Sexual disorders and dyspnoea among women with obstructive sleep apnea.

PURPOSE: We aimed to assess sexual function, sexual distress and the prevalence of female sexual dysfunction (FSD) among women with obstructive sleep apnea syndrome (OSA), and to assess if the presence of OSA and dyspnea influences the prevalence of FSD, body image during sexual activity and sexual function. METHODS: We assessed 23 women with new OSA diagnosis and 23 healthy age and body mass index (BMI) matched controls. Sexual functions were evaluated by Changes in Sexual Functioning Questionnaire (CSFQ), sexual dysfunction was diagnosed based on DSM-5 criteria during the semi-structured sexual interview, whereas body image was evaluated by Body Exposure during Sexual Activities Questionnaire (BESAQ). New York Heart Association score (NYHA) and Visual Analogue Scale (VAS) were used to assess dyspnea. RESULTS: OSA women had worse general sexual function and lower frequency of desire assessed by CSFQ (37.0 vs. 42 and 5 vs. 6), were at higher risk for FSD (CSFQ; 80% vs. 48%) and had a higher NYHA score (II vs. I). The prevalence of FSD did not differ in both groups, nor did sexual dysfunctions or body image (BESAQ). The multiple regression analysis revealed that OSA was associated with lower desire/frequency, higher NYHA scores with decreased desire/interest and worse body image during sexual activity, whereas higher VAS scores with worse desire/frequency. CONCLUSIONS: OSA probably does not influence the prevalence of sexual dysfunction in females. However, OSA, as well as the higher level of dyspnea assessed by NYHA, may decrease sexual body image and sexual performance in females.

May Dyspnea Sensation Influence the Sexual Function in Men With Obstructive Sleep Apnea Syndrome? A Prospective Control Study.

INTRODUCTION: Dyspnea sensation is frequently present in obstructive sleep apnea syndrome (OSA) patients; however, its possible influence on sexual function and body image has not been well analyzed. AIMS: To evaluate sexual function, the prevalence of sexual dysfunction (SD), and body image during sexual activity and its relationship with dyspnea in men with OSA. METHODS: 129 men were included in the prospective study, with 61 diagnosed with OSA (cases) and 68 age- and BMI-matched healthy control subjects. Patients were assessed for the severity of heart failure by the New York Heart Association scale and dyspnea by the Visual Analogue Scale. OSA was confirmed by in-laboratory polysomnography. MAIN OUTCOME MEASURES: International Index of Erectile Function (IIEF) was used as a measure of sexual function, body image during sexual activity was assessed by the Body Exposure During Sexual Activity Questionnaire, whereas SD was diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. RESULTS: The mean age of the studied population was 57.9 ± 10.8 years. Presence of dyspnea interfered with sexual life in 20% of men diagnosed with OSA and with work performance in 33%. Men with OSA had worse scores in IIEF-15 compared with control subjects and higher frequency of sexual distress compared with men with OSA. There were no differences in the rate of SD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The presence of OSA worsened the perceived body image during sexual activity. The presence of dyspnea was the only negative factor affecting sexual function in general (IIEF-15 score) and 1 of the factors affecting erectile function and orgasmic function. CONCLUSION: In men with OSA, body image is negatively influenced by the presence of OSA. Furthermore, the presence of dyspnea assessed by the New York Heart Association scale impairs sexual function in that group of men. Skoczynski S, Nowosielski K, Minarowski L, et al. May Dyspnea Sensation Influence the Sexual Function in Men With Obstructive Sleep Apnea Syndrome? A Prospective Control Study. Sex Med 2019;7:303-310.

Clinical importance of sex differences in dyspnea and its sex related determinants in asthma and COPD patients.

PURPOSE: There is an increasing amount of data regarding the influence of sex on dyspnea perception, however, the influence of sex has not been included in clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: The study included 123 clinically stable subjects. Seventy five patients had COPD, of which 70.6% were men and 29.4% were women. Forty-eight subjects had asthma, comprised of 45.8% and 54.2%, men and women, respectively. Dyspnea was assessed with the use of modified Medical Research Council (mMRC) Visual Analogue Scale VAS, and BORG scale. All patients underwent spirometry with a broncho-reversibility test. RESULTS: There were no differences in age for neither asthma patients, 56.5 ± 11.6 and 55.0 ± 12.7 (p = 0.5) for males and females, nor for COPD patients, 66.8 ± 9.0 and 66.8 ± 7.7 (p = 0.7) for males and females, respectively. Asthmatic females had more dyspnea than males when assessed with VAS, 1.85 ± 2.24 and 3.84 ± 2.80 (p = 0.01), for males and females, respectively. When assessed with BORGpre 6-MWT, dyspnea results were 0.86 ± 1.83 and 2.43 ± 2.31 (p = 0.005), for males and females, respectively. In the whole group, apart from FEV1 (for mMRC, VAS, BORGpre) and BMI (BORGpost) the severity of dyspnea was related to female sex when assessed with mMRC (OR=2.83; 95%CI: 1.25-6.42) and VAS (OR = 2.17; 95%CI:1.00-4.73). CONCLUSIONS: Although more apparent in asthma, it was revealed for the first time, that sex has a strong influence on the magnitude of dyspnea perception, both in asthma and COPD. Therefore, sex related dyspnea sensation should probably be included in clinical assessment and patient treatment.