Sleep Well

By Michael Breus, PhD, ABSM

If you’re familiar with sleep apnea, you may know that CPAP—Continuous Positive Airway Pressure therapy—is the most common treatment for the disorder. CPAP is a very effective treatment for sleep apnea—when it is used consistently. One of the difficulties associated with CPAP therapy is that people, once prescribed the treatment, don’t use it regularly—or at all. Among the most common complaints? That CPAP, with its rather prominent headpiece, is a romance killer, a decidedly un-sexy presence in the bedroom.

Before you (or your bedmate) puts that CPAP in the closet to collect dust, you’ll want to take note of this news: according to a recent study, CPAP, instead of being a hindrance to sex, can actually help men with sleep apnea improve their sex lives.

CPAP therapy involves a machine with a headpiece worn during sleep, which pushes a constant stream of air through the airway, preventing it from collapsing. It is this repeatedly collapsing airway—and the temporary halt in breathing and cut-off of oxygen—that is the hallmark of sleep apnea. Obstructive sleep apnea is among the most common sleep disorders, affecting more than 18 million Americans. The true number is likely much higher—we know that this is a sleep disorder that remains significantly under-diagnosed. Sleep apnea poses serious health risks and is linked to heart disease, stroke, high blood pressure, and obesity.

In addition to these serious health complications, OSA can also wreak havoc with a person’s sex life. Studies have shown that sleep apnea increases the likelihood of sexual dysfunction for both men and women. In addition, the disrupted, restless, and often noisy sleep of a person with OSA—which can include loud snoring—can send sleeping partners to separate beds. Not good for intimacy.

Researchers at Walter Reed National Military Medical Center have found that regular CPAP use can improve both sexual function and sexual desire among men with obstructive sleep apnea. Their study examined erectile function and libido among 92 men who’d recently been diagnosed with sleep apnea and were using CPAP therapy. All the men were under the age of 60—their average age was 45—and none were diabetic. Researchers testing the men at the outset of the study found that nearly 50% of the 92 participants were suffering from some degree of erectile dysfunction. This is not surprising—we know that men with sleep apnea are also significantly more likely to suffer from ED than men without sleep apnea.

Researchers evaluated the men at 1, 3, and 6 months after beginning CPAP therapy. They found that all the men experienced improvement in both erectile function and libido as CPAP treatment progressed. The men who had been diagnosed with erectile dysfunction at the beginning of the study experienced the most significant improvement to their sexual function and desire. But even the men without ED saw improvements to their libido and sexual function after using the CPAP to treat their sleep apnea.

This is just the latest extra benefit of CPAP therapy to be identified—that is, in addition to treating well the primary problem of sleep apnea. We recently learned that CPAP might have important benefits in reducing sensitivity to pain. People with disrupted and chronically poor sleep are often more sensitive to everyday aches and pains, and to chronic pain from disorders such as fibromyalgia.

The key to getting these additional benefits, to restoring your sleep, protecting your health, and boosting your sex life? Use CPAP consistently. We know that support from partners can help CPAP users stick with the therapy. Couples who choose to adopt a teamwork mentality—and a positive, open mindset to the presence of the device in the bedroom—may be rewarded not only with better sleep, but also with a re-invigorated sex life.

Other strategies for making the CPAP work in the bedroom?

Prepare for a period of adjustment. There’s no question that the device takes a little getting used to for some—maybe most—people. Accept that up front, and don’t give up! There’s evidence that short-term use of prescription sleep aids can help CPAP users adjust to those first weeks of the therapy, so talk to your doctor about this option, if you’re finding the adjustment process difficult.

Stay in the same bed. Snoring and sleep apnea can drive bedmates apart. Don’t let this very effective treatment for the sleep disorder keep you and your partner sleeping in separate beds. Trust me, the CPAP will be a lot quieter than the snoring was. Plus, research has shown that husbands whose wives continue to sleep in the same bed with them are significantly more likely to keep up with their CPAP use.

A word about gender. The sexual problems that are often a consequence of sleep apnea are not confined to men. Women, too, suffer in sexual function and desire as a result of OSA. The impact of sleep apnea—as well as other sleep disorders—on women’s sex lives continues to be an under-examined area of study. We have seen research that shows women with sleep apnea at a much higher risk for sexual problems than women without OSA. I hope we’ll see additional research that looks at the role CPAP might play in improving women’s sex lives.

But that doesn’t diminish the fact that this latest study brings most welcome and important news for men—and their partners. Keeping up with your CPAP routine can help to improve your sex life and your relationship, as well as your sleep.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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