A Less-Obvious Cause for Erectile Dysfunction

Disturbances of breathing during sleep, such as obstructive sleep apnea, are sometimes reported to be accompanied by erectile dysfunction (ED) in men. There are many causes of Ed – those related to the vasculature, nerves, hormones, and psychological causes. The predominant one, at least with regard to successful treatment, is the vascular change that occurs with aging arteries in the penis. These problems can be often overcome with sildenafil (Viagra®) or similar medications. Diabetics can experience peripheral neuropathy that sometimes impairs their genital sensation, while endocrine causes of ED include testosterone depletion used in the treatment of prostate cancer. But a relatively unknown cause of ED is obstructive sleep apnea.

Isolate cases of ED associated with sleep apnea have been reported. It’s been assumed that they involve the nitric oxide synthase and phosphodiesterase pathways – those that are targeted by sildenafil and similar products.

Two clinical studies have tried to address the problem. The most recent, which comes from Greece, was published in La Clinica Terapeutica. Continuous positive airway pressure, or CPAP, was used to treat subjects with obstructive sleep apnewa and sexual dysfunction, for 12 weeks. At the end of this time, sexual function had improved in the subjects with ED.

In the second study, also from Greece and published in the Asian Journal of Andrology, both Viagra and CPAP were effective in 40 men with ED and obstructive sleep apnea; Viagra 100 mg proved superior to CPAP in effectiveness.

Taken together, these findings suggest that there is a distinct association between sleep apnea and ED, and that the nitric oxide pathway is probably at fault in such patients. Certainly, it’s good news that both treatment of sleep apnea and direct medication for ED are effective in restoring sex function.