Studies Evaluating the Relationship Between Adult Allergic Rhinitis and SDB

Patients With SDB and Canadian Pharmacy

The studies in this section will deal with SDB in the form of snoring, UARS, and OSAS. Some of the studies chose to specifically differentiate these types of SDB and are noted with such designations herein.

In one study mentioned above, there was no correlation between upright, awake NR and the degree of SDB in patients referred for SDB. A second study measured NR in 36 patients with OSAS using basal anterior active rhinomanometry in both upright and supine positions, and found 7 of 36 patients with abnormal upright NR, 9 of 36 patients with a normal upright but abnormal supine NR, and 20 of 36 patients with normal NR in both positions.

Table 7—Studies Evaluating the Relationship Between Adult Allergic Rhinitis and SDB*

Source/Year Study Population Diagnostic Method Observation Conclusion
Lavie/1981 14 patients (9 males)7 normal controls Anamnesia about duration of disease, sneezing and nasal discharge, ENT examination; nasal smears for eosinophil count PSG for 2 nights During exacerbation of allergic rhinitis: periodic breathing and microarousals
McNicholas/1982 10 patients Hypersensitivity to ragweed pollen (history, skin testing), excluded asthma, medications held PSG for 2 nights: first duringpeak ragweed season (with symptoms), and 6 to 8 weeks later with no symptoms During symptomatic phase of allergic rhinitis: higher NR, and increased obstructive apneas
Young/2001 911 patients History of allergy, hay fever causing nasal congestion, on allergy PSG, questionnaire: EDS, sleep history; rhinometry Nighttime nasal obstruction associated with allergic rhinitis caused EDS, snoring, nonrestorative sleep. Those with nasal congestion associated with allergic rhinitis are 1.8 times more likely to have SDB
Craig/1998 20 patients Positive skin test responses to perennial allergen Nasal symptoms, subjective sleep, EDS during double-blind, placebo-controlled trial of nasal steroid vs placebo Nasal congestion and subjective sleep improved in those treated with nasal steroid and not with placebo

*See Table 6 for expansion of abbreviations.


Effective Treatments in Canada for Male SD

ISD Treatment. So how can the man (and the couple) revitalize sexual
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desire? The keys are to rebuild positive anticipation of sharing pleasure and eroticism; to value your partner as your intimate, erotic friend; to adopt the Good-Enough Sex model of pleasure-oriented couple sex; to experiment with blending self-entrancement arousal, partner-interaction arousal, and role-enactment arousal; to change health behaviors so you have more sexual energy; to view intercourse as a natural continuation of erotic flow and a special erotic technique, not a pass–fail test; to emphasize a variable, flexible approach to couple sexuality; to utilize testosterone to enhance sexual desire; and to maintain a regular rhythm of sensual, playful, and erotic connection and intercourse.

Ejaculatory Inhibition (EI)

Ejaculatory inhibition (EI) is the unspoken male sexual dysfunction, often misunderstood as ED. Among men over age 50, EI affects as many as 1 in 8 men. Again, the best assessment/treatment model is a couple psycho-biosocial approach. There are many possible causes and dimensions of EI from depression, to excessive masturbation, to side effects of medications to fatigue. The most common cause is not valuing couple sex, instead falling into a mechanical intercourse routine that is no longer exciting and arousing. Men typically transition to intercourse at the start of an erection, with a subjective arousal of 4 or 5, and approach intercourse as simply a matter of thrusting. When orgasm isn’t attained, the result is frustration and loss of erection.

EI Treatment. Key treatment strategies include using multiple methods of stimulation during both pleasuring and intercourse; piggybacking your arousal on your partner’s; transitioning to intercourse when you have higher subjective arousal (7 or 8); using erotic fantasies to heighten subjective arousal; being aware of and using orgasm triggers (i.e., the cues/resources you use during masturbation to allow you to let go and “come”); making requests of your partner for erotic stimulation as well as taking personal and sexual risks (including self-stimulation mixed with partner stimulation to enhance arousal); and allowing yourself to go with the erotic flow rather than try to force orgasm.