May Dyspnea Sensation Influence the Sexual Function in Men With Obstructive Sleep Apnea Syndrome? A Prospective Control Study

Abstract

Introduction: Dyspnea sensation is frequently present in obstructive sleep apnea syndrome (OSA) patients; however, its possible influence on sexual function and body image has not been well analyzed. Aims: To evaluate sexual function, the prevalence of sexual dysfunction (SD), and body image during sexual activity and its relationship with dyspnea in men with OSA. Methods: 129 men were included in the prospective study, with 61 diagnosed with OSA (cases) and 68 age-and BMI-matched healthy control subjects. Patients were assessed for the severity of heart failure by the New York Heart Association scale and dyspnea by the Visual Analogue Scale. OSA was confirmed by in-laboratory polysomnography. Main Outcome Measures: International Index of Erectile Function (IIEF) was used as a measure of sexual function, body image during sexual activity was assessed by the Body Exposure During Sexual Activity Questionnaire, whereas SD was diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Results: The mean age of the studied population was 57.9 ± 10.8 years. Presence of dyspnea interfered with sexual life in 20% of men diagnosed with OSA and with work performance in 33%. Men with OSA had worse scores in IIEF-15 compared with control subjects and higher frequency of sexual distress compared with men with OSA. There were no differences in the rate of SD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The presence of OSA worsened the perceived body image during sexual activity. The presence of dyspnea was the only negative factor affecting sexual function in general (IIEF-15 score) and 1 of the factors affecting erectile function and orgasmic function. Conclusion: In men with OSA, body image is negatively influenced by the presence of OSA. Furthermore, the presence of dyspnea assessed by the New York Heart Association scale impairs sexual function in that group of men.

Prevalence and Characteristics of Erectile Dysfunction in Obstructive Sleep Apnea Patients

“…This figure is basically consistent with the following studies. Skoczynski (51) reported that the prevalence of ED in 61 Polish OSA patients was 72.1%; Popp (52) reported that the prevalence of ED in 246 German OSA patients was 65.0%; Budweiser (53) reported that the prevalence of ED in 91 German OSA patients was 61.5%; and Zhang (54) reported that the prevalence of ED in 207 Chinese OSA patients was 60.6% and that the prevalence of severe OSA with ED was 72.2%. Moreover, the prevalence of ED in 24 Turkish OSA patients was reported to be 54.2% by Gurbuz (55).…”

“…A study by Margel (59) showed that the severity of OSA (mainly the AHI value) may be related to the severity of ED. Skoczynski (51) suggested that OSA will lead to cardiovascular complications with age, leading to an increase in AHI values, and will be accompanied by increased dyspnea, which ultimately leads to the occurrence of ED Liu (60) reported abnormal circadian rhythm is associated with a decrease in sperm count, and as the circadian rhythm improves, the sperm count can be restored. Moreover, Vincent (61) reported that when OSA worsens, it causes fear of heart failure symptoms and promotes general anxiety about sexual activity.…”