Surgical treatment for obstructive sleep apnea syndrome (OSAS) may be more effective in helping men with accompanying erectile dysfunction (ED) than nonsurgical treatments.
In a small pilot study, Korean researchers found that men who had surgical treatment [uvulopalatopharyngoploasty (UPPP)] had improved erectile function compared to men who had nonsurgical treatment [continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs)].
UPPP involves surgical removal of excess tissue in the back of the throat to widen the airway and facilitate breathing. In some cases, the uvula, tonsils, adenoids, and part of the soft palate are removed.
Patients using CPAP or MADs must use a device to keep the airway open while they sleep.
Past studies have shown that erectile dysfunction (ED) is common in men with OSAS, but can improve with OSAS treatment. The goal of this study was to examine how surgical and nonsurgical treatments for OSAS affect erectile function and quality of life.
The fifty-six participants were men over age 20 who had been diagnosed with OSAS. They were divided in to three groups: those who underwent UPPP (30 men), those who used CPAP (16 men), and those who used MADs (10 men). These groups were not random assignments; the men were categorized by the types of treatment they chose.
The men completed three questionnaires – once before treatment began and again four to nine months later. These questionnaires included the Korean International Index of Erectile Function (KIIEF-5), the Calgary Sleep Apnea Quality of Life Index (SAQLI), and the Epworth Sleepiness Scale (ESS), which measures a person’s daytime sleepiness.
Overall, the men who underwent UPPP saw a significant improvement in erectile function than the men who were treated with CPAP or MADs. All of the groups had improved in quality of life scores after treatment.
Men who had large neck circumferences and “pronounced complaints” of ED also had good results.
Larger studies are needed, however. The authors pointed out that while they could not see erectile improvement in the CPAP and MAD groups, this may have occurred because the study groups were small.
Future research could also examine why the UPPP patients had more improvement in erectile function. The authors suggested that devices could become a distraction during sexual relations. Men who had surgery would not have this issue.
“[It] should be considered that OSAS is a potential major risk factor of ED and this ED could be reversed by treating OSAS. Further well-designed studies with large scale are mandatory to clarify these supports,” the authors wrote.
The study was published online in The Journal of Sexual Medicine at the end of March.
Columbia University Department of Otolaryngology / Head and Neck Surgery
“Uvulopalatopharyngoplasty (UPPP) for Obstructive Sleep Apnea”
Healthwise via WebMD
“Uvulopalatopharyngoplasty for Obstructive Sleep Apnea”
(Last revised: June 17, 2011)
The Journal of Sexual Medicine
Shin, Hyun-Woo, MD, PhD, et al.
“Effects of Surgical vs. Nonsurgical Therapy on Erectile Dysfunction and Quality of Life in Obstructive Sleep Apnea Syndrome: A Pilot Study”
(Full-text. First published online: March 27, 2013)