Objectives: To screen subjects seeking for medical advice for their obstructive sleep apnea (OSA) or
erectile dysfunction (ED) who consider themselves healthy as regard to ED or OSAS, respectively for the
prevalence of each disease among the other group. Patients & Methods: The study aimed to include all male patients
attending Urology outpatient clinic with sexual problems without certain complaint or comment of their sleep
behavior (Group A) and all patients attending Otorhinolaryngology outpatients clinic with snoring complaints
without certain complaint or comment of their sexual function (Group B). Sleep problems assessment was
conducted using a sleep questionnaire and subjects were categorized as heavy, moderate and none/mild snorers.
Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire for a total
score of >25 is graded as normal erectile function (EF). Sexual function was assessed using the Brief Male Sexual
Function Inventory (BMSFI). Results: The study included 494 clinic attendants Group B subjects had significantly
higher mean body mass index. Among Group A 37 subjects were normal, 127 had mild, 54 had moderate and 29 had
severe ED and according to OSAS questionnaire 116 subjects had low-probability of OSA, 69 had
intermediate-probability and 62 had high-probability of OSA. Among Group B 155 subjects had low-probability of
OSA, 53 had intermediate-probability of OSA and 39 had high-probability of OSA and according to IIEF
questionnaire, 85 subjects were normal, 81 had mild ED, 53 had moderate ED and 28 had severe ED. There was
negative significant correlation between OSAS grade and IIEF-5 score in attendants of both clinics. ROC curve
analysis of OSAS grades as predictor for presence of ED showed that just presence of OSAS could be used as
screening test for presence of ED among subjects not complaining of ED with area under curve of 0.329. Conclusion:
OSAS could be considered as an underlying pathogenic factor for later development of ED in male OSAS patients.
IIEF-5 is a valid screening tool for ED and must be implemented during evaluation of OSAS patients and sleep
disorders evaluation must be considered for patients with ED |
