Why is my Face Swollen?

This is my first post, and I'm new to BiPAP therapy. This is my fifth night using my new equipment.

This morning I woke up and hardly recognized myself in the mirror. One side of my face (around my left eye) is swollen. I did struggle all night with air leaks and trying to adjust the mask to keep the leaks out. I sleep on my side, and I often switch sides throughout the night. When I switch sides, the leaks tend to get worse. There were at least two occasions when I woke up frustrated with the leaks keeping me awake (and wanting to scratch my nose) that I sat up in bed and took the mask off for a few minutes before putting it back on. When I put the mask back on, the leaks seem to subside for a while but they always returned.

I want to mention that I've also been struggling with some acne where the headband runs over the back of my neck and across the bridge of my nose. Each day, I have used CPAP wipes to clean the bands and the mask, and finally, I use a Sleep8 bag to clean the mask and tubing. I have not missed a day doing this. I also take the humidifier chamber out and clean it with hot soap and water.

The equipment I'm using is a ResMed AirTouch F20 Full Face Mask, and a ResMed AirCurve 10.

Is the face swelling normal? This is the first night I've had it.

Look at 'liners' on Padacheek.com - they're good at helping with small leaks.

And cover your headband with e.g. clean T-shirt cotton - wipes can't clean the band, only your face.

Are you sure the swelling can't be from something else you might be allergic to (e.g. in food)?

Julie wrote: ↑

Sun Jan 23, 2022 12:23 pm

Are you sure the swelling can't be from something else you might be allergic to (e.g. in food)?

I have seen those liners before, and I'm looking to order some soon. I have a different liner coming in already, so I will try those first. I doubt it's another allergy because that would be an enormous coincidence. I've never had eye swelling/puffing before, and I've only started the BiPAP therapy this week. I do think it seems related to either the mask being too tight, or the mask leaking air into my eye in the middle of the night. I just wasn't sure if this was common for CPAP users.

Welcome! For the leaks, I would add to Julie's good advice the suggestion that you watch videos on how to fit your mask. If your best efforts can't make this mask work for you, you may need to try a different mask that will work better for your particular face.

The facial swelling is not a usual thing with mask use, but sometimes people will find that the mask has moved fluids around in the facial tissues to produce temporary swelling. Did it subside fairly quickly? Any other symptoms, e.g., redness in your eye or swelling of your eyelid?

I'm curious: do you usually breathe through your nose during the day? If so, might you want to try using a nasal pillow mask rather than a full-face mask?

CPAP can cause face swelling. There are quite a few posts about it on the forum, like this one:

https://www.cpaptalk.com/viewtopic/t113 ... lling.html

Miss Emerita wrote: ↑

Sun Jan 23, 2022 12:46 pm

Welcome! For the leaks, I would add to Julie's good advice the suggestion that you watch videos on how to fit your mask. If your best efforts can't make this mask work for you, you may need to try a different mask that will work better for your particular face.

The facial swelling is not a usual thing with mask use, but sometimes people will find that the mask has moved fluids around in the facial tissues to produce temporary swelling. Did it subside fairly quickly? Any other symptoms, e.g., redness in your eye or swelling of your eyelid?

I'm curious: do you usually breathe through your nose during the day? If so, might you want to try using a nasal pillow mask rather than a full-face mask?

Thank you! I will watch the videos. I'm definitely a mouth breather at night, though during the day I'd say I'm not. My concern with a nasal mask is that I will end up breathing through my mouth anyway, and the idea of a chin strap to keep my mouth closed freaks me out a bit. I'm not sure if that makes sense or not, but it sounds deeply unpleasant to me. I have generalized anxiety disorder and I take medication for it. I tend to panic very easily and the though of wearing the mask at night has taken some adjustment for me.

As far as the face swelling, it went down and back to normal within an hour of waking up. But it was troubling to see it when I first woke up.

I'm going to order some mask liners from padacheek.com today, I think. I need to wrap the headgear in certain areas where I think it's irritating my skin, and I need to find a way to stop the leaks. I don't like waking up with the leaks and the "face flatulence" every night.

Sounds like a FFM is your best bet. Try hard with this one, then consider trying a different style. The right mask makes such a difference for the whole experience.

I'm definitely a mouth breather at night, though during the day I'd say I'm not.

A lot of us think we are obligate mouth breathers at first, because with untreated apnea, we open our mouths due to air hunger. The CPAP fixes the air hunger by keeping the airway splinted open, so we don't have to open our mouths to try to bring in more air. If you are able to breathe through your nose during the day, and your sinuses are clear enough at night, you may do very well with a nasal mask.

Here's a good test. Put your tongue up to the roof of your mouth, on the ridge just behind your teeth. Now plug your nose. Can you breathe? If the answer is no, that means you CAN seal off your mouth from your "oropharynx" so the CPAP air will stay in your airway and not come out of your mouth. You may be able to do this naturally at night, or with a little training you can do this.

The training is simple. Place your tongue up in that spot and leave it there all day, except when you eat or talk. As it becomes second nature during the day, it will usually carry over to night. Not everyone is successful with this, but to their surprise, most people are.

FatBruno wrote: ↑

Sun Jan 23, 2022 11:17 am

I use a Sleep8 bag to clean the mask and tubing. I have not missed a day doing this. I also take the humidifier chamber out and clean it with hot soap and water.

