Men with obstructive sleep apnea (OSA) who also have depressive symptoms and a low quality of life specific to sleep apnea have a higher incidence of erectile dysfunction (ED) than men with OSA alone.
Yung Jin Jeon, MD, from Seoul National University Hospital in Korea, and colleagues published the results of their cross-sectional analysis online October 19 in the Journal of Sexual Medicine. The investigators used nocturnal polysomnography as an objective sleep assessment measure. The cohort of men had a mean age of 44.8 ± 12.4 years; the ED group was older than the no-ED group (P < .0001).
The researchers found that the frequency of ED did not correlate with OSA severity. However, the scores on the Beck Depression Inventory and the Epsworth Sleepiness Scale were inversely correlated with the Korean version of the International Index of Erectile Function (KIIEF-5) (P < .0001 for each). In addition, the score of the Calgary Sleep Apnea Quality of Life was positively correlated with KIIEF-5 (P < .0001). However, the respiratory disturbance index and the lowest oxygen saturation did not correlate with KIIEF-5.
A univariate analysis revealed that excessive daytime sleepiness, low Calgary Sleep Apnea Quality of Life score, and depressive symptoms were significantly associated with ED.
When the investigators performed a multivariate logistic regression analysis and adjusted for possible confounding factors (age, body mass index, hypertension, and diabetes mellitus), they found that ED was independently associated with the Calgary Sleep Apnea Quality of Life score and depressive symptoms, but not with either the respiratory disturbance index or lowest oxygen saturation.
OSA is known to contribute to ED, and thus several studies have evaluated the effects of OSA treatment on the development of ED. The findings of the current study differ from previous data, which reported that sleep apnea was independently correlated with ED. The authors suggest that the difference stems from the large size of their study (n = 713), which was powered to detect the risk factors of depression and quality of life.
The authors conclude by suggesting that a psychological approach and psychological management may be beneficial for men with OSA and ED.
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