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Erectile dysfunction in severe sleep apnea patients and response to CPAP

International Journal of Impotence Research volume 22, pages 134–139 (2010)Cite this article

Abstract

The aim of this study was to investigate frequency and degree of ED in patients with severe sleep apnea and to evaluate the results of only continuous positive airway pressure (CPAP) therapy on ED in patients with severe obstructive sleep apnea syndrome (OSAS). This was a prospective clinical trial study. Patients with severe sleep apnea (40) were randomized into two groups. Multiple questionnaire investigation and laboratory evaluation were performed for ED, severity of OSAS and psychological status. Group 1 was treated with CPAP and group 2 was treated with only antidepressant medication for at least 1 month. Patients were evaluated after 1 month of therapy and compared with initial ones. Before CPAP, the International Index of Erectile Function (IIEF)-5 scores were significantly correlated only with body mass index (BMI; P=0.007) and not correlated significantly with Epworth Sleepiness Scale scores (P=0.286), lowest SaO2 (P=0.182), Beck's Depression Inventory scores (P=0.302) and apnea/hypopnea index (P=0.279). After 1 month of regular CPAP usage, mean value of IIEF-5 score was 15.71±5.12 before CPAP and were improved up to 19.06±3.94, statistically significant. All subjects responded positively to the CPAP treatment and their erection status was improved positively. We have found a correlation between severe OSAS and ED. CPAP is effective in improvement of sexual performance of these patients.

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References

  1. 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.

    Article  CAS  Google Scholar 

  2. Hirshkowitz M, Karacan I, Gurakar A, Williams RI . Hypertension, erectile dysfunction and occult sleep apnea. Sleep 1989; 12: 223–232.

    Article  CAS  Google Scholar 

  3. Pressman MR, Diphillipo MA, Kendrick JI, Conroy K, Fry JM . Problems in the interpretation of nocturnal penile tumescence studies: disruption of sleep by occult sleep disorders. J Urol 1986; 136: 595–598.

    Article  CAS  Google Scholar 

  4. Lavie P, Herer P, Hoffstein V . Obstructive sleep apnea syndrome as risk factor for hypertension: population study. Br Med J 2000; 320: 479–482.

    Article  CAS  Google Scholar 

  5. Guilleminault C, Tilkian A, Eldridge FL . Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases. Arch Intern Med 1977; 137: 296–300.

    Article  CAS  Google Scholar 

  6. Perimenis P, Karkoulias K, Konstantinopoulos A, Perimeni P . George Katsenis, Anastosios Athanasopoulos, Konstantinos Spyropoulos. Sildenafil versus continuous positive airway pressure for erectile dysfunction in men with obstructive sleep apnea: a comparative study of their efficacy and safety and the patients satisfaction with treatment. Asian J Androl 2007; 9: 259–264.

    Article  CAS  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB et al. Erectile dysfunction and coronary risk factors, prospective results from the Massachusetts male aging study. Prev Med 2000; 30: 328–338.

    Article  CAS  Google Scholar 

  9. Thase ME, Reynolds CF, Glanz LM . Nocturnal penile tumescence in depressed men. Am J Psychiatry 1987; 144: 89.

    Article  CAS  Google Scholar 

  10. Hirshkowitz M, Schmidt HM . Sleep-related erections: clinical perspectives and neural mechanisms. Sleep Med Rev 2005; 9: 311–329.

    Article  Google Scholar 

  11. Karacan I, Karatas M . Erectile dysfunction in sleep apnea and response to CPAP. J Sex Marit Ther 1995; 21: 239–247.

    Article  CAS  Google Scholar 

  12. American Academy of Sleep Medicine Task force. Sleep related breathing disorders in adults: recommendations for syndrome definition and measurements techniques in clinical research. Sleep 1999; 22: 667–689.

    Article  Google Scholar 

  13. Roizenblatt S, Guilleminault C, Poyars D, Cintra F, Kauati A, Tufik S . A double blind, placebo controlled, crossover study of sildenafil in obstructive sleep apnea. Arch Intern Med 2006; 166: 1763–1767.

    Article  CAS  Google Scholar 

  14. Rosen RC, Cappelleri JC, Gendrano N . The international index of erectile function: a state of the science review. Int J Impot Res 2002; 14: 226–244.

    Article  CAS  Google Scholar 

  15. Beebe D, Finer E, Holmbeck GN . Low-end specificity of four depression measures: findings and suggestions for the research use of depression tests. J Pers Assess 1996; 67: 272–284.

    Article  CAS  Google Scholar 

  16. Johns MW . A new method for measuring sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540–545.

    Article  CAS  Google Scholar 

  17. Heruti R, Shochat T, Tekes-Manova D, Ashkenazi I, Dan J . Association between erectile dysfunction and sleep disorders measured by self-assessment questionnaires in adult men. J Sex Med 2005; 2: 543–550.

    Article  Google Scholar 

  18. Aasebo U, Gyltne A, Bremnes RM, Aakvaag A, Slordal L . Reversal of sexual impotence in male patients with chronic obstructive pulmonary disease and hypoxemia with long term oxygen therapy. J Steroid Biochem Mol Biol 1993; 46: 799–803.

    Article  CAS  Google Scholar 

  19. Patel SR, White DP, Malhotra A, Stanchina ML, Ayas NT . Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: results of a meta-analysis. Arch Intern Med 2003; 163: 565–571.

    Article  Google Scholar 

  20. Hammoud A, Gibson M, Peterson M, Hamilton B, Carrel D . Obesity and male reproductive potential. J Androl 2006; 27: 619–626.

    Article  Google Scholar 

  21. Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D'Andrea F et al. Effects of lifestyle changes on erectile dysfunction in obese men, a randomized controlled trial. JAMA 2004; 291: 2978–2984.

    Article  CAS  Google Scholar 

  22. Gonçalves MA, Guilleminault C, Ramos E, Pahla A, Paiva T . Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment. Sleep Med 2005; 6: 333–339.

    Article  Google Scholar 

  23. Gambineri A, Pelusi C, Pasquali R . Testosterone levels in obese male patients with obstructive sleep apnea syndrome: relation to oxygen desaturation, body weight, fat distribution and the metabolic parameters. J Endocrinol Invest 2003; 26: 493–498.

    Article  CAS  Google Scholar 

  24. Grunstein RR . Endocrine and metabolic disturbance in obstructive sleep apnea. In: Sauders NA, Sullivan CE (eds). Sleep and Breathing. Dekker: New York, 1994, pp 449–492.

    Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. Kennedy SH, Rizvi S . Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol 2009; 29: 157–164.

    Article  CAS  Google Scholar 

  27. Kinzl JF . Major depressive disorder, antidepressants and sexual dysfunction. Neuropsychiatr 2009; 23: 134–138.

    PubMed  Google Scholar 

  28. 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.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey

    U Taskin, O Yigit, E Acioglu & M Aricigil

  2. Department of Urology, Istanbul Education and Research Hospital, Istanbul, Turkey

    G Toktas

  3. Department of Psychiatry, Istanbul Education and Research Hospital, Istanbul, Turkey

    Y Guzelhan

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  1. U Taskin
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  2. O Yigit
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  3. E Acioglu
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  5. G Toktas
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  6. Y Guzelhan
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Correspondence to U Taskin.

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Taskin, U., Yigit, O., Acioglu, E. et al. Erectile dysfunction in severe sleep apnea patients and response to CPAP. Int J Impot Res 22, 134–139 (2010). https://doi.org/10.1038/ijir.2009.54

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  • DOI: https://doi.org/10.1038/ijir.2009.54

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