IMPACT OF CPAP THERAPY ON ERECTILE FUNCTION DURING SLEEP AND TESTOSTERONE LEVEL IN MEN WITH SLEEP APNEA SYNDROME


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Abstract

The article presents the results of a polysomnographic study with simultaneous monitoring spontaneous nocturnal erections - Nocturnal Penile Tumescences (NPT) in 69 men with age-related androgen deficiency (AAD). Of these, 45 patients were diagnosed with obstructive sleep apnea syndrome (OSAS). In 34 of the 45 patients with OSAS, regimens of non-invasive ventilation with positive-positive airway pressure (CPAP) were selected. Titration was carried out using automatic CPAP-devices for 2 months. The control group (n=24) comprised men with AAD, matched by the «copy-pair» type without clinical manifestations of respiratory disturbances during sleep. Extreme fragmentation of sleep with a significant predominance of the 1st and 2nd stages of the slow sleep phase, the deficiency of deep sleep stages and the significant shortening of the fast sleep phase was leveled by using a constant positive pressure in the upper respiratory tract. CPAP-therapy produced the phenomenon of a «rebound» of slow-wave sleep and fast-sleep phase. Before treatment, men with OSAS had a disruptive pattern of NPT (quantitative and qualitative characteristics). CPAP-therapy resulted in its recovery and maximum preservation relative to fast sleep phase time boundaries. However, the trend towards increasing testosterone levels was not significant, which requires additional testosterone replacement therapy concurrently with CPAP therapy in patients with OSAS and AAD.

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About the authors

I. M Madaeva

Scientific Center for Family Health and Human Reproduction

Email: nightchild@mail.ru
Dr.Med.Sci., Head of the Somnology Center, Leading Researcher at the Pathophysiology Laboratory Irkutsk, Russia

O. N Berdina

Scientific Center for Family Health and Human Reproduction

Email: goodnight84@mail.ru
PhD., Senior Researcher, Laboratory of Pediatrics and Neurophysiology Irkutsk, Russia

N. V Semenova

Scientific Center for Family Health and Human Reproduction

Email: natkor_84@mail.ru
PhD (bio.sei.), Senior Researcher at the Pathophysiology Laboratory Irkutsk, Russia

V. V Madaev

Scientific Center for Family Health and Human Reproduction

Email: vvm@list.ru
PhD, Cardiologist Irkutsk, Russia

I. N Gutnik

Scientific Center for Family Health and Human Reproduction

Email: iphr@sbamsr.irk.ru
Dr.Bio.Sci., Senior Researcher at the Pathophysiology Laboratory Irkutsk, Russia

L. I Kolesnikova

Scientific Center for Family Health and Human Reproduction

Email: iphr@sbamsr.irk.ru
Academician of RAS, Head of the Scientific Center for Family Health and Human Reproduction Irkutsk, Russia

