Kerri L Melehan1,2,3, Camilla M Hoyos1,4, Garun S Hamilton5,6, Keith K Wong1,2,3, Brendon J Yee1,2,3, Robert I McLachlan7, Shamus O'Meagher8, David Celermajer2,8, Martin K Ng2,8, Ronald R Grunstein1,2,3, Peter Y Liu9. 1. CIRUS, Centre for Sleep & Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia. 2. Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 3. Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. 4. School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia. 5. Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia. 6. School of Clinical Sciences, Monash University, Clayton, Victoria, Australia. 7. Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia. 8. Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. 9. Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, California.
Abstract
Context:Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective: To assess the effects of CPAP and vardenafil on ED. Design: Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures: International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results:CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion:CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.
RCT Entities:
Context: Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective: To assess the effects of CPAP and vardenafil on ED. Design: Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures: International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results: CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion: CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.
Authors: Jenny Theorell-Haglöw; Camilla M Hoyos; Craig L Phillips; Brendon J Yee; Kerri L Melehan; Peter Y Liu; Peter A Cistulli; Ronald R Grunstein Journal: J Clin Sleep Med Date: 2019-02-15 Impact factor: 4.062
Authors: Danyon Anderson; Devesh Kumar; Divya Divya; Jose L Zepeda; Abrahim N Razzak; Jamal Hasoon; Omar Viswanath; Alan D Kaye; Ivan Urits Journal: Health Psychol Res Date: 2022-09-23