Sleep Blog

A study just published says 18 percent of men, aged 20 and up, suffer from erectile dysfunction. That’s right, it’s impotency but branded with a new name.

Yes, it’s a sad thing, I’m sure, to be in that situation. I’ve never had that problem, thankfully. I’m one who’s always been on the far opposite end of the spectrum in that regard, which isn’t always a good thing, either.

The study, published in the American Journal of Medicine,  was done to get an estimate on the prevalence of erectile dysfunction in what Selvin terms the ”the post-Viagra era.” It’s really not ”post-Viagra” era, as Viagra is still sold. This is, more appropriately, the “Viagra era.”

A Reuters story summed up in its opening paragraph the study’s findings, at least from the writer’s perspective, saying there’s “more bad news for those pudgy couch potatoes, junk food junkies and TV devotees — and this time it really hits them where it hurts.”

The news agency may have gotten it partially right: it hits guys where it really hurts. But that’s the least of the worry, at least in my eyes.

Looking at the little data in the Reuters article — no, I haven’t yet read the actual report — the study’s researcher, led by Elizabeth Selvin, of Johns Hopkins University, down in Baltimore, Maryland, dismissed a lot of things by waving her findings and saying:

“This really means that staying active — moving more and eating less — and staying healthy, in addition to being good for your cardiovascular health may also be good for your sexual health.”

According to the Reuters article, the condition “is strongly linked to a sedentary lifestyle of little physical exercise, poor diet, and lots of television.”

‘Jim’ doesn’t live here

Here we go. It’s plain excusitis, for one thing. To the max. Blame the television. This is basically taking the quick-and-easy way out of actually finding the root cause of the problem. Not every guy is like the husband character, “Jim” on ABC’s According to Jim. You know, he is too busy watching TV (sports, cartoons, etc.) to pay attention to his wife, his children, or others. Be warned: this is but one of my complaints.

The other things Reuters says about the study is that “a sedentary lifestyle of little physical exercise” is another contributing factor. Okay, I can understand that. I also agree with it. But as a non-aligned researcher — I preferred to do my research in newsrooms — I have a few bones to pick.

Guess what societal group has an unusually high percentage of people suffering erectile dysfunction? People with sleep disorders, especially sleep apnea. People who are sleep deprived tend to, I guess, get in the mood but not be able to make things work when the mood is ready.

This leads to the next mention in the article. Reuters says:

Not surprisingly, the condition was most common in older men. But there was a strikingly high prevalence in men with diabetes and high blood pressure.

First off, where is the “objective” reporting that’s supposedly the cornerstone of journalism? Yes, I will go there and get on that soapbox, as I spent more than 20 years in newspapers and magazines, as a journalist, as an editor, and did a lot of work focused on medicine and health care, investigative work, as well as government (cops, courts, city and county boards, and such).

It irks me to no end when I see garbage such as, “Not surprisingly …” in a “news” article. Perhaps on the women’s page, er, I’m sorry, they call it “Features” and “Home” and “Living” today, not “Women’s.” That’s fine, too. I write a lot of articles for those sections, traditionally stuff written by and for women, you know, the “daintier” and “softer” of society — the ones who wanted a “light side” of the news. Today, though, I think we all want a “light side” to the news, but that’s another story, and one for my regular blog, Scoop’s Views, not the Sleep Blog.

Dr. Selvin, quoted by Reuters, said:

“This really means that staying active — moving more and eating less — and staying healthy, in addition to being good for your cardiovascular health, may also be good for your sexual health.”

“It’s just another reason to get off the couch and exercise,” Selvin added.

The first part of that quote was fine. I agree with it. The second part, the part about “get off the couch,” well, let’s look at it realistically. If you life is going to hell in a hand basket, as the old saying goes, this sort of approach doesn’t work, and coming from a medical professional, that’s a sad comment.

Excusitis seems to be the rule

For someone who may be feeling more and more fatigued — constantly sleepy — just getting “off the couch and exercise” is not a realistic concept. First, doc, let’s find out what happened that caused the person to get to the place where they are right now. Your simple answer is not the only answer, nor, in many cases, is it even close to being the right answer. In fact, I am willing to bet, that in many cases — more than 50 percent, I would be willing to wager — that approach is actually the wrong approach.

