The Relationship between Erectile Dysfunction and Obstructive Sleep Apnoea and the Impact on Severity of ED following Treatment of OSA: A Systematic Review.

Introduction: Erectile dysfunction is a debilitating condition defined as the inability to achieve or maintain penile erection sufficient for satisfactory sexual activity. Obstructive sleep apnoea is a common sleep disorder resulting in episodes of intermittent hypoxia experienced by the patient. It has been hypothesized that a link between both conditions exists. This systematic review aims to evaluate the current literature and synthesize the evidence linking erectile dysfunction and obstructive sleep apnoea, the possible pathogenesis involved, and potential treatment options available.

Methods: This is a mixed-method systematic review and narrative synthesis reporting qualitative and quantitative data. The databases MEDLINE, PubMed, and Embase were searched between January 2000 and January 2022.

Results: Eighteen studies were included, comprising 5 randomized controlled trials, 11 prospective studies, and 2 cross-sectional studies. The literature has reported up to 82% prevalence of ED in patients with OSA. Studies investigating the role of CPAP in treating ED in this cohort of patients have shown results varying from no significant effect to complete resolution of ED.

Conclusion: There does appear to be an association between the presence of OSA and ED. Further randomized controlled trials to evaluate the efficacy of CPAP on ED in patients with OSA need to be conducted. Until more robust evidence is available, CPAP is a safe treatment likely to improve symptoms in individuals with OSA. However, the degree to which it may affect ED symptoms is not yet clear, but what appears clear is that it does not negatively impact on erectile function and is most likely to offer some degree of improvement.