C30-10 Relationship and Sexual Health Outcomes in Obstructive Sleep Apnea: Roles of Disease Severity and CPAP Treatment Adherence

Rationale Psychosocial and relational outcomes (sexual health, mood, and partner dynamics) are underrepresented in obstructive sleep apnea (OSA) research, and their dependence on disease severity and treatment remains unclear. We compared sexual health, mood, relationship quality, and dyadic adaptation across OSA severity and assessed changes with continuous positive airway pressure (CPAP) adherence. Methods We reviewed 32 published studies encompassing qualitative, observational, and randomized designs that reported AHI (mild, moderate and severe OSA), CPAP adherence, and validated relationship outcomes in adults with OSA and their partners. Extracted domains included sexual function, mood and affect, relationship or dyadic quality, and partner perspectives. CPAP adherence was defined as mean nightly use (hours/night). A structured narrative synthesis was performed emphasizing direction, strength, and consistency of associations. Results Across diverse study designs, relational and psychosocial impairments were evident across all OSA severities prior to CPAP initiation. Sexual function and overall relationship satisfaction were reduced in mild, moderate, and severe OSA. Sexual dissatisfaction and intimacy concerns were more significant in severe OSA compared with moderate or mild OSA. Relational communication and dyadic adjustment were similarly impacted across OSA severity. Together, these findings suggest that relational and sexual function disruptions occur across OSA and are not well explained by baseline OSA severity. With CPAP initiation, relational dynamics improved but treatment uptake mattered. Sustained CPAP use (≥6 h/night) was associated with moderate-to-large improvements in sexual function, mood, and relationship satisfaction, while inconsistent use (<4 h/night) produced minimal change. In sustained users, benefits typically emerged within 1-2 months, consolidated by 3-6 months, and extended to partners through better sleep, mood, and relational harmony. Conclusions Relational, psychosocial, and sexual impairments in OSA occur across OSA severities, indicating that OSA severity alone does not fully capture the burden of disease. CPAP adherence, representing treatment exposure and behavioural engagement, improves sexual, emotional, and relational domains irrespective of baseline severity. These effects appear dose-dependent, with greater adherence linked to larger and more sustained improvement. From a clinical perspective, routine adherence monitoring, early behavioural reinforcement, and inclusion of partners in education and follow-up may enhance both adherence and psychosocial outcomes. This abstract is funded by: Resmed