Erectile dysfunction

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White-collared, globe-trotting executives over the age of 45 need to watch out for sleep apnoea, according to a recent study by the Madras ENT Research Foundation.

“Our estimates show that 24 per cent of men and 9 per cent of women above 45 years in the country suffer from this problem,” says Mohan Kameswaran, Managing Director of the foundation.

Those with obesity, diabetes and a sedentary lifestyle are more prone to sleep apnoea. Smoking, excessive consumption of alcohol and heavy snoring are other risk factors associated with this disorder. It is common among middle-aged working professionals.

“With intense travelling, they have very little time for physical activity and exercise. They do not maintain a good diet. When you are young, your muscle tone is good. But it slows down after 45,” cautions Kameswaran.

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A growing body of research has also found that sleep apnoea can be a drain on intimacy, causing erectile dysfunction in men and loss of libido in women.

Scientists suspect this may have to do with sex hormones like testosterone, which rise with sleep and fall when there is a lack of it. Because it causes intermittent waking and chronic sleep deprivation, apnea may directly drive down levels of these hormones, causing sexual dysfunction.

In the most recent study, published last month in The Journal of Sexual Medicine, scientists compared 80 women with obstructive sleep apnoea between the ages of 28 and 64 with 240 women without the condition. They found that the apnea patients had significantly higher rates of sexual dysfunction. Their findings echoed those of earlier studies on women and apnea.

In a study in 2009, researchers looked for signs of sexual problems in 401 men who showed up at a clinic for suspected sleep apnea. Of those who received the diagnosis, about 70 percent also had erectile dysfunction, compared with 34 percent in those without sleep apnea.

But on the bright side, treatment can make a difference. Patients who undergo surgery to correct facial abnormalities that contribute to apnea see improvements in intimacy, and those who start using masks at night that administer continuous positive airway pressure also report benefits in their sexual relationships.

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Two studies that link the quality of sleep to the occurrence of erectile dysfunction and other urologic conditions were presented to reporters during the 2011 Annual Meeting of the American Urological Association (AUA).

The studies suggest that men with erectile dysfunction (ED) should be screened for obstructive sleep apnoea (OSA). After adjusting for age and other health conditions, patients with ED were more than twice as likely to have sleep apnoea than their normal counterparts.

This was the largest study to date to demonstrate a relationship between obstructive sleep apnoea and erectile dysfunction. Researchers at Mount Sinai Medical Center in New York evaluated 870 consecutively enrolled men through a cardiac screening program. Patients were screened for obstructive sleep apnea and erectile dysfunction through clinical questionnaires and were asked about their history of cardiovascular disease, blood pressure, diabetes and smoking. The mean age in the study population was 47.3 years, with a mean BMI of 30.2.

Sixty-three percent of patients in the study screened positive for obstructive sleep apnea, 5.6 percent had a history of diabetes, and 29 percent had a smoking history. The likelihood for having OSA increased as the severity of ED increased.

The good news for patients with both OSA and ED is that treatment for sleep apnea through continuous positive airway pressure therapy (CPAP), together with drug therapy, has been shown to improve symptoms of ED.

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