No, I don’t like excuses — not from myself or anyone else. I also don’t like the word ”can’t,” but I can understand, though not appreciate the word ”won’t.” Too often they seem to go hand-in-hand.

Listening to a doctor, or anyone else, for that matter, say something like, “just get off the couch and exercise” is something that has always driven me mad. First, does the doctor — or the “other person,” you know, the “good-hearted” neighbor, concerned friend, or other, who wants to “encourage” you to take action — know the challenges you are facing? Did the doctor — or the other person first ask, “Is there anything keeping you from exercising?” In more than 90 percent of the cases, I am willing to wager the answer would be no. Mind you, I’m not a gambling man, but I’ve dealt with far too many people, listened to far too many stories from people all around the country over the past seven years, and I have a good grasp of the medical profession’s handling of things.

Funny thing about that fatigue

If a person is overweight, the doctor says, “Lose weight.” If a person complains to the doctor about being sleepy all the time, the doctor often says, “Get more rest.” If the person has high blood pressure, they are told to reduce their salt intake, but often are given pills to reduce the blood pressure, and sometimes, the person even gets a water pill to help eliminate excess water. Yep, that’s too often the case in modern medicine: give a pill and call me in the morning.

Sorry, doc, but this isn’t TV. That adage about taking a pill — or an aspirin — and calling you in the morning wore out back when it was first introduced. This is the 21st Century. It’s time for medical practitioners to stop practicing medicine and start doing medicine. The old joke is: “Doctor’s have no idea what they’re doing. That’s why they “practice” medicine.” One day, and maybe I’ll still be alive, they may begin to actually start “doing” medicine.”

With our military personnel in Iraq and Afghanistan, would you feel comfortable if you heard they were all “practicing” the art of combat? No. They are engaged in combat. Why should we expect any less from medical providers?

Yes, I know. There are going to be some, especially people who are health care providers, family of health care providers, and those rare few who have a good health care provider — who jump up and down to defend the person they know. Guess what: If you do know a health care provider who really does medicine, you know, who really goes out of his or her way to really understand what’s at the heart of the patient’s problem, what’s causing Issue A, Issue B, and Issue C, not saying, “Here’s a prescription for some pills. I’ll see you in two months.”

Gregory House to Exam Room 1, please

Not that I agree with many of the tactics, but I would like to have a primary care physician that was almost identical to the character on the television show House, MD. Why? Because the guy digs and digs until he has the real culprit of what’s ailing you. He doesn’t rely on the old, “You’re overweight, stop eating” routine. He doesn’t go for the old, “High blood pressure, no salt and pop these pills” trick. I hate to break it to you, but passing pills is a dog-and-pony show. Any moron could learn which pills to prescribe based solely on symptomology. Doctors, supposedly, are learned in their profession. They attend medical school, fulfill requirements of a residency program, yet when a patient shows up for an appointment, they seemingly want to treat the medical appointment as a scripted television show: everything must be done and over with in 15 minutes — or less.

Treating individuals is just that. Individual. No two people are the same, and when someone shows up in a physician’s office, the physician must recognize this. If someone’s overweight, find out why. Is it because they are a couch potato? Is it because they are chronically fatigued? Are they sleeping their lives away, yet each day when they wake up, even after 12 or 13 hours of sleep, they still feel sleepy? There’s a problem, doc.

If people are chronically fatigued, they aren’t going to exercise.

Yes, I know. There are going to be some who want to chime in with: “But if they would just get off their duff and exercise, they’d feel better.” Give me a break, Einstein. Go get drunk, but be sure you exceed the legal limit for your state. Then, once you’re at that point, go walk a straight line. You will not be able to do it, and chances are, you won’t want to try, either. The same holds true when your live day-after-day fatigued.

Viagra to the rescue … not!

