To ED or not to ED--is erectile dysfunction in obstructive sleep apnea related to endothelial dysfunction?

Camilla M Hoyos; Kerri L Melehan; Craig L Phillips; Ronald R Grunstein; Peter Y Liu

doi:10.1016/j.smrv.2014.03.004

To ED or not to ED--is erectile dysfunction in obstructive sleep apnea related to endothelial dysfunction?

Sleep Med Rev. 2015 Apr:20:5-14. doi: 10.1016/j.smrv.2014.03.004. Epub 2014 Mar 18.

Authors

Camilla M Hoyos¹, Kerri L Melehan², Craig L Phillips³, Ronald R Grunstein², Peter Y Liu⁴

Affiliations

¹ NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia. Electronic address: camilla.hoyos@sydney.edu.au.
² NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia.
³ NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia.
⁴ Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA.

PMID: 24813467
DOI: 10.1016/j.smrv.2014.03.004

Abstract

Both obstructive sleep apnea (OSA) and erectile dysfunction (ErectD) are highly prevalent and largely under diagnosed medical conditions. These disorders often co-exist, with about half of the male OSA population having ErectD and vice versa. OSA is strongly associated with an increased risk of cardiovascular mortality while ErectD has been proposed as a phenotypic marker of cardiovascular disease. This implies that the two conditions may be linked by a common pathophysiological mechanism. In this review we provide evidence supporting the hypothesis that endothelial dysfunction (EndoD) may be the common pathophysiological mechanism linking OSA with both ErectD and cardiovascular complications. EndoD is one of the earliest markers of cardiovascular disease and substantial evidence suggests that OSA independently causes EndoD. There is also strong evidence that causally links EndoD with organic ErectD. Further research should be directed at determining the value of simultaneously assessing both ErectD and OSA in patients presenting with symptoms of either condition. In both ErectD and OSA clinics, identifying both conditions could improve overall cardiovascular risk stratification whilst treatment of OSA could reduce both ErectD and cardiovascular risk.

Keywords: Endothelial dysfunction; Erectile dysfunction; Obstructive sleep apnea.

Publication types

Review

MeSH terms

Cardiovascular Diseases / drug therapy
Cardiovascular Diseases / etiology
Cardiovascular Diseases / physiopathology
Endothelium, Vascular / physiopathology*
Erectile Dysfunction / drug therapy
Erectile Dysfunction / etiology*
Erectile Dysfunction / physiopathology
Humans
Male
Phosphodiesterase 5 Inhibitors / therapeutic use
Sleep Apnea, Obstructive / complications*
Sleep Apnea, Obstructive / physiopathology
Vascular Diseases / etiology*
Vascular Diseases / physiopathology

Substances

Phosphodiesterase 5 Inhibitors