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Surprise finding in sex and sleep apnoea trial


Sexual function in sleep apnoea is a relatively well-researched field. Many studies have shown that the sleep disorder is associated with erectile dysfunction, ejaculation disorder and decreased frequency in sexual relations in men. Fewer studies have been carried out in women, but those that have been done show an association with pain during sex, insufficient vaginal lubrication and lower libido. The question, therefore, is no longer whether sleep apnoea affects people’s sex lives, but whether treatment improves the situation.

A prospective study from Washington University in the US offers some answers. The researchers looked at 182 people diagnosed with sleep apnoea who answered a quality of life survey at diagnosis, and a year after. The questionnaire included two items about sex: “Because of medical problem unable to have sexual relations” and “lack of desire for sexual relations”. Respondents had to score those items from 0 to 5, with 0 indicating no problem and 5 indicating the problem is as bad as it can be.

Among the participants, 72 used a CPAP machine after diagnosis, while 110 didn’t or weren’t able to. The researchers found a substantial difference between the two cohorts, with the patients on CPAP therapy reporting greater sexual satisfaction than those who weren’t. But when they adjusted for a range of socioeconomic and other confounders, they found the gains were all skewed to one gender. Women’s libido bounced back, but men’s didn’t.

“We were surprised to see a pretty big effect on women, but minimal effect on men, especially given previous literature,” says lead author Dr Sebastian Jara.

He says the findings go against previous studies which have found a positive effect of CPAP on men’s sex lives. But he says the reason for the discrepancy between his team’s study and previous ones might be to do with differences in the cohorts studied. Previous studies tended to look at men who already had a sexual problem such as erectile dysfunction, and measured whether CPAP helped with the problem.

“Those subjects might have been starting from a relatively worse-off place, which may have resulted in higher self-reported improvement,” he speculates.

Men with sleep apnoea have been more intensively studied than women, because of a perception that it is more of a man’s disorder. But Dr Jara says there is a growing recognition that women can be affected as well, and can benefit from CPAP therapy.

He says that even if his study did not demonstrate a benefit in sexual satisfaction in men, there are many other reasons why a man with sleep apnoea would want to start therapy.

“A myriad of other long-term health benefits and improvements in well-being have been demonstrated with CPAP,” he points out.

The study was published in JAMA Otolaryngology & Head and Neck Surgery. You can access it here.