FYI: That Sleep8 ozone generator is going to cause premature aging of your mask and tubing.
It does not clean your stuff. It just cleans out your wallet.

There is a lot of problems associated with ozone. Any residual ozone in the tubing can cause lung irritation.
Total speculation on my part but if you're not typically allergic to silicone, the swelling might even be due to the silicone / ozone combo.

Return it if possible.

BTW A lot of us do not feel the need to wash the humidifier chamber daily either.

Using ozone cleaners will void the warranty on your machine.

Miss Emerita wrote: ↑

Sun Jan 23, 2022 12:46 pm

...watch videos on how to fit your mask.

I've tried looking this up. Can you recommend a particular video, or a source to find one?

FatBruno wrote: ↑

Sun Jan 23, 2022 1:46 pm

I'm definitely a mouth breather at night, though during the day I'd say I'm not.

My thinking is that out of habit we do at nite what we do all day long w/o realizing it. Pay attention and be more conscious of your breathing during the day to see. Try to focus on breathing thru your nose during the day.

FatBruno wrote: ↑

Sun Jan 23, 2022 12:36 pm

I've only started the BiPAP therapy this week.

Have you used cpap before this?

FatBruno wrote: ↑

Sun Jan 23, 2022 11:17 am

When I switch sides, the leaks tend to get worse. There were at least two occasions when I woke up frustrated with the leaks keeping me awake (and wanting to scratch my nose) that I sat up in bed and took the mask off for a few minutes before putting it back on. When I put the mask back on, the leaks seem to subside for a while but they always returned.

It sounds like your bipap is an auto? IF so, what may be happening as the pressure increases it puts more force on the straps which will stretch from the increase in force. These straps will have to be re-adjusted each nite as they tend to weaken from the daily stress.

What helped me was to get to bed 30 min. early - set the pressure to the highest you expect - then lay down in your sleeping position while adjusting the straps. Your face will change shapes when laying down.
Do NOT compress the mask seal too flat. just enuff to stop any leaks. The mask seal needs to be able to float some in order to seal correctly.
The other thing to consider is that a FFM has more surface in contact with the face making it harder to seal than both a nasal mask or nasal pillows.

Janknitz wrote: ↑

Sun Jan 23, 2022 8:11 pm

I'm definitely a mouth breather at night, though during the day I'd say I'm not.

A lot of us think we are obligate mouth breathers at first, because with untreated apnea, we open our mouths due to air hunger. The CPAP fixes the air hunger by keeping the airway splinted open, so we don't have to open our mouths to try to bring in more air. If you are able to breathe through your nose during the day, and your sinuses are clear enough at night, you may do very well with a nasal mask.

Here's a good test. Put your tongue up to the roof of your mouth, on the ridge just behind your teeth. Now plug your nose. Can you breathe? If the answer is no, that means you CAN seal off your mouth from your "oropharynx" so the CPAP air will stay in your airway and not come out of your mouth. You may be able to do this naturally at night, or with a little training you can do this.

The training is simple. Place your tongue up in that spot and leave it there all day, except when you eat or talk. As it becomes second nature during the day, it will usually carry over to night. Not everyone is successful with this, but to their surprise, most people are.

Amen to what she said. Learning about the tongue seal freed me from tape, adhesives, straps, etc. Do be mindful that gravity will cause jaw drop. I found that side sleeping on a flat firm pillow eliminated the pull of gravity on my jaw. Good luck!

I am a mouth breather during the day so I assumed I was one at night also. I was wrong. A nasal mask fixed many of the leaking problems and I found out I don't mouth breath at night.

Well, I had a very difficult night again. I watched some videos yesterday, and I got the impression that the mask is NOT supposed to be strapped to your face so tightly. I'm thinking now that was what caused the face swelling the night before. I've had this mask strapped to my head so tightly that it's pretty uncomfortable. However, it's the only way I've been able to maintain any kind of seal and prevent leaking.

So, I decided to approach my new routine differently last night: I laid down and put the mask on loosely and got into a sleeping position (on my side) and attempted to adjust the mask. My BiPAP machine is currently controlled by my doctor; I have no way of seeing or changing the settings for the air pressure. The only thing I can control is the Ramp feature, which I've set to 5 minutes. Last night, I decided to turn OFF the ramp feature so that I could adjust my mask to the actual pressure.

I struggled with this for about an hour, and I even managed to fall asleep briefly at one point only to be awoken with more mask leaks. I kept repeatedly tightening the mask to create a seal, but it became more and more uncomfortable. My prescription says "IPAP Max 25cwp". I seem to remember reading that my machine runs to a max setting of 25, so it's possible this is running the highest and hardest that it can. If that's the case, I wonder if that is the reason I cannot create a good seal. I'm not sure.

Finally, out of absolute frustration I took the mask off entirely after two hours. I needed sleep, even if it did come with all the apneas. I felt disappointed, defeated, and highly annoyed.

I have also wondered if I have the right size mask. It's a Large. I have ordered a Medium because after looking at the chart again, it's possible it's just too big for my face. I hope to get that soon.

I'd rather use the machine tonight, but I have no idea how to approach it anymore. It leaks in multiple places. It's noisy and wakes my wife up when it does. It wakes me up. I can't lay there for hours struggling to keep this damn thing strapped to my face and get any kind of quality sleep.