Treatment of obstructive sleep apnoea as a therapeutic modality for associated erectile dysfunction

Aim: This study aimed to determine the impact of long-term treatment with continuous positive airway pressure (CPAP) and obstruction relieving surgical procedure on obstructive sleep apnoea syndrome (OSAS) patients on erectile function (EF). Methods: Eighty male OSAS patients, suffering from erectile dysfunction (ED) were studied. The severity of OSAS was determined by evaluation of daytime sleep tendency using the Epworth Sleepiness Scale (ESS), measure of minimal oxygen saturation (SaO2) percentage and the frequency of apnoea-hypopnea index (AHI) during sleep. EFs were assessed using five-question International Index of Erectile Function (IIEF-5) questionnaire. The nocturnal penile rigidity of the patients was evaluated using automated Rigiscan. Results: Patients were subjected to CPAP every night for 3 months. After 3 months of CPAP treatment, the patients showed significant improvements in ESS and recorded much lower SaO2 percentages compared with their pre-treatment measures. Moreover, post-treatment AHIs were significantly lower, compared with pre-treatment indexes. Post-treatment evaluation of EFs showed significant improvements. Conclusions: In summary, OSAS in male patients can be considered as an underlying pathogenic factor for later development of ED. Therefore, its treatment can induce significant improvement in patients' EF. The mechanism underlying ED in patients with OSAS remains unclear. However, nasal CPAP, which is the gold standard in treatment of OSAS patients, and obstruction relieving surgery have been found effective in improving sexual performance and quality of life.