CPAP Therapy and Romance: A Few Simple Secrets to Success
Getting into bed and strapping a device across your face or nostrils doesn’t fit our cultural image of what romance should look like, but neither do most of the experiences we have in our day to day lives. Real romance, as most of us learn during our first serious relationship, is more about being in love than falling in love, and that means accepting your partner for who they are, whatever the hangups. Mutual support can go a long way to save any relationship, and when it comes to life-or-death necessities, why be picky?
What the Patients Are Saying
Not surprisingly, given PAP therapy’s record for increasing energy and stamina, device users on sleep apnea forums have expressed more positive attitudes about their relationships than complaints about CPAP killing the mood. Studies actually show measurable increases in libido following regular and sustained PAP therapy treatments. This, combined with reduced snoring and headaches, can actually lead to more romance and intimacy, rather than less. After all, what is so discouraging about a partner who uses a therapy device for improved health, mood, libido, and memory? It seems that the only common negative experience associated with CPAP use in relationships is the insecurity felt by the user, or in a worse case scenario, an unsupportive partner. For whatever reasons, there are some couples who remain in separate beds and separate bedrooms whether CPAP works its magic or not. But the solution, it seems, has little to do with CPAP and a lot to do with teamwork.
Spousal Support 101
The importance of a patient’s initial experiences with PAP therapy are well documented, and spousal involvement is often an essential component of that process. In agreement with patient accounts, recent studies have found that spousal involvement is a major factor in determining CPAP compliance during the first six months of therapy. These initial months are critical for long-term compliance because patients develop an early impression of what the therapy experience will consist of, and how it will fit into the bigger picture of their lives. And since benefits to both health and relationships depend upon long-term compliance, many doctors recommend a “teamwork mentality” that keeps a positive and open-minded approach to therapy needs.
Now this doesn’t mean that a patient should expect unconditional support for whatever therapy habits they develop. A “teamwork mentality” calls for equal input and consideration. This means that you show courtesy and remain open to suggestions from your partner. According to the National Sleep Foundation, about 6 in 10 adults regularly sleep with a partner, and more than a quarter of American relationships are adversely affected by sleep problems. In those circumstances, CPAP therapy can either be a source of improvement or another reason to be apart. But adherence to treatment will be a necessity either way.
Researcher Lichuan Ye of Northeastern University in Boston told Reuters Health that “spouses can make a significant difference in their partners’ health behaviors.” Ye and his research team found that “positive, supportive couples who focused on the benefits for both the patient and the sleep partner were the most successful.” While Ye does not give patients free reign to make demands of their partners whatever the cost, he does, however, suggest that open communication is the key to any big change in a relationship. Sleep apnea is a life threatening disorder, and PAP therapy is the only current treatment virtually guaranteeing a reduced risk of apnea events, heart attacks, and stroke. If a partner is simply unwilling to provide support or communicate his or her concerns, there is always the chance that the relationship itself is unhealthy. In such cases the counsel of friends, family, or a professional therapist may help to guide you in the direction of a healthy decision for a better homelife. But if there is a willingness to work together and show a sense of mutual respect, there is always a chance for a more harmonious union.
Romance for CPAP Beginners
Michael Breus, PhD, ABSM, points out on his website The Sleep Doctor that there are many factors that contribute to daily strains on our romantic relationships, and CPAP use is no different from any other distraction. “Let’s face it,” Doctor Breus explains. “You may feel unattractive…but the key to getting these additional benefits, to restoring your sleep, protecting your health, and boosting your sex life, is to use CPAP consistently.” For those who are just beginning treatment, Dr. Breus suggests that a period of adjustment is inevitable. Even for the most optimistic patients, the devices take some getting used to. This should be accepted up front, but also discussed between partners at the most opportune time. Not too soon of course; there’s no need to announce your sleep apnea treatment on a first date. But at the same time, disclosure should occur prior to a sleepover experience. “Going without the mask” simply means risking an apnea event to avoid a passing moment of awkwardness.
