Adherence to continuous positive airway pressure (CPAP) therapy in men with obstructive sleep apnea (OSA) and erectile dysfunction (ED) significantly improves erections and sexual desire, a randomized controlled study has found. This finding should motivate men with both ED and OSA — a common co-occurrence — to use their prescribed CPAP machine nightly. Kerri Melehan, a doctoral student in Sydney, Australia’s Royal Prince Alfred Hospital and colleagues recruited 61 men with moderate or severe OSA (apneahypopnea index >20/h) and a 6-month or longer history of erectile dysfunction. They randomly assigned them to 12 weeks of treatment with CPAP. Subjects underwent polysomnography before and after treatment. The investigators measured the men’s number of sleep-related erections by recording and monitoring penile tumescence. Participants also reported subjective measures of their sexual function, relationship satisfaction, selfesteem, quality of life, sleepiness level, and satisfaction with ED treatment.
The 55 men who completed the trial had a mean age of 54 years, an average body mass and a mean serum testosterone level. They had an apneahypopnea index (AHI) of 43.9/h on average. In the CPAP vs sham-CPAP part of the study, there were 2 statistically significant findings for the entire group — those receiving actual CPAP had more erections during sleep (average of 4.1 vs 2.4) and better overall sexual satisfaction according to the study report. But the quality of erectile function did not significantly improve the findings showed.
For the subgroup of 20 CPAP recipients who adhered to at least 4 hours of treatment nightly, however, there were additional significant improvements in erectile function/quality and sexual desire as well as self-esteem, sleepiness, social function, and mental health, with reduced depression and stress.
“I can say with complete certainty that CPAP improves erectile dysfunction,” Ms Melehan said. “I think mental factors play a role because they feel more alive and awake.” In addition, she speculated that better oxygenation with CPAP may improve arterial stiffness. That is good news for men with OSA who also have ED
SUMMER VENDOR FAIR DRAWS CROWD
The Summer Support Group Meeting drew a large turnout for the annual Vendor Fair. Seven vendors showcased their latest in CPAP machines, masks, nasal pillows, oral appliances and services.
For those who missed the meeting, the following websites can bring you up to date on the latest;
Contra Costa Sleep Center: www.ccsleepcenter.com
Dental & Sleep Medicine Offices: www.drselleck.com
Fisher & Paykel: www.fphcare.com/sleep-apnea/
Respironics: www.healthcare.philips.com/us_en/homehealth/sleep/
ResMed: www.resmed.com/us/products/productspatients.html?nc=patients
N2Sleep: www.n2sleephomecare.com
Oxygen Plus: oxygenplusonline.com
THE JOURNEY THROUGH THE NIGHT
(excerpted from the Stanford Sleep Book)
Did you know just a regular night’s sleep had so many elements to it? Not many people know really about how complex sleep really is, or how many changes and events occur in just a single, ordinary night.
The following graph is a visual representations of how we generally progress through the different stages of sleep in a typical night.
The graphic representation above shows the transitions and relative amount of time spent in each stage of sleep in a typical night for a human adult. Notice that deep, slow-wave sleep is most prevalent at the start of the night, and that as the night progresses proportionally more and more time is spent in the rejuvenating REM sleep.
Sleep is entered through non-REM Stage 1, which usually persists for only a few minutes. During sleep onset Stage 1, sleep is easily interrupted by very low intensity stimuli, like a door closing or a gentle nudge.
In Stage 2 sleep the sleeper is more difficult to arouse; a stimulus that would produce wakefulness from Stage 1 will often not invoke a complete awakening. In most adults, Stage 4 of this first sleep cycle of the night is very deep sleep, and it is much harder to awaken the sleeper at this time than later in the night. Stage 4 typically continues for about 20 to 40 minutes, after which a series of body movements usually signals an “ascent” to lighter non-REM sleep stages.
A few minutes of Stage 3 may occur, or there may be a direct transition to Stage 2 sleep. After 5 or 10 minutes, the first period of REM sleep appears. This first REM episode of the night is often quite shortlived, usually lasting between 1 to 10 minutes.
