Erectile dysfunction in obstructive sleep apnea syndrome—Prevalence and determinants

AbstractIntroductionOSAS (obstructive sleep apnea syndrome) is defined by recurrent episodes of upper airway obstruction during sleep, causing multiple clinical consequences. Literature review suggests that OSAS induces a spectrum of abnormalities in neural, hormonal and vascular regulation that contribute to the development of ED (erectile dysfunction).The aims of this study were to estimate the prevalence of ED in OSAS patients and evaluate its determinants.Methods62 patients from Hospital S. João Sleep Laboratory with newly diagnosed OSAS were included in the study and answered the IIEF-5 (international index erectile function 5 item version) questionnaire.ResultsThe prevalence of ED in OSAS patients was 64.4%. Age and diabetes constituted themselves as independent risk factors for more severe degrees of ED: OR=1.226 (95% CI: 1.062–1.415) and OR=31.205 (95% CI: 1.222–796.557), respectively. Compared with nonsmokers, ex-smokers group revealed a positive association with ED: OR=4.32 (95% CI: 1.09–17.11). Hypertension and ACEI (angiotensin converting enzyme inhibitors) or ARB (angiotensin II receptor blockers) therapy were also correlated to ED symptoms: OR=3.25 (95% CI: 1.09–9.65) and 7.39 (95% CI: 1.52–35.99), respectively.No association was found relating BMI (p=0.254), alcoholic habits (p=0.357), acute myocardial infarction (p=0.315), dyslipidemia (p=0.239), metabolic syndrome (p=0.215) and ED.OSAS severity was not associated with ED in our sample.ConclusionsThe prevalence of ED in OSAS patients is high. ED determinants in our sample were age and diabetes. Past smoking habits, hypertension and ACEI/ARB therapy also revealed a statistically significant association with ED