Erectile dysfunction and symptoms of sleep disorders

Sleep apnea often is associated with impotence and/or erectile dysfunction (ED). The purpose of this study was to test whether a presentation for ED confers a pretest probability for obstructive sleep apnea hypopnea syndrome (OSAHS).

A self-report survey for sleep complaints was conducted in consecutive male patients (>16 years of age) presenting to a urologic practice site.

The survey was provided to new and follow-up out-patients over a 2 month period of time. Other information collected included the presenting complaint, the clinical diagnosis for ED, and history of preexisting medical conditions.

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285 males [91% of the sample: 50 years old (range 16-82) and body mass index, 27.3 (range 16.8-52.5)] completed the survey. 181 (63%) had complaints of ED; of those, 76% had a final diagnosis of organic and 8.2%, psychogenic or both psychogenic and organic ED. Of all respondents, 35.4% reported persistent snoring, 14% reported persistent waketime sleepiness or fatigue, and 26.8% were at "high risk" (Netzer et al., 1999) for OSAHS. Some were high risk for insomnia (13.6%) and restless legs syndrome or for narcolepsy (2% each). There was a correlation between those with ED complaints (p<0.014) or those with a final diagnosis of organic ED (p<0.029) and snoring. In a logistic model that included age, snoring, and preexisting conditions, only age, depression, and history of hypercholesterolemia, were found to vary significantly among those with and without ED.

Urology patients will report a variety of sleep problems, but neither persistent snoring nor suspected OSAHS is correlated uniquely to ED.