title: Low Quality of Life and Depressive Symptoms as an Independent Risk Factor for Erectile Dysfunction in Patients with Obstructive Sleep Apnea.
abstract: BACKGROUND
  Accumulating evidence indicates that obstructive sleep apnea (OSA) is associated with a high prevalence of erectile dysfunction (ED), but the factors that predict the risk of ED in OSA patients have yet to be defined clearly.
  
  
  OBJECTIVE
  The aims of the present study were to investigate the clinical characteristics of OSA patients with ED and to identify plausible predictors of ED.
  
  
  METHODS
  The present cross-sectional analysis included 713 male patients who visited Seoul National University Hospital for snoring and/or daytime sleepiness from 2006 to 2014. An in-laboratory polysomnography procedure was conducted to obtain objective recordings of OSA and other sleep parameters.
  
  
  METHODS
  The demographic data of all patients were obtained, and each patient completed all requirements of the following questionnaires: the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Korean version of the International Index of Erectile Function (KIIEF-5), the Beck Depression Inventory (BDI), and the Epworth Sleepiness Scale (ESS). ED and OSA were defined as a KIIEF-5 < 21 and a respiratory disturbance index (RDI) ≥ 5, respectively. Depressive symptoms were defined as a BDI ≥ 10.
  
  
  RESULTS
  The frequency of ED did not differ significantly according to OSA severity. In Spearman's correlation analysis, the BDI and the ESS were inversely correlated with the KIIEF-5, whereas the SAQLI was positively correlated with the KIIEF-5. The RDI and the lowest oxygen saturation (SaO2 ) did not exhibit significant correlations with the KIIEF-5. A multivariate logistic regression analysis adjusted for possible confounding factors showed that ED was independently associated with the SAQLI and depressive symptoms, but there was no significant association of ED with either the RDI or the lowest SaO2 .
  
  
  CONCLUSIONS
  The present study demonstrated that depressive symptoms and a low quality of life specific to sleep apnea are independent risk factors for ED in OSA patients.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yung Jin
authors.initials: YJ
authors.lastname: Jeon
authors.affiliation: Obstructive Upper airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dae Wui
authors.initials: DW
authors.lastname: Yoon
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Doo Hee
authors.initials: DH
authors.lastname: Han
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae-Bin
authors.initials: TB
authors.lastname: Won
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.|Obstructive Upper airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea.|Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Hyun-Woo
authors.initials: HW
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Beck Depression Inventory; Calgary Sleep Apnea Quality of Life Index; Epworth Sleepiness Scale; Erectile Dysfunction; International Index of Erectile Function; Obstructive Sleep Apnea; Polysomnography