that apnea is often tied to heart problems. It'd be interesting to see just how many of us have symptoms like these, and why.

[tinette]

I have this problem.I have had all the tests run and everything is "normal".I can't live like this.It is driving me insane.I'm thinking of stopping the machine use to see if it helps.

[archangle]

I usually sleep in a recliner. With one recliner, my legs would swell. With another recliner, no swelling. It would take a few days for it to go away when I got out of the "bad" recliner.

Try sleeping in a different position, putting a pillow under one or both legs, etc. Perhaps something about your sleeping position is restricting blood or fluid flow in your legs. Easy enough to try.