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Medline ® Abstract for Reference 24

of 'Treatment of male sexual dysfunction'

Effect of continuous positive airway pressure therapy on sexual function and serum testosterone in males with type 2 diabetes and obstructive sleep apnoea.
Knapp A, Myhill PC, Davis WA, Peters KE, Hillman D, Hamilton EJ, Lim EM, Davis TM
Clin Endocrinol (Oxf). 2014;81(2):254.
OBJECTIVE: There have been no studies of the effect of continuous positive airway pressure (CPAP) therapy on erectile dysfunction (ED) and serum testosterone in men with type 2 diabetes and obstructive sleep apnoea (OSA), a patient group at increased risk of ED and hypogonadism. The aim of this study was to determine whether CPAP improves sexual and gonadal function in males with type 2 diabetes and a pre-CPAP apnoea-hypopnoea index>15/h.
DESIGN: Substudy of a trial assessing the effect of 3 months of CPAP on cardiovascular risk in type 2 diabetes.
PATIENTS: Of 35 males starting CPAP, 27 (mean ± SD age 65·4 ± 9·6 years, median [interquartile range]diabetes duration 12·1 [5·2-15·3] years) completed the trial.
MEASUREMENTS: Serum total and free testosterone, responses to the Androgen Deficiency in the Aging Aale (ADAM) and Sexual Health Inventory for Men (SHIM) questionnaires.
RESULTS: There were no significant changes in mean total or free testosterone (baseline concentrations 12·7 ± 4·5 nm and 0·26 ± 0·07 pm, respectively), or SHIM score (baseline 13 [5-17]), after 3 months of CPAP (P > 0·20). The ADAM score (baseline 6·2 ± 2·1) fell after 1 month (to 5·0 ± 2·6) and was maintained at this level at 3 months (P = 0·015). The Epworth Sleepiness Scale score decreased and self-reported physical activity increased over 3 months (P ≤ 0·017) without a change in body mass index (P = 1·00).
CONCLUSIONS: These findings imply that CPAP therapy improves somnolence and promotes exercise in men with type 2 diabetes, but that there is no direct benefit for gonadal or sexual function.
School of Medicine and Pharmacology, University of Western Australia, Fremantle, WA, Australia.