Sleep apnea and cardiovascular disease. Implications for understanding erectile dysfunction

There is increasing recognition of the high and rising prevalence of obstructive sleep apnea (OSA). It has been suggested that OSA may contribute to erectile dysfunction. This review will examine the evidence and potential mechanisms, including abnormalities of neural, endothelial and hormonal function, linking OSA to erectile dysfunction.

Available data suggest, but do not prove, a higher prevalence of erectile dysfunction in OSA. Certainly, the pathologic processes activated by OSA are also those that may predispose to impaired erectile function. Further well-designed and controlled studies are needed to show conclusively that any increased prevalence of erectile dysfunction in OSA is secondary to the OSA per se and not a consequence of the frequently associated comorbidities, such as obesity and vascular disease, that characterize this patient population.