Association Between Erectile Dysfunction and Sleep Disorders Measured by Self-Assessment Questionnaires in Adult Men

Abstract

Background Erectile dysfunction (ED) is often associated with sleep disorders and sleep apnea syndrome (SAS) in mostly middle-aged and elderly men. Sleep disorders and ED are also prevalent in younger men. Purpose To study the association between ED, sleep disorders, and SAS, particularly among adult men. Methods A health screening program is offered by the Israel Defense Force (IDF) for career servicemen older than 25 years, for the purpose of early detection of ED and sleep disorders, among other concealed morbidities. The Sexual Health Inventory for Man questionnaire (SHIM) was used to measure ED. The Sleep Quality (SQ) questionnaire, developed by the medical services of the IDF, was used to characterize SAS and other sleep disorders. Results From 2002 through 2003, 3,363 men (mean age, 36.1 ± 6.8 years) replied to the SHIM and SQ questionnaires. Of these men, 337 (10%) scored high (≥25) in the SQ questionnaire, suggesting moderate to severe sleep disorders, and 870 men (25.8%) scored low (≤21) in the SHIM questionnaire, suggesting ED. There was a negative correlation between the scores in the SHIM questionnaire and in the SQ questionnaire (r = −0.29, P < 0.0001)—even after age adjustment and after excluding men with risk factors for both ED and SAS (such as essential hypertension, diabetes mellitus, and obesity; r = −0.21, P < 0.0001). This correlation was consistent with all severity levels of ED and sleep disorders. Conclusions Sleep disorders, in particular SAS, and ED are prevalent and may be related in adult men. Either ED or sleep disorders should be considered whenever the other is suspected in adult men. Sleep disorders and ED should also be investigated for the purpose of treating underlying systemic diseases and emotional disorders, and in order to prevent late complications of atherosclerosis.

Sildenafil combined with continuous positive airway pressure for treatment of erectile dysfunction in men with obstructive sleep apnea

“…Supporting these findings, studies of nocturnal penile tumescence in men with ED revealed a high rate of sleep disorders ranging from 44% to 61% [6][7][8]. Recently, Heruti et al [9] reported on the close relation between OSA and ED, so that either of them should be considered whenever the other is suspected in adult men.…”

Erectile dysfunction in severe sleep apnea patients and response to CPAP

“…ED, the inability to achieve or maintain an erection sufficient for sexual intercourse, 17 can arise due to hormonal, 18 vascular, 19 neurological, psychological and endocrinological disorders. 13 It is evident that obese men have a higher incidence of ED affecting their sexual life.…”

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

“…and further detailed by Schmidt and Wise in 1981 19. Since then, higher prevalences of ED in the OSA groups have been published in numerous studies,202122232425 depending on the diagnostic tool used. The prevalence of ED is as high as 69%,262728 with poorer sexual function in OSA patients compared with control patients matched for comorbidities and age 2325293031.…”

“…Since then, higher prevalences of ED in the OSA groups have been published in numerous studies,202122232425 depending on the diagnostic tool used. The prevalence of ED is as high as 69%,262728 with poorer sexual function in OSA patients compared with control patients matched for comorbidities and age 2325293031. This growing evidence leads to the recommendation in some papers of asking the patients about sleep disturbances,25323334 or even snoring35 during ED assessment.…”

“…The prevalence of ED is as high as 69%,262728 with poorer sexual function in OSA patients compared with control patients matched for comorbidities and age 2325293031. This growing evidence leads to the recommendation in some papers of asking the patients about sleep disturbances,25323334 or even snoring35 during ED assessment. In a survey study, snoring was associated with complaints of ED and with an organic ED diagnosis,36 while OSA has been clearly named as an independent risk factor for ED,37 with positive correlation between both entities 38.…”