It was back in 1998 that the FDA approved Pfizer’s application to market Viagra, the first pill, but certainly not the first treatment, for impotency. Somewhere along the line, the name of it went from impotency to erectile dysfunction. Perhaps that was so the health insurance prescription plans would cover Viagra.

An earlier option, one that some men who have suffered severed penises have used, is a mechanical implant, sort of like a balloon, which is implanted during a short surgical procedure. I remember reading up on the subject when Lorenna Bobbitt bobbed her former husband, John. Or did she chomp? I forget. Sick woman, no matter the case.

Anyway, after Viagra burst on the scene, it didn’t only offer a non-surgical optionally provided a treatment option, but also brought what some call “awareness,” to the forefront of discussion. Politicians and other familiar faces advertised Viagra. It isn’t like people never heard of impotency. Pfizer didn’t create public service announcements about what impotency really is, or anything. The company created ads to push up the sales of it penis-popping pill. Sorry, but that is not awareness. That’s capitalism, pure and simple. The company made a killing with those ads, too.

To get a fair and accurate sample, one that represented a cross-section of America, the researchers based their findings on data from 2,126 men.

According to the study, an estimated 18.4 percent of U.S. men, 20 years of age and older — about 18 million men, in all – suffer from the ailment. Breaking the numbers down a little more, it was estimated that around 5.1 percent of men between 20 and 39 suffered from it; as did 14.8 percent of those aged 40 to 59; around 43.8 percent for those 60 to 69 years of age, and about 70.2 percent for those age 70 and over.

Men who said they were “never able” or “sometimes able” to maintain an erection were listed as having erectile dysfunction. Those who said they were “always or almost always able” or “usually able” were not.

Looking at those numbers, yes, with a study, I could find that it was the wearing of spectacles that led to the ailment, or maybe the wearing of baseball caps. It could have been a lot of stuff that could have been correlated if you look at the numbers.

For guys who are in the 20’s and 30’s, it is only 5.1 percent. It jumps to 14.8 percent when they hit 40 to 59. Well, that could be the middle-age tire settling in, it could be bad eating. It could be lack of exercise. It could be lack of interest in a partner — of no availability of a partner. It could be many things. The numbers aren’t alarmingly high, though, all things considered.

Now, when you look at the next group, those aged 60 to 69, well, the numbers jump to 43.8 percent. Yes, that’s a major jump — and a significant portion of the population. What ages was that again? Yep, 60 to 69. Okay, that could explain a lot. If you look at a lot of folks that age, they aren’t getting around too well, let alone getting it up. No, I’m not really being callous. But if someone isn’t walking well, let alone doing well, health-wise, do you really think the parts for sex are going to fare any better? Let’s get real.

The last group in the study, those guys aged 70 and over. The percentage shoots up to 70.2 percent for those guys not being able to engage in sexual relations. Again, let’s look at the overall health, not simply dismissing things as people being couch potatoes.

Half the men in the study who had diabetes also had erectile dysfunction, according to the article. Yep, that makes sense. That’s a known link, so there’s no rocket science there, nor anything for the NIH to spend money to “discover” through a new study.

Study results also show that almost 90 percent of men with erectile dysfunction had risk factors for cardiovascular disease, including diabetes, high blood pressure, poor cholesterol levels or smoking. Wow! That’s terrific! It also goes right back to prove my point. Get off the couch potato garbage and do real research.

Real research would have looked for the answers, for the cause of the problem, not at finding that the boob tube causes wilting winkies.

All the symptoms listed for erectile dysfunction, all the symptoms listed in the Reuters article, all sound alarming familiar. Why? Because they all tie right back into the same thing I hear all the time. The cause? Sleep apnea or other undiagnosed or untreated sleep disorders. Sorry, but that isn’t rocket science. Well, not these days. Dr. William C. Dement helped make it real, taking all the mystery from sleep.

In fact, doing little more than a simple Google search of the symptoms turns up information about sleep disorders, particularly sleep apnea. I did that, and could write up my findings for the NIH, and it would be free. If they want to pay me $1,000, I’d be glad to write up a 10-page summary of the findings, based on medical summaries, symptomology, and findings of other research. No cash, no paper, no Google link, though.

