Erectile dysfunction and disease-specific quality of life in patients with obstructive sleep apnea

Abstract

Several reports have suggested a high incidence of erectile dysfunction (ED) among patients with obstructive sleep apnea syndrome (OSAS). The aim of this study was to investigate the correlation between OSAS and ED, or disease-specific quality of life (QOL) in patients with OSAS. In addition, we analyzed specific polysomnographic (PSG) parameters in predicting ED in OSAS patients. In total, 32 patients with OSAS and 27 normal controls were asked to complete the Korean versions of the International Index of Erectile Function questionnaire (KIIEF-5) and the Calgary Sleep Apnea Quality of Life Index (SAQLI). All patients then underwent a full-night in-laboratory PSG examination. Patients were diagnosed with OSAS if they had clinical symptoms suggestive of OSAS for at least 1 year and an apnea-hypopnea index (AHI) of more than 10 in PSG. Nineteen patients (59.3%) in the OSAS group showed ED, which was significantly higher than in the control group (8 patients, 29.6%, P ¼ 0.012). In addition, SAQLI scores worsened as AHI increased (r ¼ 0.327, P ¼ 0.011) and as the lowest oxygen saturation level decreased (r ¼ 0.420, P ¼ 0.001). ED was not significantly correlated with AHI (r ¼ 0.061, P ¼ 0.649); however, it was significantly correlated with the lowest oxygen saturation decreased (r ¼ 0.338, P ¼ 0.009). When the cutoff value for the lowest oxygen saturation level to predict ED was set at 77%, its positive predictive value was 88.9% (sensitivity ¼ 0.70, specificity ¼ 0.62). Thus, all male patients with OSAS should be screened for erectile dysfunction and more comprehensive consultation is needed, especially, if their lowest oxygen saturation levels are below 77%.

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

“…and further detailed by Schmidt and Wise in 1981 19. Since then, higher prevalences of ED in the OSA groups have been published in numerous studies,202122232425 depending on the diagnostic tool used. The prevalence of ED is as high as 69%,262728 with poorer sexual function in OSA patients compared with control patients matched for comorbidities and age 2325293031.…”

“…Since then, higher prevalences of ED in the OSA groups have been published in numerous studies,202122232425 depending on the diagnostic tool used. The prevalence of ED is as high as 69%,262728 with poorer sexual function in OSA patients compared with control patients matched for comorbidities and age 2325293031. This growing evidence leads to the recommendation in some papers of asking the patients about sleep disturbances,25323334 or even snoring35 during ED assessment.…”

“…In OSA patients, the lower O 2 saturation was a significant predictor ( P = 0.01) of the presence of ED 34. Despite this data, it remains unclear if this effect on the erectile function occurs in the entire range of OSA severities or only in the moderate and severe OSA patients 212325283034…”

Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

“…Alterations in the nitric oxide cyclic guanosine monophosphate pathway may be one of the other mechanisms involved. Psychological factors, including decreased libido and mood changes associated with sleep fragmentation, may be similarly associated (2,20). Sleep fragmentation itself, irrespective of intermittent hypoxia, is known to affect similar physiologic consequences, including sympathetic activation.…”

“…Sleep fragmentation itself, irrespective of intermittent hypoxia, is known to affect similar physiologic consequences, including sympathetic activation. Shin et al (2) demonstrated that total sleep time is longer in the OSAS group, but sleep and REM latency are similar in the OSA and control groups. Their analysis revealed a nonsignificant difference between ED scores and sleep parameters.…”