1. ¹Department of Otorhinolaryngology, Seoul National University College of Medicine and Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea
2. ²Department of Psychiatry, Asan Medical Center, Seoul, Korea
3. ³Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence: Dr D-Y Kim, Department of Otorhinolaryngology, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul 110-744, Korea. E-mail: dongkim@snu.ac.kr

Received 17 July 2008; Revised 12 August 2008; Accepted 20 August 2008; Published online 11 September 2008.

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=0.012). In addition, SAQLI scores worsened as AHI increased (r=0.327, P=0.011) and as the lowest oxygen saturation level decreased (r=0.420, P=0.001). ED was not significantly correlated with AHI (r=0.061, P=0.649); however, it was significantly correlated with the lowest oxygen saturation decreased (r=0.338, P=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=0.70, specificity=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%.