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Evaluation of erectile dysfunction in nonobese and non-diabetic patients with obstructive sleep apnea syndrome
Obstructive Sleep Apnea Syndrome (OSAS) is a highly prevalent sleep-related respiratory disorder, affecting about 4% of adult males and 2% of females. It is characterized by intermittent airway collapse during sleep, and occurs due to hypotonia of the pharyngeal dilator muscles, including the genioglossus muscle, leading to hypoxemia and hypercapnia. Erectile Dysfunction (ED) is defined as the consistent inability to achieve and / or maintain a penile erection that enables effective sexual intercourse.
Patients with OSAS often have erectile dysfunction. According to studies by Lopez-Jimenez et al. (2008), 20% of patients with erectile dysfunction have OSAS and 33% of individuals with OSAS have erectile dysfunction and / or decreased libido. The possible mechanisms by which OSA predisposes to erectile dysfunction are: change in autonomic vascular control, endothelial dysfunction and sleep fragmentation.
To identify the relationship between complaints of erectile dysfunction in male patients with OSAS, considering age, body mass index (BMI), smoking and drinking habits, and the presence of systemic arterial hypertension. Relate complaints of erectile dysfunction from the International Index of Erectile Function (IIEF) to the severity of OSAS, to the minimum oxygen saturation (SatO2), to the REM sleep density and total testosterone (TT) levels among individuals with OSAS.
A cross-sectional retrospective study was carried out with male patients, military or not, diagnosed with OSAS, performed by PSG, aged over 20 years, from the sleep clinic of the Otorhinolaryngology Service of HNMD in May 2017. through August 2018.
The following data were collected in a routine consultation previously performed by the HNMD Sleep Disease Service and recorded in an electronic medical record: age, comorbiditis, history of smoking and drinking, BMI and values obtained in IIEF questionnaires (completed by the patient). AHI, REM, and minimum SatO2, in PSG.
After data analysis it was possible to verify an average of 78.89% in the nadir O2 and 46% of the patients presented nadir O2. There was a significant relationship between nadir O2 and ED complaints from IIEF (p = 0.008) and it was also observed that ED complaints worsened with aging.
Thus, it was possible to show that in a non-obese and non-diabetic population with OSAS, in addition to aging, hypoxia (nadir O2) was related to ED.
Sleep Apnea Obstructive Syndrome; Erectile dysfunction; IIEF; hypoxia
Hospital Naval Marcílio Dias - Rio de Janeiro - Brasil, Universidade Federal do Estado do Rio de Janeiro - Rio de Janeiro - Brasil
Ana Carolina Daflon Scoralick , Alonço Cunha Viana, Maria Helena Melo, André Cavalcante