Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction

Kerri L. Melehan, Camilla M. Hoyos, Garun S. Hamilton, Keith K. Wong, Brendon J. Yee, Robert I. McLachlan, Shamus O'Meagher, David Celermajer, Martin K. Ng, Ronald R. Grunstein, Peter Y. Liu

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

Abstract

Context Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective To assess the effects of CPAP and vardenafil on ED. Design Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.

Original languageEnglish
Pages (from-to)1601-1611
Number of pages11
JournalJournal of Clinical Endocrinology and Metablism
Volume103
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Cite this

Melehan, Kerri L. ; Hoyos, Camilla M. ; Hamilton, Garun S. ; Wong, Keith K. ; Yee, Brendon J. ; McLachlan, Robert I. ; O'Meagher, Shamus ; Celermajer, David ; Ng, Martin K. ; Grunstein, Ronald R. ; Liu, Peter Y. / Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction. In: Journal of Clinical Endocrinology and Metablism. 2018 ; Vol. 103, No. 4. pp. 1601-1611.
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title = "Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction",
abstract = "Context Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective To assess the effects of CPAP and vardenafil on ED. Design Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.",
author = "Melehan, {Kerri L.} and Hoyos, {Camilla M.} and Hamilton, {Garun S.} and Wong, {Keith K.} and Yee, {Brendon J.} and McLachlan, {Robert I.} and Shamus O'Meagher and David Celermajer and Ng, {Martin K.} and Grunstein, {Ronald R.} and Liu, {Peter Y.}",
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Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction. / Melehan, Kerri L.; Hoyos, Camilla M.; Hamilton, Garun S.; Wong, Keith K.; Yee, Brendon J.; McLachlan, Robert I.; O'Meagher, Shamus; Celermajer, David; Ng, Martin K.; Grunstein, Ronald R.; Liu, Peter Y.

In: Journal of Clinical Endocrinology and Metablism, Vol. 103, No. 4, 01.04.2018, p. 1601-1611.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction

AU - Melehan, Kerri L.

AU - Hoyos, Camilla M.

AU - Hamilton, Garun S.

AU - Wong, Keith K.

AU - Yee, Brendon J.

AU - McLachlan, Robert I.

AU - O'Meagher, Shamus

AU - Celermajer, David

AU - Ng, Martin K.

AU - Grunstein, Ronald R.

AU - Liu, Peter Y.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Context Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective To assess the effects of CPAP and vardenafil on ED. Design Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.

AB - Context Erectile function is important for life satisfaction and often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g., vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. Objective To assess the effects of CPAP and vardenafil on ED. Design Sixty-one men with moderate-to-severe OSA and ED were randomized to 12 weeks of CPAP or sham CPAP, and 10 mg daily vardenafil or placebo in a two-by-two factorial design. Main Outcome Measures International Index of Erectile Function (primary end point), treatment and relationship satisfaction, sleep-related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. Results CPAP increased the frequency of sleep-related erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness, or sleep-disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function, and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem, relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. Conclusion CPAP improves overall sexual satisfaction, sleep-related erections, and arterial stiffness. Low-dose daily vardenafil improves certain aspects of sexual function and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life.

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DO - 10.1210/jc.2017-02389

M3 - Article

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EP - 1611

JO - Journal of Clinical Endocrinology and Metablism

JF - Journal of Clinical Endocrinology and Metablism

SN - 0021-972X

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