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Randomized Controlled Trial
. 2007 Jul;4(4 Pt 2):1153-62.
doi: 10.1111/j.1743-6109.2006.00341.x. Epub 2006 Nov 1.

Sexual function and obstructive sleep apnea-hypopnea: a randomized clinical trial evaluating the effects of oral-appliance and continuous positive airway pressure therapy

Aarnoud Hoekema  1 , Anna-Lucia Stel, Boudewijn Stegenga, Johannes H van der Hoeven, Peter J Wijkstra, Mels F van Driel, Lambert G M de Bont
Affiliations
Randomized Controlled Trial

Sexual function and obstructive sleep apnea-hypopnea: a randomized clinical trial evaluating the effects of oral-appliance and continuous positive airway pressure therapy

Aarnoud Hoekema et al. J Sex Med. 2007 Jul.

Abstract

Introduction: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with sexual dysfunction. Although successful treatment with continuous positive airway pressure (CPAP) has been demonstrated to improve sexual function, the effects of oral-appliance therapy are unknown.

Aim: The aims of this study were to determine to what extent untreated male OSAHS patients experience sexual dysfunctions compared with control subjects, and second, to evaluate the effects of oral-appliance and CPAP therapy on sexual functioning.

Methods: Sexual functioning was determined in 48 OSAHS patients with the Golombok Rust inventory of sexual satisfaction (GRISS) and a testosterone measurement. GRISS outcomes were compared with 48 age-matched male controls without any sexual problems. Patients were randomized for either oral-appliance or CPAP therapy. After 2-3 months of treatment, the GRISS and testosterone measurements were repeated.

Main outcome measure: The outcomes on the GRISS were used as the main outcome measure.

Results: Compared with controls, OSAHS patients had significantly more erectile dysfunction (mean +/- standard deviation; OSAHS 8.7 +/- 3.8 vs. controls 6.8 +/- 2.6) and sexual dissatisfaction (mean +/- standard deviation; OSAHS 9.7 +/- 4.2 vs. controls 8.1 +/- 2.6) as indicated by the GRISS. No significant changes in the GRISS or testosterone levels were observed in the 20 and 27 patients completing the follow-up review for oral-appliance and CPAP therapy. A correlation was demonstrated between the extent of erectile dysfunction at baseline and improvements in erectile function following treatment (r = -0.547, P = 0.000).

Conclusions: This study confirms that male OSAHS patients show more sexual dysfunctions compared with age-matched control subjects. Although significant improvements in sexual functioning in neither the oral-appliance nor CPAP-treated group could be established, our findings suggest that untreated OSAHS patients with pronounced erectile dysfunction experience some improvement following treatment.

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