The culprit: TV

Getting down to the real culprit of the study is simple: the boob tube. Television. The box of moving picture. Cable. ESPN. Porn-on-demand.

The study makes two points here:

• men who watch three or more hours of television per day are much more likely to have erectile dysfunction than men who watch less than one hour per day;
• men with erectile dysfunction were less likely to have done vigorous physical activity in the previous 30 days than other men.

Both of those points are interesting. But you know what? It’s like I said earlier. I could say guys who wore baseball caps or drove compact cars or wore boxers vs. briefs suffer erectile dysfunction more.

Who’s a suspect?

The results here, to be honest, are suspect. Why? Again, because the same basic things that are keeping men plopped in a chair or on the couch, watching the boob tube, are the same things keeping men out of bed with their lovers. Is it all attributable to television? Hardly. Let’s move past berating and blaming television for all the woes in life and society.

To be sure, television does have a place for blame. Violence is one place, but that, again, is for one for my regular blog, Scoop’s Views, not the Sleep Blog.

Focusing only on this issue, I hate to disagree (yes, I’m being sarcastic! I love being disagreeable) it goes much deeper than a bag of corn chips and a comfortable recliner. I am certain. There are far too many commonalities to be dismissed. But the bigger question is: Why were they overlooked? Perhaps they were overlooked for the very same reason so many men and women remain undiagnosed with a sleep disorder. Because too many in medicine are too far behind the times in recognizing the role of sleep in overall health.

According to the summary in the Reuters article,

Selvin said there are two clear messages from the findings. One is that lifestyle changes — losing weight, exercising more and eating healthier foods — may be very effective in warding off erectile dysfunction rather than merely relying on a pill.

“By making lifestyle changes now, you can prevent this decline in sexual function,” Selvin said.

This is where I would butt heads with the doctor, as I do so often for others in real life. I get on the phone, talk with a physician who wants to say,

“This person cannot have sleep apnea because: (she is a woman; he/she is too old; he/she is too young; he/she too skinny; he/she too ugly; he/she too hairy; he/she too smart; he/she sleeps too much; he/she sleeps too little …), besides, I would know if they had apnea. I’m a doctor.”

Yes, they are all actual comments I’ve heard from doctors around the country — including the “too ugly” and “too hairy” comments. The part about “I would know … I’m a doctor,” well, sadly, that’s a real comment, as well.

Just because a person is a doctor does not mean they know all there is to know in the field of medicine. Would you trust an oncologist to treat you for genital herpes? Would you trust an endocrinologist to treat your impetigo? You’d probably want the oncologist to focus on cancer, the endocrinologist focusing on, well, you get the picture. If you have a specialist, the specialist focuses on that spectrum of medicine. A general practitioner is more like the “Jack of All Trades, Master of None.” They have to know a little about a lot, but often never know a lot about any one thing. There’s just not time, and with the explosion of research that we see every month, there’s no way in God’s green creation any doctor, especially a general practitioner, could keep up with on a regular basis — and still be a practicing physician.

The article said Dr. Selvin says another big message from the findings is that doctors need to be more aggressive in screening and managing middle-aged and older patients. I say, as I did above, that doctors ought treat each person as an individual, not offer the classic textbook remedy or following symptoms based on the prescribing recommendations of a pill.

In doing a little research for this post, I found a link to the Third Age Blog, with an article titled, An Easy Way to Lose Weight in 2007. According to that, the “healthiest” size waist to have is anything less than 34 inches. That means when I was 14, I was unhealthy. It means that when I was in the Army, with a 38 inch waist, when it came to my Class A, you know, the Dress Greens, or a 40 inch waist in my BDUs, or the camouflage fatigues. Then again, I had a 60-inch chest.

As I scanned that article, I dismissed it, immediately, when I saw something about turning vegetarian. I like my red meat. Research has also shown the body needs stuff found in red meat for you to stay healthy.

Link to Erectile dysfunction affects 18 percent of U.S. men - CNN.com

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