Obstructive sleep apnea and erectile dysfunction: still a neglected risk factor?

Zias, Nikolaos; Bezwada, Vishnu; Gilman, Sean; Chroneou, Alexandra

doi:10.1007/s11325-008-0212-8

Cited by 41 publications

(35 citation statements)

References 80 publications

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“…The mechanisms underlying the development of ED [23] and the relative contribution of OSA are not fully understood [5], but may include hormonal, neural, psychological, and vascular abnormalities [16]. In the present study, nocturnal hypoxemia was most consistently associated with ED and its subscores.…”

Section: Discussionmentioning

confidence: 53%

Sleep Apnea is an Independent Correlate of Erectile and Sexual Dysfunction

Budweiser

Enderlein

Jörres

et al. 2009

The Journal of Sexual Medicine

124

100

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Introduction Obstructive sleep apnea (OSA) has been linked with erectile dysfunction (ED), but it is unknown whether this association is maintained in the presence of other risk factors for ED. Aim The aim of this study was to evaluate the relationship between ED/sexual dysfunction and polysomnographic measures of sleep apnea in patients with known risk factors for ED. Methods Prospective cross-sectional analysis of 401 male patients undergoing in-lab polysomnography for suspected OSA. Erectile (EF) and sexual function were assessed by the 15-item International Index of Erectile Function (IIEF-15) questionnaire. Main Outcome Measures Severity of OSA via apnea–hypopnea index (AHI) and mean/lowest nocturnal oxygen saturation (SaO2). The IIEF-15 including the sexual domains: EF, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. Results OSA (AHI > 5/h) was diagnosed in 92% of patients. ED (EF subdomain ≤ 25) was present in 69% of patients with, and 34% of patients without OSA (P < 0.001). Multivariate stepwise regression analyses including known risk factors for ED, such as age, obesity, coronary heart disease, peripheral occlusive disease, hypertension, diabetes, prostate surgery, and β-blocker treatment, and measures of sleep apnea identified mean nocturnal SaO2 as independently associated with ED (P = 0.002; mean [95% CI] normalized slope 0.126 [0.047; 0.205]). Age (P < 0.001), peripheral occlusive disease (P = 0.001), prostate surgery (P = 0.018), and hypertension (P = 0.021) were confirmed as risk factors for ED, but did not abolish the sleep apnea-associated risk. Similar results were obtained for sexual dysfunction. Logistic regression analysis using the diagnosis of ED (EF subdomain ≤ 25) as binary dependent variable confirmed that mean nocturnal SaO2 (P = 0.012), as well as age (P < 0.001) were independently associated with ED. Conclusions ED and overall sexual dysfunction were highly prevalent in patients with suspected OSA. Irrespective of known risk factors, mean nocturnal SaO2 was an additional, independent correlate of these dysfunctions, suggesting that OSA-related intermittent nocturnal hypoxemia specifically contributes to their development.

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Section: Discussionmentioning

confidence: 53%

Sleep Apnea is an Independent Correlate of Erectile and Sexual Dysfunction

Budweiser

Enderlein

Jörres

et al. 2009

The Journal of Sexual Medicine

124

100

View full text Add to dashboard Cite

show abstract

“…Other symptoms include non-refreshing sleep, bed partner observed pauses in breathing, restless sleep, insomnia, automatic behaviors at night for which they are amnestic (Schenck & Mahowald, 2008), impotence and decreased libido (Zias, Bezwada, Gilman, & Chroneou, 2009), enuresis and nocturia (Umlauf & Chasens, 2003), irritability, depression (Jackson et al, 2011), cognitive problems (Ayalon, Ancoli-Israel, Aka, McKenna, & Drummond, 2009;Yaffe et al, 2011;Bahammam et al, 2011), nocturnal heartburn, night sweats and morning headaches (Cruz, Drummond, & Winck, 2011).…”

Section: Obstructive Sleep Apnea Syndrome (Osas)mentioning

confidence: 99%

Integrating Sleep Management into Clinical Practice

Schuman

Attarian

2012

J Clin Psychol Med Settings

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“…Mientras que para algunos autores esto supone un efecto de clase, otros lo relacionan principalmente con diuré ticos tiazídicos, betabloqueantes y alfabloqueantes 2,9,25 .En nuestro estudio, probablemente limitado por el tamaño de la muestra, aunque existe una tendencia con todos los grupos farmacoló gicos, solo encontramos esta asociació n en los pacientes tratados con antagonistas del calcio. Shiri et al 26 tambié n observaron có mo los pacientes hipertensos en tratamiento con antagonistas del calcio, antagonistas de los receptores de la angiotensina II, betabloqueantes y diuré ticos presentaban mayor riesgo de DE.…”

Section: Discusió Nunclassified

“…En mú ltiples estudios se ha relacionado el SAOS con otras enfermedades, concluyendo que este es causa independiente de hipertensió n arterial (HTA), y que puede producir enfermedad cardiovascular, ictus e incluso disfunció n del sistema endocrino [1][2][3] . En otros estudios se sugiere que el SAOS grave es un factor que contribuye al desarrollo de la disfunció n eré ctil (DE), a travé s de mecanismos hormonales, neuroló gicos, vasculares y psicoló gicos 2 .…”

Section: Introducció Nunclassified