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Sat, Aug. 17

Treating sleep apnea can reduce erectile dysfunction

Dear Dr. Rosenberg,

I am 45 years old and have erectile dysfunction. Recently I was diagnosed with sleep apnea. I've been told that treatment for my sleep-disordered breathing could help my ED. Is this true?

A: Yes. In a recent study at Walter Reed Army Hospital, more than half the men with sleep apnea had ED. They began CPAP, and the majority reported a significant improvement in sexual function. This is one of several studies to confirm these findings.

Dear Dr. Rosenberg,

I have been struggling with my CPAP masks for several years. No matter what type of mask I get, after a few days my nose gets so stuffy that I cannot wear it. I have tried all types of nasal sprays, both prescription and non-prescription. Do you have any ideas?

A: There is a mask that delivers CPAP pressure through the mouth only. It is called the Oracle, and is made by a company called Fisher and Paykel. I have had considerable success in using this mask in patients with nasal congestion.

Dear Dr. Rosenberg,

I have been experiencing heart palpitations at night. My cardiologist put a heart monitor on me for a few days. He said I went into an arrhythmia called atrial fibrillation while sleeping. Now he wants me to have a sleep study. I live alone but I don't think I stop breathing.

A: The majority of instances of atrial fibrillation arising out of sleep are related to sleep apnea. The obstruction of the airway results in stretching of the upper chamber of the heart. This plus exposure to low oxygen and stimulation of the sympathetic nervous system (fight or flight system) can cause atrial fibrillation. Any treatment to prevent this from recurring is far more likely to work if underlying sleep apnea is treated.

Dear Dr. Rosenberg,

Why is it that men seem to have a much higher incidence of sleep apnea? I keep reading this but no one explains why.

A. There are several reasons. First, men have a longer upper airway than women. Therefore, there are more potential sites that might collapse. Secondly, until the menopause, women produce hormones that stimulate the respiratory system and tend to prevent drops in oxygen. When you combine these factors, it is easy to see why men are more vulnerable to sleep apnea.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Dr., Prescott Valley, AZ 86314.

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