Erectile Dysfunction in Patients with Sleep Apnea – A Nationwide Population-Based Study

Abstract

Increased incidence of erectile dysfunction (ED) has been reported among patients with sleep apnea (SA). However, this association has not been confirmed in a large-scale study. We therefore performed a population-based cohort study using Taiwan National Health Insurance (NHI) database to investigate the association of SA and ED. From the database of one million representative subjects randomly sampled from individuals enrolled in the NHI system in 2010, we identified adult patients having SA and excluded those having a diagnosis of ED prior to SA. From these suspected SA patients, those having SA diagnosis after polysomnography were defined as probable SA patients. The dates of their first SA diagnosis were defined as their index dates. Each SA patient was matched to 30 randomly-selected, age-matched control subjects without any SA diagnosis. The control subjects were assigned index dates as their corresponding SA patients, and were ensured having no ED diagnosis prior to their index dates. Totally, 4,835 male patients with suspected SA (including 1,946 probable SA patients) were matched to 145,050 control subjects (including 58,380 subjects matched to probable SA patients). The incidence rate of ED was significantly higher in probable SA patients as compared with the corresponding control subjects (5.7 vs. 2.3 per 1000 patient-year; adjusted incidence rate ratio = 2.0 [95% CI: 1.8-2.2], p<0.0001). The cumulative incidence was also significantly higher in the probable SA patients (p<0.0001). In multivariable Cox regression analysis, probable SA remained a significant risk factor for the development of ED after adjusting for age, residency, income level and comorbidities (hazard ratio = 2.0 [95%CI: 1.5-2.7], p<0.0001). In line with previous studies, this population-based large-scale study confirmed an increased ED incidence in SA patients in Chinese population. Physicians need to pay attention to the possible underlying SA while treating ED patients.

The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study

“…Being the most common type of sleep-disordered breathing, sleep apnea (SA) is usually characterized by repetitive shallowing and stopping of breaths during sleep, which is usually accompanied with intermittent hypoxia, arousal, and sleep fragmentation [ 8 ]. Polysomnography (PSG) is usually performed to establish the diagnosis of SA [ 9 ].…”

Blood Oxygen Accumulation Distribution Area Index Is Associated With Erectile Dysfunction in Patients With Sleep Apnea—Results From a Cross-sectional Study

“…2e6 Epidemiological and clinical studies have shown that erectile dysfunction (ED) shares similar comorbidities with OSA. 7 A series of studies conducted with sleep medical center patients as participants have reported that the prevalence of ED in patients with OSA ranges from 41% to 80%. 8e11 In a large population-based cohort study, researchers found that people with OSA exhibited an increased risk of ED; this study reported an ED incidence 9.44fold higher in the apnea cohort than that in the nonapnea cohort.…”

Sleep disorders in patients with erectile dysfunction

“…Erectile dysfunction (ED) shares similar comorbidities with OSA [6,7]. The association between sleep disordered breathing and sexual dysfunction was first described by Guilleminault et al [8] in 1981, when they reported a 48% ED rate in men with severe OSA.…”