Erectile dysfunction is independently associated with apnea-hypopnea index and oxygen desaturation index in elderly, but not younger, community-dwelling men

Sean A. Martin, Sarah L. Appleton, Robert J. Adams, Anne W. Taylor, Andrew Vincent, Nicholas R. Brook, Peter G. Catcheside, Andrew Vakulin, R. Douglas McEvoy, Nick A. Antic, Gary A. Wittert

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Abstract

Objective(s) To examine the association between obstructive sleep apnea (OSA) and other sleep indices using polysomnography (PSG) data and erectile dysfunction (ED) in a representative cohort of men. Design Cross-sectional. Setting Community-based. Participants Aged 40+ years (n = 734; mean age [SD], 60.8 [10.9]). Measurements Men with no prior OSA diagnosis who underwent in-home PSG (Embletta X100; 2010-11) and ED assessment (Global Impotence Rating) were selected. Un-adjusted and multi-adjusted regression models of ED were fitted against PSG measures, along with qualifying sociodemographic, lifestyle, and health-related covariates. Mediation effects were examined using the Baron-Kenny method. Results Of the men examined, 24.7% (n = 181) had ED, most notably in men older than 65 years (cf. men 35-49 and 50-64years; P < .001). There was no significant association between ED and any of the PSG measures for allaged men. Given an observed ageinteraction within OSA categories (P = .005), analyses were repeated in age-stratified samples (<65 years; 65+ years). In men younger than 65 years, only severe OSA was found to have an association with ED (2.01; 1.13-4.69) in unadjusted models. For men aged 65+ years, an independent association with ED was found for apnea-hyponea index (AHI; 1.55;1.02-2.36), moderate (AHI:10.0-19.9; 1.79;1.18-2.43), and severe (AHI:20.0+; 4.84;2.56-9.93) OSA, and oxygen desaturation index (ODI; both continuous [1.48;1.03-1.99] and >16 seconds [2.79;1.23-6.32]). The effect of AHI on ED was shown to be primarily mediated through ODI (63.4%, Sobel P value = .29). Conclusions In younger, community-based men, there appeared no independent relationship between objective measures of sleep and ED. However, there appears a strong, independent relationship between OSA, ODI, and ED in men 65 years and older.

Original languageEnglish
Pages (from-to)250-256
Number of pages7
JournalSleep Health
Volume3
Issue number4
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Dysfunction
  • Erectile
  • Hypoxemia
  • Men's health (MeSH terms)
  • Obstructive
  • Polysomnography
  • Sleep apnea

ASJC Scopus subject areas

  • Behavioral Neuroscience

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