title: Association of Sleep Disordered Breathing with Erectile Dysfunction in Community Dwelling Older Men.
abstract: We investigated the association between sleep disordered breathing and erectile dysfunction in older men.
  
  
  
  We performed a cross-sectional analysis of community dwelling men age 67 years or older enrolled in the Osteoporotic Fractures in Men Sleep Study. Participants underwent overnight polysomnography (2003 to 2005) and completed sexual health questionnaires (2005 to 2006). We defined sleep disordered breathing using the apnea-hypopnea index or nocturnal hypoxemia. Erectile dysfunction was defined using the MMAS (Massachusetts Male Aging Study) scale and, in sexually active men, the International Index of Erectile Function. We used logistic regression to examine the association between sleep disordered breathing and erectile dysfunction.
  
  
  
  Mean participant age was 76±5 years. Of the 2,676 men completing the MMAS, 70% had moderate to complete erectile dysfunction. Among 1,099 sexually active men completing the IIEF-5 (5-item International Index of Erectile Function), 26% had moderate to severe erectile dysfunction. A higher apnea-hypopnea index was associated with greater odds of MMAS defined moderate to complete erectile dysfunction after adjusting for age and study site (OR 1.39, 95% CI 1.00-1.92 for severe sleep disordered breathing vs none, p trend=0.008), but not after further adjustment for body mass index, socioeconomic status and comorbidities (OR 1.05, 95% CI 0.75-1.49, p trend=0.452). Greater nocturnal hypoxemia was associated with increased odds of MMAS defined moderate to complete erectile dysfunction (unadjusted OR 1.36, 95% Cl 1.04-1.80 vs none) but this was attenuated after adjustment for age and study site (OR 1.24, 95% CI 0.92-1.66). Sleep disordered breathing was not associated with erectile dysfunction by 5-item International Index of Erectile Function.
  
  
  
  In this cross-sectional analysis in older men sleep disordered breathing was associated with higher odds of erectile dysfunction in unadjusted analyses that was largely explained by higher body mass index and increased comorbidity among men with sleep disordered breathing. Prospective studies accounting for obesity and multimorbidity would further clarify the association of sleep disordered breathing and erectile dysfunction.
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, and Malcom-Randall VAMC, Gainesville, Florida. Electronic address: s.bozorgmehri@ufl.edu.
authors.forename: Shahab
authors.initials: S
authors.lastname: Bozorgmehri
authors.affiliation: Department of Medicine, and Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, Veterans Affairs Health System, Minneapolis, Minnesota; Geriatric Research Education and Clinical Center, Veterans Affairs Health System, Minneapolis, Minnesota.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Fink
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, California.
authors.forename: Neeta
authors.initials: N
authors.lastname: Parimi
authors.affiliation: Department of Urology, College of Public Health and Health Professions & College of Medicine, University of Florida, and Malcom-Randall VAMC, Gainesville, Florida.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Canales
authors.affiliation: Department of Medicine, and Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, Veterans Affairs Health System, Minneapolis, Minnesota.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.affiliation: Departments of Psychiatry and Medicine, University of California, San Diego, La Jolla, California.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.affiliation: Department of Medicine (Nephrology), College of Public Health and Health Professions & College of Medicine, University of Florida, and Malcom-Randall VAMC, Gainesville, Florida.
authors.forename: Muna
authors.initials: M
authors.lastname: Canales
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D057187:Independent Living; D008297:Male; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis
keywords: erectile dysfunction; sleep apnea syndromes