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%.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Margel D, Cohen M, Livne PM, Pillar G . Severe, but not mild, obstructive sleep apnea syndrome is associated with erectile dysfunction. Urology 2004; 63: 545–549.
Arruda-Olson AM, Olson LJ, Nehra A, Somers VK . Sleep apnea and cardiovascular disease. Implications for understanding erectile dysfunction. Herz 2003; 28: 298–303.
Goncalves MA, Guilleminault C, Ramos E, Palha A, Paiva T . Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment. Sleep Med 2005; 6: 333–339.
Akashiba T, Kawahara S, Akahoshi T, Omori C, Saito O, Majima T et al. Relationship between quality of life and mood or depression in patients with severe obstructive sleep apnea syndrome. Chest 2002; 122: 861–865.
Schiavi RC, Mandeli J, Schreiner-Engel P, Chambers A . Aging, sleep disorders, and male sexual function. Biol Psychiatry 1991; 30: 15–24.
Fanfulla F, Malaguti S, Montagna T, Salvini S, Bruschi C, Crotti P et al. Erectile dysfunction in men with obstructive sleep apnea: an early sign of nerve involvement. Sleep 2000; 23: 775–781.
Seftel AD, Strohl KP, Loye TL, Bayard D, Kress J, Netzer NC . Erectile dysfunction and symptoms of sleep disorders. Sleep 2002; 25: 643–647.
Hirshkowitz M, Karacan I, Arcasoy MO, Acik G, Narter EM, Williams RL . Prevalence of sleep apnea in men with erectile dysfunction. Urology 1990; 36: 232–234.
Karacan I, Karatas M . Erectile dysfunction in sleep apnea and response to CPAP. J Sex Marital Ther 1995; 21: 239–247.
De Serres LM, Derkay C, Sie K, Biavati M, Jones J, Tunkel D et al. Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2002; 128: 489–496.
Baldassari CM, Mitchell RB, Schubert C, Rudnick EF . Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg 2008; 138: 265–273.
Ku JH, Park DW, Kim SW, Paick JS . Cross-cultural differences for adapting translated five-item version of International Index of Erectile Function: results of a Korean study. Urology 2005; 65: 1179–1182.
Flemons WW, Reimer MA . Development of a disease-specific health-related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med 1998; 158: 494–503.
Flemons WW, Reimer MA . Measurement properties of the calgary sleep apnea quality of life index. Am J Respir Crit Care Med 2002; 165: 159–164.
Johns MW . A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991; 14: 540–545.
Rechtschaffen A, Kales A . A Manual of Standardized Terminology, Technique, and Scoring System for Sleep Stages of Human Subjects. BIS/BRI, UCLA: Los Angeles, 1968.
Margel D, Tal R, Livne PM, Pillar G . Predictors of erectile function improvement in obstructive sleep apnea patients with long-term CPAP treatment. Int J Impot Res 2005; 17: 186–190.
Horner RL, Brooks D, Kozar LF, Tse S, Phillipson EA . Immediate effects of arousal from sleep on cardiac autonomic outflow in the absence of breathing in dogs. J Appl Physiol 1995; 79: 151–162.
Katragadda S, Xie A, Puleo D, Skatrud JB, Morgan BJ . Neural mechanism of the pressor response to obstructive and nonobstructive apnea. J Appl Physiol 1997; 83: 2048–2054.
Haight JS, Djupesland PG . Nitric oxide (NO) and obstructive sleep apnea (OSA). Sleep Breath 2003; 7: 53–62.
Perimenis P, Karkoulias K, Konstantinopoulos A, Alchanatis M, Perimeni PP, Athanasopoulos A et al. The impact of long-term conventional treatment for overlap syndrome (obstructive sleep apnea and chronic obstructive pulmonary disease) on concurrent erectile dysfunction. Respir Med 2007; 101: 210–216.
Köhler TS, Kim J, Feia K, Bodie J, Johnson N, Makhlouf A et al. Prevalence of androgen deficiency in men with erectile dysfunction. Urology 2008; 71: 693–697.
Stewart DA, Grunstein RR, Berthon-Jones M, Handelsman DJ, Sullivan CE . Androgen blockade does not affect sleep-disordered breathing or chemosensitivity in men with obstructive sleep apnea. Am Rev Respir Dis 1992; 146: 1389–1393.
Moore P, Bardwell WA, Ancoli-Israel S, Dimsdale JE . Association between polysomnographic sleep measures and health-related quality of life in obstructive sleep apnea. J Sleep Res 2001; 10: 303–308.
Lloberes P, Marti S, Sampol G, Roca A, Sagales T, Munoz X et al. Predictive factors of quality-of-life improvement and continuous positive airway pressure use in patients with sleep apnea-hypopnea syndrome: study at 1 year. Chest 2004; 126: 1241–1247.
Acknowledgements
We thank Dr W Flemons for his permission to translate the Calgary Sleep Apnea Quality of Life Index (SAQLI) into Korean and to use it in this study. The authors have no financial or other potential conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shin, HW., Rha, YC., Han, D. et al. Erectile dysfunction and disease-specific quality of life in patients with obstructive sleep apnea. Int J Impot Res 20, 549–553 (2008). https://doi.org/10.1038/ijir.2008.39
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ijir.2008.39
Keywords
This article is cited by
-
Association between obstructive sleep apnea and erectile dysfunction: a systematic review and meta-analysis
International Journal of Impotence Research (2018)
-
Obstructive sleep apnea and urological comorbidities in males: a population-based study
Sleep and Breathing (2016)