27 Jun Effects of obstructive sleep apnoea and its treatment over the erectile function: a systematic review
Erectile dysfunction (ED) is considered a condition with a broad range of etiologies. Obstructive sleep apnoea (OSA) syndrome is one of the lesser studied risk factors for ED. The authors of this paper intend to summarise the current evidence on the relationship between OSA and sexual impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients.
They conducted a systematic review of articles related to the physiology of OSA and erectile dysfunction, and to the treatments of OSA syndrome and their reported outcomes in erectile and sexual function.
Some of their key findings:
- Higher prevalence’s of erectile dysfunction is often reported in groups with OSA. However, whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear.
- Several hypotheses were proposed to explain the physiology of the association between OSA and erectile dysfunction.
- Continuous Positive Airway Pressure as a treatment for OSA patients with erectile dysfunction has achieved a significative improvement in the sexual parameters in most of the studies.
- Phosphodiesterase type 5 inhibitors (iPDE5) on demand are useful as a treatment for erectile dysfunction in this subgroup of patients, with high satisfaction rates.
- The surgical treatment for OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular Advancement Devices is still undefined.
There is growing evidence of the risk of ED in OSA patients. Despite the lack of knowledge of the mechanisms of the sexual problems in these patients, there is a proven relationship between the severity of both entities. It seems to be reasonable to recommend asking about the sleep disorders during the erectile dysfunction clinical interview, due to the fact that the treatments of sleep disordered breathing will improve the sexual results, in particular, CPAP therapy. The iPDE5 on demand seems to be a good treatment for the ED in this cohort of patients, with the best outcomes and satisfaction rates when associated with CPAP therapy.
Campos-juanatey F,Fernandez-barriales M,Gonzalez M,Portillo-martin JA. Urology Department, Marques de Valdecilla University Hospital, Santander, 39008, Spain. Asian J. Androl..2017 May-Jun;19(3):303-310.