Dr. Breus also recommends a sense of humor. It is a serious matter, but there is always room for a little lighthearted humor in the face of danger. Time should be preserved not only for serious conversations about the issues involved, but also for quality time to simply enjoy one another’s company. When the mask goes on, it doesn’t have to be a barrier. “It’s not a permanent fixture,” Dr. Breus reminds us. “Like a piece of clothing, you can simply take it off.” And for cuddling, some suggest a method of “little spooning” during the night, meaning that the CPAP user is in front to allow the tubing to face away from both of you. These kinds of accommodations are very easy, and can even be a bit amusing to those with a sense of adventure. As long as you are enjoying one another’s company, there is little that can get in the way of your happiness.
Some Notes on CPAP Hygiene
Another issue that is extremely important, for new users as well as those with experience, is CPAP hygiene. This is important whether or not a patient is in a relationship, but for partners it can be an additional nuisance when odors or unclean equipment become an issue. Each machine and mask has its own cleaning instructions found in the product manual user’s guide, but in general there are three main components that require maintenance: the tubing, the filters, and the mask. Always check the smell of the air that flows from the tube, and if any scent of staleness or mildew is emitted, it may be time to wash or replace the tubing. CPAP filters are usually located on the back of the unit. You can test the filter by touching it with the tip of your finger. If dust particles are visible, it should be rinsed or replaced. Masks should be cleaned regularly after each use, and most of them only require warm water and a mild detergent. Make sure that components are completely dry before using again. Also, if your machine includes a humidifier, you should check its chamber regularly for any sign of residue or discoloration. Chambers can be cleaned well using soft-bristle brush and mild soap or detergent.
The Not-So Secrets of Success
A relationship is a relationship. Simply because one partner is diagnosed with sleep apnea doesn’t change the underlying dynamics of a loving connection between two people. And when it comes to romance, it shouldn’t matter what you or your partner do in their sleep. Romance is always about the moments and the feelings you and your partner share. Therapy can fit into this picture as easily as any other activity. It is an important part of a patient’s life, and therefore part of the relationship as well.
Maud Purcell, a Licensed Clinical Social Worker and guest writer on psychcentral.com, lists “a realistic view of committed relationships” as her number-one ingredient to a happy union. She also mentions “making the most of your differences.” Other ingredients are fairly commonplace and accepted. Honesty, communication, time together and time apart; none of these elements change with the introduction of a bedtime device. A realistic view of relationships means not demanding too much, but at the same time keeping the possibilities open. If you view your relationship as a work in progress, there is always room for improvement, and always time for adjustment when something new is introduced.
The bottom line: CPAP is a minor encumbrance with lasting benefits to health and relationships. If couples can learn to tolerate the inconveniences of nightly therapy, there is little need for conflict. Neither partner can get a decent night’s sleep when one is snoring and the other is choking for want of breath. Snoring alone is estimated to be the third most common cause of divorce in both the U.S. and Great Britain. In a study at the University of California at Berkeley, lead investigator and psychologist Amie Gordon found that disrupted sleep also leaves couples “less in tune” to their partners. “They become more selfish,” she explains. And it’s very hard to have a “teamwork mentality” without a team.
It is estimated that over 20 million Americans have sleep apnea, but only a quarter of them are diagnosed and treated effectively. Untreated sleep apnea is a risk factor for heart attacks, strokes, diabetes, and neurocognitive damage due to low oxygen levels in the brain. At its worst, daytime sleepiness threatens much more than a relationship, causing thousands of motor vehicle crashes and workplace accidents every year. The list of related diseases and disorders is long, and the list of potential benefits for sustained therapy continues to grow with advances in research and technology. Whatever difficulties your relationship faces, it is very unlikely that discontinuing CPAP therapy is an answer. At a time when increases in public awareness have helped to break down stereotypes and boost user confidence, the last thing your love life should be is an excuse not to comply with a lifesaving treatment.
Centers for Disease Control and Prevention – https://www.cdc.gov/features/dsdrowsydriving/index.html
Behavioral Sleep Medicine – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363003/
Medical News Today – https://www.medicalnewstoday.com/releases/246542.php
National Sleep Foundation – https://www.sleepfoundation.org/articles/sleep-apnea-and-heart-disease-0
Sleep Doctor – https://thesleepdoctor.com/2012/07/10/cpap-is-good-for-sex/
Southwest Journal of Pulmonary Critical Care – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512877/