Conference Coverage

CPAP compliance compatible with good sex

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Assess sexual quality of life in OSA

Dr. Octavian C. Ioachimescu, FCCP, comments: Adherence to CPAP therapy for obstructive sleep apnea (OSA) remains a problem in day-to-day practice. Whenever a patient, often but not always a young patient, brings up the issue of CPAP not being 'sexy' in the bedroom, I ask a simple question: "How sexy do you think it is to be snoring, snorting, gasping, choking, or drooling?" That realization seems to work, at least for a while.

If validated, a sexual quality of life questionnaire may be a good instrument to assess this domain of OSA symptoms. If findings of better CPAP adherence being correlated with better sexual quality of life are reproduced in a rigorous trial, then we would welcome another tool in our armamentarium to motivate, engage and empower our patients to participate in the act of therapy. Why not 6 hours and 80% of the nights? Or 8 hours and 100% of the nights?

Dr. Ioachimescu is an associate professor of pulmonary medicine at the Emory University Atlanta VA Medical Center in Decatur, Georgia.


 

AT CHEST 2014

References

AUSTIN, TEX. – Patients who consider themselves too sexy for their continuous positive airway pressure devices should reconsider, according to a presenter at the annual meeting of the American College of Chest Physicians.

“Despite the unsexy appearance of a positive airway pressure device in the bedroom, patients who don’t comply with their CPAP [protocols] do not have a better sexual quality of life,” said Dr. Salman Alim, who presented the original investigation during a quality and clinical improvement session.

Sexual quality of life questionnaires were distributed to 52 men being treated at a single site with continuous positive airway pressure (CPAP) for obstructive sleep apnea. The 10-question survey used a scale of 1-8, with 80 being the highest score, to evaluate aspects of the participants’ emotional and physical satisfaction with their sex lives. Patients were considered CPAP-compliant if they used their device 4 or more hours nightly at least 70% of the time before going to sleep.

The compliant cohort of 27 men, whose average age was 59 years, had a sexual quality of life score of about 38. The noncompliant group of 25 men, whose average age was 56 years, had a score of about 48.

After adjusting for confounding variables such as age, body mass index, erectile dysfunction, use of phosphodiesterase inhibitors, and depression, CPAP compliance did not predict one’s sexual quality of life, reported Dr. Alim, who was with Rosalind Franklin University in North Chicago, Ill., at the time of the study and is now with Physicians Regional Healthcare System in Naples, Fla.

“Although this is not a validated survey … the study’s findings can be the basis to develop a hypothesis that can be tested more rigorously. At the least, the results provide clinicians with useful information on counseling patients on adherence with CPAP,” Dr. Mark Rosen, medical director of the American College of Chest Physicians, said in an interview.

The authors of the study said that they had no relevant disclosures.

wmcknight@frontlinemedcom.com

On Twitter @whitneymcknight

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