CPAP for sleep apnea improves sex for women, but not men

Newly published research from the University of Washington suggests use of a CPAP machine can improve overall quality of sexual life for women.  In their press release (read it here), they report surprise that it did not improve for men. Dr. Sebastian Jara, the study’s lead author, is quoted as saying:

“This study measured sexual quality of life in terms of patients’ self-perceptions. We were surprised to see a pretty big effect in women, but minimal effect in men – especially given previous literature.”

Published online (May 24, 2018) in the JAMA Otolarngology – Head and Neck Surgery ((Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485)) (read the full article here), the study compared 72 CPAP users (60% male) to 110 non CPAP users (65% male). Subjects were largely white (75%) married (69%) well educated (53% college or greater) with a mean age of 47.2.

Data was collected at the beginning and after 12 months by self report (CPAP use monitored by machine). Both groups showed “baseline deficit in sexual QOL”.

“At 12 months, CPAP users experienced a mean improvement in sexual QOL, with a moderate to large ES [Effect Size] and a 95% CI consistent with an important clinical association (mean [SD] change, 0.7 [1.2]; 95% CI, 0.4-1.0; ES, 0.60). In contrast, nonusers had no significant change in sexual QOL at 12 months (mean [SD] change, 0.1 [1.1]; 95% CI, –0.1 to 0.4; ES, 0.11).”

“The subgroup analysis of men in this initial model revealed no difference in sexual QOL improvement at 12 months between CPAP users and nonusers (adjusted difference, 0.03; 95% CI, −0.38 to 0.43; ES, 0.04), whereas the subgroup analysis of women showed a greater improvement in sexual QOL at 12 months in CPAP users than nonusers (adjusted difference, 0.88; 95% CI, 0.08-1.68; ES, 0.57).”

The authors point to many previous studies that showed improved sexual functioning for men using CPAP. They also point to one study ((Petersen  M, Kristensen  E, Berg  S, Midgren  B.  Long-term effects of continuous positive airway pressure treatment on sexuality in female patients with obstructive sleep apnea. Sex Med. 2013;1(2):62-68.)) that showed use of CPAP helped with sexual dysfunction, but no changes in isolated sexual difficulty, sexual distress, or overall satisfaction.

Take Care

The biggest problem with this study was likely in the assessment of sexual Quality of Life (SQOL). SQOL was assessed with two questions from the sex-related questions in the SNORE-25. 1) “Because of medical problem, unable to have sexual relations”; and 2) “Lack of desire for sexual relations”. The mean score of these 2 Likert scale items was used to produce a sexual QOL score ranging from 0 to 5 (higher is worse). Not only is this a non-validated assessment of Sexual Quality of Life, I would theoretically challenge the individual questions AND averaging these two very different questions as an appropriate assessment of Sexual Quality of Life.



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