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Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Mild obstructive sleep apnea (OSA) is more prevalent than moderate and severe OSA and is more frequent in men than women. The association between OSA and female sexual dysfunction (FSD) is still poorly explored in published studies. Our aim was to investigate the prevalence of FSD in women with mild OSA and assess the impact of OSA on FSD, as well as to determine the predictors for FSD risk.

Methods

The sample comprised 70 women aged 26–65 years: a control group (N = 28) with no sleep complaints, and a group with mild OSA (an apnea–hypopnea index of  5 or more and less than 15 events/hour, N = 42), who had been diagnosed using polysomnography performed in the sleep laboratory of a sleep research institute. All participants volunteered to take part in the study and completed the female sexual function index (FSFI), the Beck depression index (BDI), the Kupperman menopausal index (KMI), and the Epworth sleepiness scale (ESS). Their socioeconomic group was assessed using the Brazilian Economic Classification Criterion. Polysomnography and serum levels of free testosterone and total testosterone were analyzed.

Results

We found low FSFI scores (< 26.55) in the mild OSA (18.1) and control (21.7) groups (p = 0.97). There was no statistically significant difference between the mild OSA group and the control group. However, a higher BMI (p = 0.04), a higher BDI (p = 0.02), and being sexuality inactive (p = 0.001) were risk factors for FSD.

Conclusion

There was a high prevalence of FSD in the entire sample. The presence of mild OSA did not affect sexual function in this sample. Depressive symptoms and a high BMI were associated risk factors for FSD. Being sexually active may protect female sexual function.

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Abbreviations

OSA:

Obstructive sleep apnea

FSD:

Female sexual dysfunction

FSFI:

Female sexual function index

ESS:

Epworth sleepiness scale

BDI:

Beck depression index

BMI:

Body mass index

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Acknowledgements

The authors would like to acknowledge the assistance of the Associação Fundo de Incentivo à Pesquisa (AFIP), the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Conselho Nacional de Pesquisa (CNPq). LB, MLA, ST and HH are recipients of CNPq fellowships.

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) provided financial support in the form of Grant Universal (#478965/2012–5) funding, as well as Associação Fundo de Incentivo à Pesquisa (AFIP). The funding agency had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil

    Glaury Coelho, Lia Bittencourt, Monica Levy Andersen, Thais Moura Guimarães, Luciana Oliveira e Silva, Sergio Tufik & Helena Hachul

  2. Departamento de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil

    Gabriela Pontes Luz

  3. Departamento de Ginecologia, Universidade Federal de São Paulo - UNIFESP, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, 04024-002, Brazil

    Helena Hachul

Authors
  1. Glaury Coelho
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  2. Lia Bittencourt
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  3. Monica Levy Andersen
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  4. Thais Moura Guimarães
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  8. Helena Hachul
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Correspondence to Helena Hachul.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This current cross-sectional study was approved by the Ethical Committee of UNIFESP (#0315/2015).

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Key message

Women with obstructive sleep apnea have a risk of presenting with female sexual dysfunction, and mild obstructive sleep apnea has a high prevalence among women. We found a high prevalence of female sexual dysfunction risk in the entire sample, with BMI and depressive symptoms, but not mild OSA, being risk factors.

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Coelho, G., Bittencourt, L., Andersen, M.L. et al. Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction. Sleep Breath 26, 697–705 (2022). https://doi.org/10.1007/s11325-021-02433-w

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  • DOI: https://doi.org/10.1007/s11325-021-02433-w

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