To begin with, the authors explain that 30% to 68% of men with obstructive sleep apnea (OSA) suffer from some level of sexual dysfunction. Loss of interest in sex has been associated with the number of apneas and how low a patient’s oxygen level goes when asleep. They warn us that CPAP treatment has not definitively been shown to improve sexual function.
The authors designed the study to look at OSA patients’ perceptions of their intimate and sexual relationships, the association with daytime sleepiness, and degree of impairment compared to normal values, and to document if there was any improvement with CPAP treatment.
They studied 123 men, with most of the patients being middle-aged, obese, and with severe sleep apnea. The patients rated their intimate and sexual relationships with a questionnaire that asked about sexual desire, ability to become sexually aroused, and ability to have an orgasm.
The results showed that men with OSA have worse intimate and sexual relationships and this is related to daytime sleepiness. Following treatment with CPAP, intimate and sexual functioning improved, with the most severe amount of OSA showing the largest improvement. This improvement was related to improvement in daytime sleepiness.
Why would men with OSA have worse intimate and sexual relationships? Being tired may mean men are less interested and have more difficulty with sexual activity. OSA can affect certain hormones like testosterone, which could then impact sexual interest and performance. Finally, low oxygen levels have been associated with impotence. The authors also point out that, although regular CPAP use did improve sexual functioning, 43% of those OSA patients using CPAP for 3 months did not improve to a level seen in men who do not have OSA at all.