How Sleep Apnea Is Linked to Female Sexual Dysfunction

Patient Expert

The fatigue, stress, anxiety, and sleepiness associated with sleep disorders such as insomnia is known to lower libido. Studies have also linked sleep disturbances with fertility problems — particularly among men.

Although many studies have investigated sexual dysfunction among men with obstructive sleep apnea (OSA), it wasn’t until 2017 that research was published that investigated the effect of OSA on sexual function in premenopausal women.

The study, published in Urological Oncology, included 22 premenopausal women who had been diagnosed with OSA after undergoing polysomnography. Thirteen premenopausal women with normal polysomnography scores served as the control group. The average age of participants was 42 years.

What is female sexual dysfunction?

As pointed out by the authors of the study, female sexual dysfunction (FSD) is thought to be underestimated yet it affects roughly 40 percent of women at some point in their lifetime. Symptoms of FSD include:

  • Decreased sexual desire
  • Decreased sexual arousal
  • Difficulty reaching orgasm
  • Pain during sex or vaginal contact

What causes female sexual dysfunction?

Previous studies have linked FSD with factors such as:

  • Age
  • Obesity
  • Menopause
  • Hormonal dysfunction (particularly thyroid disease)
  • Poor physical health

The link between female sexual dysfunction and OSA

Participants in the 2017 study were grouped according to their Apnea-Hypopnea Index scores. Mild OSA was defined by an AHI of between five and 15 per hour, moderate OSA by an AHI of between 15 and 30 per hour, and severe OSA by an AHI of 30 and over per hour.

Sexual function was measured using the Female Sexual Function Index (FSFI) — a questionnaire that includes 19 questions in the following six categories:

  • Desire
  • Arousal
  • Lubrication
  • Orgasm
  • Satisfaction
  • Pain

FSFI scores range from 2 to 36, with lower scores indicating more severe sexual dysfunction. The study found that women with OSA had significantly lower FSFI scores for:

  • Desire
  • Arousal
  • Orgasm

No significant differences were found when researchers looked at FSFI scores for lubrication, satisfaction, and pain. There was also no significant difference in average FSFI scores and OSA severity.

Why is OSA linked to female sexual dysfunction?

Researchers of the study suggested that the pudendal nerve may play a key role — previous studies have found that oxygen deprivation associated with pauses in nighttime breathing can lead to numbness in this nerve, which is responsible for carrying sexual sensation.

The authors also highlighted previous studies that found women with OSA were found to have lower levels of testosterone compared to women without the sleep disorder. Finally, the reduced quality of life and mood associated with OSA may also lead to reduced sexual desire.

How to address sexual dysfunction caused by OSA

Unfortunately, female sexual dysfunction related to OSA has not been studied to the same extent as male sexual dysfunction related to OSA. However, since research has found continuous positive airway pressure (CPAP) treatment can improve sexual function in men, the treatment may help address symptoms of sexual dysfunction in women, too.

OSA is treatable and doesn’t always require CPAP therapy — oral appliances and even tonsillectomy are additional potential treatment options. Successfully treating your OSA is a good first step to take if you feel your sexual desire and function is suffering as a result of your sleep disorder. Be sure to discuss any concerns you may have with your doctor.

See more helpful articles:

The Sleep Challenges Faced by Women

Does Obstructive Sleep Apnea Increase Depression Risk?

What All Women Need to Know About Sleep Disordered Breathing