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Sleep Disorders in Patients with Erectile Dysfunction - Beyond the Abstract

Obstructive sleep apnea (OSA) is prevalent in about 9-14% of men1. OSA has been associated with several significant comorbidities, including metabolic and cardiovascular diseases2. Several studies have suggested links between OSA and erectile dysfunction (ED), but the evidence remains inconclusive. Currently, there is a need for easy accessible and reliable tools for non-specialist clinicians to diagnose OSA and provide referrals to specialists. 

The objective of this prospective, non-randomized study was to evaluate the prevalence of OSA in men presenting with ED. Between February and September 2016, a total of 129 patients diagnosed with ED completed three questionnaires: the International Index of Erectile Function (IIEF), the Obstructive Sleep Apnoea Screening questionnaire and the Insomnia Severity Index (ISI).

An OSA diagnosis was made based on a score of >3 on the OSA Screening questionnaire, which has a 92.9% sensitivity in identifying moderate-to-severe OSA. In total, 55% of patients were diagnosed with OSA and referred to a sleep specialist. This study also found that older age and higher body mass index (BMI) was associated with OSA diagnosis. 

This study had several limitations, including a high risk-population that may have to lead the research team to have biased results toward surgical intervention. Additionally, the research team has not received the results from the sleep specialist. Due to the many comorbidities and consequences of OSA, it is crucial to obtain an early diagnosis and treatment. In terms of future directions, a questionnaire-based diagnostic tool could prove beneficial for non-specialist clinicians to refer patients in receiving the treatment they need.

Written by: Zhamshid Okhunov, MD, University of California Irvine

References:  
1. Lacedonia D et al. Prevalence of comorbidities in patients with obstructive sleep apnea syndrome, overlap syndrome and obesity hypoventilation syndrome. Clin Respir J 2018; 1-7.
2. Jennum P, Kjellberg J. Health, social and economic consequences of sleep-disordered breathing: a controlled national study. Thorax. 2011; 66(7):560-566.

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