Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment

Background and purpose: To evaluate the effect of one month of continuous positive airway pressure (CPAP) in a subgroup of obstructive sleep apnea (OSA) patients with erectile dysfunction (ED) and compare this subgroup with age- and body mass index (BMI)-matched OSA patients without ED. Patients and methods: Prospective general, sleep, psychiatric and sexologic evaluations were conducted. Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Sleep Disorders Questionnaire (SDQ), Quality of Life SF-36, and polysomnography were used. Seventeen OSA patients with ED were compared prior to CPAP treatment and during CPAP treatment with age- and BMI-matched OSA patients without ED. Parametric and non-parametric statistics, chi-square, Fisher exact test and multiple regression analyses were performed. Results: Ninety-eight men (BMI = 28.8 kg/m(2), apnea-hypopnea index (AHI) = 49.6 events/h, ESS = 14.8, BDI = 8.4, and lowest SaO(2) = 75.3%) were divided into subgroups of lowest SaO(2) > 80% (A) and lowest SaO(2) <= 80% (B). (A) Forty-six men had a mean lowest SaO(2) of 85.7% +/- 2.9, AHI = 29.5 +/- 17.6, age = 46.3 +/- 9.3 years, ESS = 13.6 +/- 4.2, BMI = 25.8 +/- 4.8. Seven of the patients had ED. (B) Fifty-two men had a mean lowest SaO(2) = 60.10 +/- 10.0%, AHI = 67.4 +/- 24.5, BDI = 9.0 +/- 6.9, age = 47.4 +/- 9.4 years, ESS = 16.2 +/- 4.4, BMI = 31.4 +/- 5.1. Twenty-one of the patients had ED (chi(2) : P = 0.006). Significant variables for ED were lowest SaO(2) and age (r = 0.17). CPAP-treated subgroup: ED subjects had significantly lower SaO(2), ESS, BDI and SF-36 subscale scores than OSA controls. Nasal CPAP eliminated the differences between groups, and ED was resolved in 13 out of 17 cases. Conclusions: ED in OSAS is related to nocturnal hypoxemia, and about 75% of OSAS patients with ED treated with nasal CPAP showed remission at one-month follow-up, resulting in significant improvement in quality of life. (c) 2005 Elsevier B.V. All rights reserved.