The end of a REM episode and the transition to non-REM stages of sleep may be associated with some body movement, and a very brief arousal; or the transition may occur with no movements at all and no arousal. Often there is a change in body position such as a rolling over or a series of smaller adjustments. Throughout the night Non-REM and REM sleep continue to alternate.
The duration of the first sleep cycle–from sleep onset to the end of the first REM episode–is typically 60 to 90 minutes.
In the second sleep cycle, there is less Stage 4 and more Stage 2 sleep. The REM portion of the second cycle is a little longer than the first, usually around 10 to 20 minutes. The duration of the second sleep cycle, measured from the end of the first REM sleep period to the end of the second, is generally longer than the first, averaging 100 to 110 minutes.
In the third REM sleep period and beyond, Stages 3 and 4 are usually entirely absent or present in very small amounts; the non-REM portion of these cycles is almost entirely Stage 2 sleep. REM episodes tend to become longer in later cycles–the fourth or fifth REM episode typically lasts 30 to 45 minutes–leaving room for some serious dreaming time towards the end of the night.
Brief episodes of wakefulness tend to occur in later cycles, generally in association with transitions between Stage 2 and REM sleep, but these brief arousals are usually not remembered in the morning.
In summary, a night of sleep is characterized by a cyclic alternation of non-REM sleep and REM sleep. The average period of this cycle is typically 90 minutes. The first third of the night is usually considered the deepest sleep. REM sleep and Stage 2 predominate in the last third of the night.
SLEEP & FOOD CRAVING
( courtesy of United Healthcare newsletter )
A study funded by the National Institute of Health found that sleep patterns are linked to food cravings. Subjects who got only 4 hours of sleep each night reported a 23% increase in food cravings, especially for high fat, sweet and salty foods.
A “Couple” of Sleep Problems
(From the National Sleep Foundation)
By the time a couple has been together 20 years, they’ll have spent over 50,000 hours (roughly six to seven years) together in their bed. You’d think they’d have everything worked out by then . . . . Yet an estimated 23 percent of U.S. couples sleep apart, according to a survey conducted by the National Sleep Foundation. A survey of builders and architects reports an up-tick in the requests for dual master bedrooms!
For the other 77 percent of couples that do sleep together, the National Sleep Foundation survey indicates that one partner loses an average of 49 minutes of sleep per nightdue to some disruptive behavior, such as snoring, tossing and turning, watching TV, or preferring a warmer or cooler room.
Yet despite this, many psychologists warn that sleeping apart might not be a good solution to sleep issues. They believe that sleeping comfortably with your partner is an essential component of a healthy relationship. So before resorting to separate beds or bedrooms, it’s important to identify and attempt to resolve those potentially disruptive conflicts, even before they occur.
To put it in perspective, most marriages in the United States today start when the couples are in their mid to late twenties— and have therefore spent about a quarter of a century developing their own personal sleep habits and routines. There is an initial period of unlearning and relearning when it comes to sharing the bedroom, and for a while there is relative calm.
But as life progresses, our sleep patterns and habits slowly transform. We change careers, have children, gain weight, get pets. We age. And as we do, we may begin to snore, sleep warm, develop aches and pains, sleep more lightly and wake more frequently.We age at different rates, and men and women age uniquely, introducing potential conflicts in bed. The good news: most of these new “incompatibilities” are easily addressed once they are acknowledged and targeted. In the end, the real goal is simply to improve everybody’s sleep quality. Solving the “offender’s” issue will allow both partners to sleep better. If one simply traipses off to another bedroom without addressing the real problem, there could be unresolved consequences for one or both of you.
Subtle changes in sleeping habits or bedtime routines could help. Sleep accessories such as eye masks, ear plugs or sound machines have helped many. New bedding technologies can solve temperature disputes or disturbances from motion created by tossing and turning.
Finally, the solution may be something more involved. Millions of Americans have developed sleep disorders that require medical intervention. Any serious unresolved sleep issue should be discussed with your primary healthcare provider. After all, it’s about improving everyone’s sleep.