title: Effect of continuous positive airway pressure therapy on sexual function and serum testosterone in males with type 2 diabetes and obstructive sleep apnoea.
abstract: 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.
  
  
  METHODS
  Substudy of a trial assessing the effect of 3 months of CPAP on cardiovascular risk in type 2 diabetes.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle, WA, Australia.
authors.forename: Arthur
authors.initials: A
authors.lastname: Knapp
authors.forename: Paul C
authors.initials: PC
authors.lastname: Myhill
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Davis
authors.forename: Kirsten E
authors.initials: KE
authors.lastname: Peters
authors.forename: David
authors.initials: D
authors.lastname: Hillman
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Hamilton
authors.forename: Ee Mun
authors.initials: EM
authors.lastname: Lim
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone