1325 ERECTILE DYSFUNCTION IS INDEPENDENTLY ASSOCIATED WITH SLEEP APNEA IN A LARGE POPULATION OF MIDDLE-AGED MEN

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20111325 ERECTILE DYSFUNCTION IS INDEPENDENTLY ASSOCIATED WITH SLEEP APNEA IN A LARGE POPULATION OF MIDDLE-AGED MEN Boback Berookhim, Mary Ann McLaughlin, Mark Woodward, Rupa Iyengar, Simonette Sawit, Cynara Maceda, Jacqueline Moline, and Natan Bar-Chama Boback BerookhimBoback Berookhim New York, NY More articles by this author , Mary Ann McLaughlinMary Ann McLaughlin New York, NY More articles by this author , Mark WoodwardMark Woodward New York, NY More articles by this author , Rupa IyengarRupa Iyengar New York, NY More articles by this author , Simonette SawitSimonette Sawit New York, NY More articles by this author , Cynara MacedaCynara Maceda New York, NY More articles by this author , Jacqueline MolineJacqueline Moline Great Neck, NY More articles by this author , and Natan Bar-ChamaNatan Bar-Chama New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1145AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obstructive sleep apnea (OSA) is a common condition, which has been recently associated with erectile dysfunction (ED). A number of different mechanisms have been proposed to describe this association, including endothelial dysfunction and nocturnal hypoxemia. The Berlin Questionnaire is the most widely used questionnaire for OSA, with published sensitivity up to 86% and specificity of 87% (Netzer NC, 1999, Ahmadi N, 2008). We aim to describe an independent association between patients with ED and those at risk for OSA as assessed by the Berlin Questionnaire. METHODS We evaluated 870 consecutively enrolled men in the ongoing Law Enforcement Cardiac Screening program (LECS), a subset of the World Trade Center Medical Monitoring and Treatment Program. Patients who scored positive on the Berlin Questionnaire were defined to be at high risk for OSA. ED was assessed by use of the International Index of Erectile Function −5 (IIEF-5), and was defined as IIEF < 22. A multivariate, binary logistic regression was performed to adjust for age, history of cardiovascular disease, systolic blood pressure, diabetes, smoking and body mass index (BMI). RESULTS The mean age of the patients in the study population was 47.3 years, with a mean BMI of 30.2. 63% of patients screened positive for OSA, 5.6% of patients had a history of diabetes, and 29% had a smoking history. After adjusting for age and comorbidities, patients with ED were more than twice as likely to have OSA than their normal counterparts (OR 2.15, 95% confidence interval 1.42–3.26, p = 0.0003). The likelihood of having OSA increased as the severity of ED increased (Wilcoxon test, p= 0.0005) (see figure 1). CONCLUSIONS On multivariate analysis, ED is independently associated with patients at high risk for OSA, and the risk of having OSA increased as the severity of ED increased. This is the largest study to date demonstrating this relationship, and verifies recently published data (Budweiser, 2009). Given these findings, this study suggests that men with ED should also be screened for OSA . Normal Erectile Function (IIEF > 22) Mild ED (IIEF 17–21) Mild to Moderate ED (IIEF 12–16) Moderate ED (IIEF 8–11) Severe ED (IIEF < 8) Percent of patients at high risk for OSA 59% 72% 79% 83% 88% © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e530 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Boback Berookhim New York, NY More articles by this author Mary Ann McLaughlin New York, NY More articles by this author Mark Woodward New York, NY More articles by this author Rupa Iyengar New York, NY More articles by this author Simonette Sawit New York, NY More articles by this author Cynara Maceda New York, NY More articles by this author Jacqueline Moline Great Neck, NY More articles by this author Natan Bar-Chama New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...