Outcome of CPAP Treatment on Intimate and Sexual Relationships in Men with Obstructive Sleep Apnea

Reishtein, Judith L.; Maislin, Greg; Weaver, Terri E.

doi:10.5664/jcsm.27817

Cited by 28 publications

(25 citation statements)

References 37 publications

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“…snoring‐induced sleep disruption) often leads to patients and their spouses sleeping apart (Billmann and Ware, 2002). In previous reports, we observed that patients demonstrated improved intimacy and sexual relationships following 3 months of CPAP treatment (Reishtein et al. , 2010; Ye et al.…”

Section: Discussionmentioning

confidence: 83%

Predictors of continuous positive airway pressure use during the first week of treatment

Pack

Maislin

et al. 2011

Journal of Sleep Research

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Summary This study aimed to identify pre-treatment and immediate early treatment factors predicting continuous positive airway pressure (CPAP) use during the first week of therapy, when the pattern of non-adherence is established. Four domains of potential predictors were examined: pre-treatment demographic and clinical factors, patients’ perceived self-efficacy, treatment delivery (mask leak and bothering side effects), and immediate disease reduction (residual respiratory events and flow limitation). The Autoset™ Clinical System objectively documented daily CPAP use, mask leak, residual respiratory events, and flow limitation. Ninety-one CPAP-naïve patients with newly diagnosed obstructive sleep apnea were followed for 1 week after treatment initiation. Mean CPAP daily use during the first week was 3.4 ± 2.7 hours, with significantly lower use observed in Black than non-Black participants (2.7 vs. 4.4 hours, respectively, p= 0.002). Less intimacy with partners caused by CPAP was the only treatment side effect correlated with CPAP use (r= -0.300, p=0.025). Reduced CPAP use during the first week was simultaneously associated with being Black, higher residual apnea-hypopnea index, and the treatment side effect of less intimacy with partners. The three factors together accounted for 25.4% of the variance in the CPAP use (R2=0.254, p<0.01). These data suggest the need to assess the impact of CPAP on intimacy and troubleshoot aspects of the treatment that interfere with sexual relationships. Assessing the presence of residual respiratory events may be important in promoting CPAP adherence. The association of race and CPAP use needs to be further explored by including more socioeconomic information.

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Section: Discussionmentioning

confidence: 83%

Predictors of continuous positive airway pressure use during the first week of treatment

Pack

Maislin

et al. 2011

Journal of Sleep Research

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“…In a survey of 467 men, Andersen et al [16] demonstrated that obesity, low testosterone levels, and OSA were associated with a higher risk of ED complaints. On the other hand, Reishtein et al [70] found that patients with pronounced complaints of ED experienced some improvement following oral appliance and CPAP therapy, but significant and sustained improvements could not be established. Furthermore, there were no significant changes in the testosterone levels following the treatment.…”

Section: Discussionmentioning

confidence: 99%

Sexual Dysfunction in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Liu

Kang²,

Zhao³

et al. 2015

The Journal of Sexual Medicine

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Introduction Sexual dysfunction is an under-recognized problem in men and women with obstructive sleep apnea (OSA). Epidemiologic findings were inconclusive regarding the risk for sexual dysfunction associated with OSA. Aim The aim of this study was to examine the association between OSA and sexual dysfunction. Methods The PubMed, Cochrane Library, and Embase databases were searched for observational studies on the OSA and the risk of sexual dysfunction. The methodologic quality of the case–control and cohort studies was assessed with Newcastle–Ottawa Scale (NOS). The cross-sectional study quality methodology checklist was used for cross-sectional study. Data were pooled for the random-effects model. Sensitivity analyses were conducted to assess potential bias. Main Outcome Measure The association between OSA and sexual dysfunction was summarized using relative risk (RR) with a 95% confidence interval (CI). Results This meta-analysis included 1,275 participants from nine studies. Five studies reported the incidence of erectile dysfunction (ED); the remaining four studies reported the incidence of female sexual dysfunction (FSD). Pooled results demonstrated that OSA was associated with increased risk of ED (pooled RR = 1.82, 95% CI: 1.12–2.97) as well as FSD (pooled RR = 2.00, 95% CI: 1.29–3.08). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. Conclusions Evidence from the observational studies suggested that OSA individuals might have an increased incidence of sexual dysfunction despite significant heterogeneity. More researches are warranted to clarify the relationship between OSA and the increased risk of sexual dysfunction.

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“…In studies using pre-and postmeasures without a control group, CPAP treatment in general resulted in improved erectile function (32,33), gonadal function (34) orgasmic function, intercourse satisfaction, overall satisfaction and overall sexual function, although sexual desire did not improve (32). Reishten et al found that after CPAP of 3 months, intimacy and the sexual relationship was significantly improved, and more so for those with severe OSA (AHI ≥ 60), including fewer problems with desire, intimacy, arousal and orgasm (35). Objective measurements using Rigiscan also demonstrated significant improvement in erectile function (33).…”

Section: Interventions In the Management Of Sexual Dysfunctionmentioning

confidence: 99%

Determinants of sexual dysfunction and interventions for patients with obstructive sleep apnoea: a systematic review

et al. 2015

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Aims: Obstructive sleep apnoea (OSA) may negatively affect a couple's sexual relationship. This systematic review evaluated what characteristics are determinants of sexual function and dysfunction in women and men with OSA, and what interventions are shown to be effective. Methods: A systematic literature review was conducted using PubMed, CINAHL, Cochrane and TRIP, and articles published between January 2004 and December 2014 in English; original research; adults ≥ 18 years; and both experimental and non-experimental designs. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies was used to assess study quality. Of 21 studies, six studies (no randomised control trials, RCTs) included women and 15 (with six RCTs) studies included men. Extracted data were scrutinised and adjusted until consensus was reached; suitable quantitative data were pooled in statistical meta-analysis. Results: Sexual function was affected similarly in both genders, but effective interventions were reported only for men. In some studies, OSA severity and medications contributed to greater sexual dysfunction. In women, menopausal status, hormone levels and SaO 2 < 90% were determinants of sexual dysfunction, while for men factors included BMI, hormonal status and inflammatory markers. Continuous positive airway pressure (CPAP) not only improved clinical measures such as excessive daytime sleepiness but also the erectile and orgasmic function. Nevertheless, sildenafil was superior CPAP with regard to erectile dysfunction. Conclusions: The findings illustrate important contributors to sexual dysfunction; however, firm generalisations cannot be made. There were limited RCTs and none for women, indicating further RCTs are needed to determine how OSA affects sexual function. Review criteriaThis systematic review is based on a search of four databases (PubMed, CINAHL, Cochrane and TRIP). The articles included experimental, quasiexperimental, non-experimental and/or mixed method designs. Eligible studies focused specifically on obstructive sleep apnoea (OSA) and erectile dysfunction or sexual dysfunction. Each study was independently assessed by two reviewers for quality on six components (selection bias, study design, confounders, blinding, data collection method, withdrawals/dropouts) and an overall global rating.

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Outcome of CPAP Treatment on Intimate and Sexual Relationships in Men with Obstructive Sleep Apnea

Cited by 28 publications

References 37 publications

Predictors of continuous positive airway pressure use during the first week of treatment

Predictors of continuous positive airway pressure use during the first week of treatment

Sexual Dysfunction in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Determinants of sexual dysfunction and interventions for patients with obstructive sleep apnoea: a systematic review

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