Erectile dysfunction and obstructive sleep apnea syndrome: a post-hoc evaluation of Italian survey results

Background: The aim of the current study was to identify predictors of erectile dysfunction (ED) and obstructive sleep apnea syndrome (OSAS) in male participants at Italian web-survey. Methods: A cross-sectional web-based survey was administered via Google Forms between July 17 and October 31, 2022, among Italian participants. The erectile function and the excessive daytime sleepiness were measured through the International Index of Erectile Function - 5 (IIEF5) and Epworth Sleepiness Scale (ESS), respectively. Two separate and independent multivariable logistic regression models (mLRMs) were fitted to predict ED and OSAS, respectively, in men answering to the survey. Results: A total of 238 patients were identified. Of those, 58 (24%) reported to be affected by OSAS disease. Higher proportion of mild (21 vs. 6%), mild-to-moderate (9 vs. 5%), and severe (16 vs. 7%) ED were recorded in OSAS vs. non-OSAS patients (P<0.001). In mLRMs predicting ED (IIEF5≤7), age (OR: 1.04, 95% confidence interval [CI]: 1.01-1.06; P=0.002), and IPSS total score (OR:1.08, 95% CI: 1.02-1.15; P=0.006) were independent predictors. In mLRMs predicting OSAS, age (OR: 1.08, 95% CI: 1.05-1.12; P<0.001), Body Mass Index (BMI; OR: 1.12, 95% CI: 1.05-1.21; P<0.001), and ESS score (OR:1.14, 95% CI: 1.05-1.24; P=0.001) were independent predictors. In the subgroup analyses predicting severe ED, ESS and age or BMI or IPSS resulted as independent predictors (OR from 0.7 to 0.8; all P<0.05). Conclusions: The ESS score independently predicted severe ED in males. As a result, the OSAS disease should be explored in patients who harbored severe ED to address those patients for a prompt ear, nose and throat evaluation.