SEATTLE — Long-term use of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea improves a range of health markers including, for women, improvement in sexual quality of life.

That’s according to an observational study in JAMA Otolaryngology-Head & Neck Surgery, which pointed out that obstructive sleep apnea (OSA) reduces libido and intimacy and can cause erectile dysfunction in men. A study team led by University of Washington researchers and including the Seattle VAMC sought to determine if treatment for OSA improves sexual quality of life (QOL).1

“Continuous positive airway pressure (CPAP), the first-line treatment for OSA, may improve sexual QOL,” study authors wrote. “In men with OSA, several studies reported that CPAP is associated with improvements in partner intimacy and in sexual function, such as erectile dysfunction, orgasmic function, and sexual satisfaction. However, limited data exist for women.”

To remedy that, the researches focused on 182 patients — more than 35% women — with newly diagnosed obstructive sleep apnea who were prescribed CPAP treatment from September 2007 through June 2010. The analysis involved issues of CPAP use, defined as more than four hours per night vs. nonuse, defined as fewer than 0.5 hours per night. A survey determined changes in sexual QOL.

The prospective cohort study at a single, tertiary medical center lasted from Sept. 1, 2007, through June 30, 2010, with follow-up completed June 30, 2011. Participants included 115 men (63.2%) with a mean age of 47.2 with severe OSA (mean [SD] apnea-hypopnea index, 32.5 [23.8] events per hour).

Results at the 12-month follow-up indicated that 72 CPAP users (mean [SD] use, 6.4 [1.2] hours per night) had greater improvement than 110 nonusers (0 [0] hours per night) in sexual QOL scores (0.7 [1.2] vs 0.1 [1.1. The difference was 0.54; 95% CI, 0.18-0.90, for an effect size of 0.47.

Researchers reported that a moderate treatment association was documented after adjustment for age, sex, race/ethnicity, marital status, income level, educational level, body mass index, apnea-hypopnea index, and the Functional Comorbidity Index (adjusted difference, 0.49; 95% CI, 0.09-0.89; effect size, 0.43).

On the other hand, subgroup analysis revealed a large treatment association for women (adjusted difference, 1.34; 95% CI, 0.50-2.18; effect size, 0.87) but not for men (adjusted difference, 0.16; 95% CI, −0.26 to 0.58; effect size, 0.19).

“Successful CPAP use may be associated with improved sexual QOL,” study authors concluded. “Subgroup analysis revealed a large improvement in women but no improvement in men. Further study is warranted to test other measures of sexual QOL and other treatments.”

“This study supported the hypothesis that long-term CPAP therapy is associated with improved sexual QOL in a cohort of patients with OSA,” they added. “Our results showed that CPAP users experienced a greater improvement of sexual QOL when compared with CPAP nonusers. This association was noted in the unadjusted and the fully adjusted models after including several important confounders. Subgroup analysis for CPAP users showed that men had no treatment outcome and that women had a pronounced treatment outcome in sexual QOL improvement, which differs from previous studies that observed a more pronounced treatment outcome in men.”

1Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep Apnea: Follow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2018 May 24. doi: 10.1001/jamaoto.2018.0485. [Epub ahead of print] PubMed PMID:29800001.