Sleep Apnea and Erectile Dysfunction

Obstructive sleep apnea is a fairly common sleep disorder in which there is a sudden changes in the rhythm and rate of breathing during deep stages of sleep. Although there are several clinical varieties of sleep apnea; the obstructive sleep apnea is a potentially serious type, especially in regards to the long term complications and potential adverse effects on overall health.The obstructive sleep apnea is characterized by contraction of throat muscles which leads to sudden but brief interruption of breathing during deep sleep followed by automatic resolution of normal breathing. The incidence of obstructive sleep apnea is much higher in obese individuals. Additionally, some degree of obstructive sleep apnea is common in elderly population.

Association of Obstructive Sleep apnea (OSA) With Erectile Dysfunction (ED)

According to several research studies, it has been observed that approximately 50 -65% men who experience severe obstructive sleep apnea eventually develops some degree of erectile dysfunction. The exact etiology or pathophysiology of erectile dysfunction in the setting of OSA is not exactly known, but based on extensive clinical and interventional research; following theories have been postulated by investigators:

• Sleep deprivation and lack of sleep negatively affects the capacity of an individual to develop/ sustain normal erection: Several clinical studies have suggested that the primary male sex hormone, testosterone is produced and synthesized mainly at the night time. It has been observed that inappropriate or insufficient sleep can significantly reduce the concentration of testosterone in the male body leading to compromised libido and decreased erections.
• Body Fatigue: Insufficient sleep is directly associated with unexplained fatigue that directly leads to impaired sexual activity.
• Oxygen Deprivation: Decreased concentration of oxygen in the body due to obstructive sleep apnea and impaired breathing can act as a contributing factor that may lead to erectile dysfunction in men. This is mainly because sufficient supply of oxygen is required to achieve optimal erection and sustain motor activity of muscles.

Clinical statistics indicates that individuals who receive treatment for obstructive sleep apnea reports progressive improvement in the sexual activity in males.

Some Classic Symptoms of Obstructive Sleep Apnea (OSA)

In most cases, obstructive sleep apnea is largely concealed since sleep abnormalities are usually reported during deep breathing. It has been observed that sleeping partners are usually first to notice the OSA. Affected individuals experience these characteristic symptoms:

• Sleepiness at daytime
• Breathing cessation at night
• Shortness of breath leading to abrupt awakenings
• Nightmares
• Dry mouth at night
• Sore-throat
• Chest pain or angina pain at night (especially if pauses in breathing are long)
• Headaches in the morning
• Inability to concentrate or function during the daytime
• Mood swings, blues – if left poorly managed, individuals may develop depression
• Insomnia
• Higher propensity to develop hypertension

Why Should You See a Doctor For OSA Management?

Consultation with physician becomes necessary if the patient is observing any of the symptoms discussed below.

• Loud snoring (during sleep)
• Severe shortness of breath which disturbs the sleep and alters quality of life due to constant drowsiness (falling asleep while performing routine work, watching television or during driving)
• Erectile dysfunction

Home Remedies and Lifestyle Modifications For the Management of OSA and Erectile Dysfunction:Following are some self-care tips through which obstructive sleep apnea can be controlled effectively.

• Weight Loss: obesity is strongly associated with erectile dysfunction as well as obstructive sleep apnea. Experts suggest that effective weight loss can help in dealing with both the disorder without requiring any other intervention.
• Aerobics: Different exercises like aerobics can also help in improving both the condition
• Avoid Use of Sleeping Pills and Tranquillizers: Use of tranquillizers and alcohol intake is negatively associated with sexual function. Likewise, experts believe that any condition that affects the reflexes and motor functioning can worsen sleep apnea.
• Sleep Position: Sleeping on the abdomen (instead of back) helps in reducing the OSA. A good night sleep allow individuals to maintain a more functional lifestyle.

If home remedies are ineffective at restoring normal erectile activity; it is highly recommended to opt for more invasive procedures (for example adenoid or tonsil surgery, if OSA is due to organic conditions). It is imperative to understand that OSA is a serious issue which may lead to hypertension, stroke, Alzheimer’s disease, dementia, diabetes and other health issues if left untreated.References:

1. Fanfulla, F., Malaguti, S., Montagna, T., Salvini, S., Bruschi, C., Crotti, P., ... & Rampulla, C. (2000). Erectile dysfunction in men with obstructive sleep apnea: an early sign of nerve involvement. Sleep, 23(6), 775-781.
2. Goncalves, M. A., Guilleminault, C., Ramos, E., Palha, A., & Paiva, T. (2005). Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment. Sleep medicine, 6(4), 333-339.
3. Margel, D., Cohen, M., Livne, P. M., & Pillar, G. (2004). Severe, but not mild, obstructive sleep apnea syndrome is associated with erectile dysfunction. Urology, 63(3), 545-549.