Too Sleepy For Sex?
Excerpt By Pat Curry, HealthScoutNews Reporter

(HealthScoutNews) -- Doctors have known for years that snoring is the top symptom of sleep apnea, a potentially life-threatening condition that blocks airflow while a person sleeps. Now, researchers are finding that sleep apnea and snoring can also ruin your love life.

A survey of almost 5,000 patients who snore revealed that an overwhelming majority were sleeping in separate rooms from their partners. And because sleep apnea sufferers rarely get a good night's sleep, they wake up feeling tired, which can definitely lead to a lackluster sex life.

"Young patients with apnea don't feel they have any energy -- some people, they get into depression," says Dr. Ali Vaziri from the Center for Corrective Jaw Surgery in Philadelphia, which did the survey and specializes in the treatment of snoring and sleep apnea.

Studies have already shown there is a strong relationship between sleep apnea and erectile dysfunction. Since that relationship was established in 1990, researchers have been looking for the underlying cause.

"We found that people with severe sleep apnea have, on average, lower testosterone," says Dr. Max Hirshkowitz, an associate professor of psychiatry and medicine at Baylor College of Medicine, which has conducted two studies on the subject.

Two other studies in the last decade, by the Sleep Disorders Center at Royal Prince Alfred Hospital in Sydney, Australia, found that after sleep apnea was treated, testosterone levels were higher and some sexual function was restored. The complications of snoring and sleep apnea, including high blood pressure, excessive daytime sleepiness, and increased risk of heart attack or stroke, also can suppress a healthy interest in sex.

The frequency of erectile dysfunction in sleep apnea patients, Hirshkowitz says, is "probably multi-factorial," with those factors including sleepiness, reduced oxygen consumption and reduced libido from lower testosterone.

Giving patients testosterone makes sleep apnea worse, he adds. Giving them female hormones to lower their testosterone improves the sleep apnea, "but the cure is the worse than the disease," he says, because of impotence that could then result.

The best treatment for sleep apnea, he adds, is continuous positive air pressure (CPAP), a mask that sleep apnea patients wear to hold the airway open and keep oxygen flowing freely as they sleep. Studies on CPAP and erectile dysfunction found that between 25 and 30 percent of patients recovered sexual function after treatment.

The Center for Corrective Jaw Surgery's findings were presented at the recent annual meeting of the American College of Oral and Maxillofacial Surgeons.

The survey, of 4,900 surgical patients, reported that 80 percent of patients, because of snoring, were sleeping in separate rooms from their bed partners.

"They work all day, come home and fall asleep watching TV. They have no energy for physical activity. After treatment, they do say it improves their sex life," Vazir says.

Post-surgical surveys, he adds, reported that snoring was reduced in intensity by an average of 90 percent and in frequency by 87 percent. Additionally, more than 80 percent reported improved relationships.

Vaziri says that in the post-operative survey, patients were asked if they "spend more time together in bed," and 100 percent said yes. One hundred percent of the patients between the ages of 25 and 40 say the procedure improves their sex life.

Of course, many people snore without having sleep apnea.

According to the Academy of Dental Sleep Medicine, snoring occurs "when the structures in the throat are large and when the muscles relax enough to cause the airway to narrow and partially obstruct the flow of air."

Causes can include nasal deformities, a deviated septum, trauma from an injury to the nose, enlarged tonsils, a long soft palate and uvula (the piece of tissue that hangs down in the back of your throat), and excess fat deposits. As air tries to pass around the obstructions on its way to the lungs, the throat structures vibrate.

Treatments include oral appliances to stabilize the jaw and tongue, tonsillectomy to remove the tonsils or tonsillar coblation to shrink their size, as well as surgery to remove excess tissue from the soft palate. Losing weight can also improve a person's snoring and sleep apnea.

Hirshkowitz emphasizes that while surgery will probably get rid of the snoring, it doesn't mean that sleep apnea patients are cured.

"You're treating a symptom, but you may have created a more dangerous situation," he says.

He adds: "A good example is this: you have chest pain, so you go into an emergency room and someone gives you a pain killer. You still have cardiac ischemia; you just can't feel it. There's a whole bunch of experimental surgical procedures to modify the airway. If it helps, that's great. But you don't know if it's helped until you test it afterwards. You need follow-up."

What to Do: For information on normal breathing, snoring and sleep apnea, check out the Academy of Dental Sleep Medicine Web site. For details on surgical treatments for snoring and sleep apnea, check out Snorenet. To see just how tired you are, take the Daytime Sleepiness Quiz at the National Sleep Foundation.

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