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Sleep Apnea and Erectile Dysfunction

This Forum is for Frequently Asked Questions and information regarding Sleep Apnea.

Sleep Apnea and Erectile Dysfunction

Postby Linda » Tue Aug 09, 2005 7:57 am

Q: What affect does sleep apnea or cpap therapy have on erectile dysfunction?

The following information is provided:

The following abstract is taken from the website for the National Library of Medicine.
It's a little clinical, but the conclusion of the abstract was interesting.
Source: National Library of Medicine (website), July 2005

Click here for link

Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment.

Goncalves MA, Guilleminault C, Ramos E, Palha A, Paiva T.

ISTEL-Porto, Portugal; Stanford University Sleep Disorders Clinic, 401 Quarry Road, Suite 3301, Stanford, CA 94305, USA.

BACKGROUND AND PURPOSE: To evaluate the effect of one month of continuous positive airway pressure (CPAP) in a subgroup of obstructive sleep apnea (OSA) patients with erectile dysfunction (ED) and compare this subgroup with age- and body mass index (BMI)-matched OSA patients without ED. PATIENTS AND METHODS: Prospective general, sleep, psychiatric and sexologic evaluations were conducted. Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Sleep Disorders Questionnaire (SDQ), Quality of Life SF-36, and polysomnography were used. Seventeen OSA patients with ED were compared prior to CPAP treatment and during CPAP treatment with age- and BMI-matched OSA patients without ED. Parametric and non-parametric statistics, chi-square, Fisher exact test and multiple regression analyses were performed. RESULTS: Ninety-eight men (BMI=28.8kg/m(2), apnea-hypopnea index (AHI)=49.6 events/h, ESS=14.8, BDI=8.4, and lowest SaO(2)=75.3%) were divided into subgroups of lowest SaO(2)>80% (A) and lowest SaO(2)</=80% (B). (A) Forty-six men had a mean lowest SaO(2) of 85.7%+/-2.9, AHI=29.5+/-17.6, age=46.3+/-9.3 years, ESS=13.6+/-4.2, BMI=25.8+/-4.8. Seven of the patients had ED. (B) Fifty-two men had a mean lowest SaO(2)=60.10+/-10.0%, AHI=67.4+/-24.5, BDI=9.0+/-6.9, age=47.4+/-9.4 years, ESS=16.2+/-4.4, BMI=31.4+/-5.1. Twenty-one of the patients had ED (chi(2): P=0.006). Significant variables for ED were lowest SaO(2) and age (r=0.17). CPAP-treated subgroup: ED subjects had significantly lower SaO(2), ESS, BDI and SF-36 subscale scores than OSA controls. Nasal CPAP eliminated the differences between groups, and ED was resolved in 13 out of 17 cases. CONCLUSIONS: ED in OSAS is related to nocturnal hypoxemia, and about 75% of OSAS patients with ED treated with nasal CPAP showed remission at one-month follow-up, resulting in significant improvement in quality of life.

The following is another abstract from the website for the Natonal Library of Medicine.
Note, there is a different conclusion from that of the previous described study.
Source: National Library of Medicine (website), Winter 1995

Link Here

Karacan I, Karatas M.

Department of Psychiatry, Baylor College of Medicine, Houston, Texas 77030, USA.

This study assessed characteristics of sexual dysfunction in sleep apnea and the efficacy of treatment with continuous positive airway pressure (CPAP). Twenty-two men with sleep apnea syndrome and also sexual dysfunction served as subjects in this study. Tests included physical, psychological, neurological, and penile vascular examinations, along with polysomnography, nocturnal penile tumescence (NPT), and penile rigidity. All patients clinically had a history of snoring and difficulty getting and maintaining erections. Results indicate that erectile dysfunction in patients with sleep apnea could be related to patient's age and chronic cerebral hypoxia due to apnea. Treatment with CPAP relieved erectile dysfunction in one-third of these patients.

PMID: 8789505 [PubMed - indexed for MEDLINE]

The following information is taken from the WebMDHealth website. Article: May 2005

Click here for link

Sleep Apnea Affects Sexuality, Intimacy

Patients who are treated for their sleep apnea may see an improvement their sex lives.

By Linda Little
WebMD Medical News Reviewed By Michael Smith, MD
on Wednesday, May 25, 2005
Treatment Improves Relationships, Sexual Arousal

This story is part of WebMD's coverage of the American Thoracic Society 2005 International Conference.

May 25, 2005 (San Diego) -- Patients who are treated for their sleep apneasleep apnea may see an improvement their sex lives.

"It could be that they are less tired once the sleep apnea is being treated," says Terri E. Weaver, RN, PhD, associate professor and chairwoman of the biobehavioral and health sciences division at the University of Pennsylvania. She presented her findings at the American Thoracic Society annual meeting.

Sleep apnea is a serious sleep disorder that occurs when a person's airway collapses and breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night. Loud snoring -- a hallmark of the condition -- occurs when the airway collapses.

One of the most common treatments for sleep apnea is called CPAP (continuous positive airway pressure). The patient wears a mask over the nose and/or mouth. An air blower forces air through the upper airway. This prevents the upper airway tissue from collapsing during sleep.

Treatment Makes the Difference

Sleep apnea patients who were treated with CPAP for six hours each night had a reduction in daytime sleepiness and fatigue and an increase in intimacy and sexuality, researchers report.

It is clear that participants with sleep apnea had a decrease in intimacy and sexual relations, says Andrew L. Ries, MD, professor of medicine and family and preventive medicine at the University of California in San Diego.

"But it appears that the major difference is whether the patients were complying with treatment or not complying," he says. "One of the big problems in the treatment of sleep apnea is getting people to accept it and stay with it."

Who Needs Testing?

"Those who snore, have a collar size over 17 inches, who are male, and overweight need to be diagnosed and treated for obstructive sleep apnea," says Weaver. "Treatment is effective in improving a variety of areas of life including intimacy and sexual relationships."

Episodes of apnea can occur 20 or 30 times a night, says Weaver. "This results in extremely fragmented sleep; it is like someone waking you up 20 or 30 times a night."

The study included 156 patients, mostly men, with sleep apnea. Participants with sleep apnea were treated with CPAP and then compared with people without sleep apnea.

Patient sleepiness and intimacy and sexuality were measured. There were four components on the intimacy and sexuality scale -- relationships, desire, arousal, and orgasm.

Daytime Sleepiness, Sexuality Improves With Treatment

Participants' daytime sleepiness improved significantly with CPAP, especially in patients with more severe sleep apnea, she says. "After treatment, participants improved substantially but didn't quite go back up to normal."

In addition, the effect of treatment with CPAP improved patients' sexuality.

"There was a definite relationship between the improvement in sleep apnea and sexual functioning," Weaver says. "They had more energy and were more sexually active than before."


SOURCES: American Thoracic Society 2005 International Conference, San Diego, May 20-25, 2005. Terri E. Weaver, RN, PhD, associate professor and chairwoman, Biobehavioral and Health Sciences Division, University of Pennsylvania. Andrew L. Ries, MD, MPH, professor of medicine and family and preventive medicine, University of California, San Diego.

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