Is sexual dysfunction in women with obstructive sleep apnea-hypopnea syndrome associated with the severity of the disease? A pilot study.

INTRODUCTION: Obstructive sleep apnea-hypopnea syndrome (OSAHS) may have a significant negative effect on sexual function.

AIM: To evaluate female sexual function in women with OSAHS.

METHODS: Twenty-six patients with OSAHS were evaluated in two groups according to apnea-hypopnea index as mild (5-15, Group I, N = 16) or moderate-severe (>or=15, Group II, N = 10). A third group (N = 10) of patients suspected of sleeping disorders other than OSAHS who also underwent polysomnographic studies served as the control group. All women were evaluated with a detailed sexual history including Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). Meanwhile, serum levels of estradiol, prolactin, total and free testosterone and dihydroepiandrostenedione-S were determined.

MAIN OUTCOME MEASURES: FSFI, BDI, and serum hormonal levels.

RESULTS: The mean ages and total FSFI scores of Group I, Group II and the control group were 46 +/- 7.1, 45 +/- 3.8, and 41 +/- 5.4 (P > 0.05); 24.7 +/- 5.3, 24.5 +/- 6.3, and 30.0 +/- 2.5 (P < 0.05), respectively. The mean FSFI domain scores were not statistically different between Groups I and II (P > 0.05) (desire, 3.18 +/- 1.2 vs. 2.92 +/- 1.6; arousal, 3.96 +/- 1.1 vs. 3.67 +/- 1.2; lubrication, 4.83 +/- 1.0 vs. 4.12 +/- 1.1; orgasm 4.0 +/- 1.1 vs. 5.15 +/- 2.9; satisfaction 3.96 +/- 1.1 vs. 4.05 +/- 1.4 pain; 4.84 +/- 1.2 vs. 4.65 +/- 1.3). However, the mean scores of desire (3.18 +/- 1.2 vs. 3.96 +/- 0.7), orgasm (4.0 +/- 1.1 vs. 5.0 +/- 1.1), and satisfaction (3.96 +/- 1.1 vs. 4.76 +/- 1.0) domains of Group I were significantly lower than the control group. Meanwhile, the mean scores of desire (2.92 +/- 1.6 vs. 3.96 +/- 0.7) and lubrication (4.12 +/- 1.1 vs. 5.22 +/- 0.9) domains were statistically different between Group II and the control group. The mean BDI scores of patients in Group I, Group II and the control group were 19.3 +/- 6.3, 20.2 +/- 6.6, and 11.0 +/- 7.1, respectively (P < 0.01). In addition, the mean levels of hormonal parameters were not significantly different from the control group (P > 0.05).

CONCLUSIONS: OSAHS is associated with a significant decrease in female sexual function. However, severity of OSAHS is not related with the degree of female sexual dysfunction (FSD). This situation reveals that both organic and psychogenic issues are being involved in FSD related with OSAHS.