References

  1. Guilleminault C., Partinen M., Hallman K. Familial aggregates in obstructive sleep apnea syndrome. Chest/ 1995;107:1275-1282.
  2. Peppard P.E., Young T., Barnet J.H., Palta M., Hagen E.W., Hla K.M. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006-1014. doi: 10.1093/aje/kws342.
  3. Tufik S., Santos-Silva R., Taddei J.A., Bittencourt L.R.A. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med. 2010;11:441-6. doi: 10.1016/j.sleep. 2009.10.005.
  4. Glybochko P.V., Alyaev Yu.G., Chalyi M.E. et al. Sex disorders in men. M.: GEOTAR-Media, 2012. 112 p. Russian (Глыбочко П.В., Аляев Ю.Г., Чалый М.Е. и др. Половые расстройства у мужчин. М.: ГЭОТАР-Медиа, 2012. 112 с.).
  5. Catesby J., Hirshkovitz M. Monitoring penile erection during sleep. Sleep Medicine, ed. by T. Lee- Choiong. 2002;91;673-681.
  6. Madaeva I.M., Kolesnikova L.I., Berdina O.N., Semenova N.V., Dolgikh V.V., Madaev V.V. Evaluation of erectile function during the night in men with obstructive sleep apnea syndrome: new possibilities of modern sleep medicine. Urology. 2014;3:32-36
  7. Douglas N.J. Control ventilation during sleep. Principles and Practice of Sleep Medicine. 2 Ed. Philadelphia: Harcourt Brace & Company. 1994;204-211.
  8. Lunenfeld B., Mskhalaya G., Zitzmann M., Arver C., Kalinchenko S., Tishova Y., Morgentaler A. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male. 2015:18(1);5-15. doi: 10.3109/13685538.2015.1004049.
  9. Pressman M.R., DiPhillipo M.A., Kendrick J. Problems in the interpretation of nocturnal penile tumescence studies: discruption of sleep by occult sleep disordes. J Urol. 1986;136:595-599.
  10. Chen W., Liu Z.Y., Wang L.H., Zeng Q.S., Wang H.Q., Sun Y.H. Are the Aging Male’s Symptoms (AMS) scale and the Androgen Deficiency in the Aging Male (ADAM) questionnaire suitable for the screening of late-onset hypogonadism in aging Chinese men? Aging Male. 2013;16:92-96. doi: 10.3109/13685538.2013.805319.
  11. Dedov I.I., Kalinichenko S. Yu. Age-related hypogonadism in men. M.: Practical medicine. 2006;240 p. Russian (Дедов И.И., Калинченко С.Ю. Возрастной андрогенный дефицит у мужчин. М.: Практическая медицина. 2006;240 с.
  12. Y Yang Q., Phillips C.L., Melehan K.L., Rogers N.L., Seale J.P., Grunstein R.R. Effects of short-term CPAP withdrawal on neurobehavioral performance in patients with obstructive sleep apnea. Sleep. 2006;29(4):545-552.
  13. Ibishev Kh.S., Khripun I.A., Gusova Z.R. et al. Problem of testosterone deficiency and erectile dysfunction in men (literature review). Urology 2014;6:104-107.
  14. Karkoulias K., Perimenis P., Charokopos N., Efremidis G., Sampsonas F., Kaparianos A., Patouchas D., Tsiamita M., Spiropoulos K. Does CPAP therapy improve erectile dysfunction in patients with obstructive sleep apnea syndrome? Clin Ter. 2007;158:515-518.
  15. Miyauchi Y., Okazoe H., Okujyo M., Inada F., Kakehi T., Kikuchi H., Ichikawa H., Arakawa Y., Mori Y., Kakehi Y. Effect of the Continuous Positive Airway Pressure on the nocturnal urine volume or night-time frequency in patients with obstructive sleep apnea syndrome. Urology. 2015;85(2):333-36. doi: 10.1016/j.urology. 2014.11.002.
  16. Redline S., Kirchner H.L., Quan S.F., Gottlieb D.J., Аpur V., Newman A. The effects оf age, sex, ethnicity, and sleep-disordered breathing on sleep architec- ture. Arch Intern Med. 2004;164:406-418. doi: 10.1001/archinte.164.4.406.
  17. Penev P.D. Association between sleep and morning testosterone levels in older men. Sleep. 2007;30:427-432.
  18. Barrett-Connor E., Dam T.T., Stone K., Harrison S.L., Redline S., Orwoll E. The Association of testosterone levels with overall sleep quality, sleep architecture, and sleep- disordered breathing. J Clin Endocrinol Metab. 2008;93:2602-2609. doi: 10.1210/jc. 2007-2622.
  19. Belkin A.A., Frank M.A., Gomzhin A.I., Alekseeva E.V. Features of diagnosis oferectile dysfunctionatpatients witha sleep apnea syndrome. Ural Medical Journal. 2006;8:51-52
  20. Ellis D.J., Doghramji K., Bagley D.H. Snap-Gauge Band versus penile rigidity in impotence assessment. The Journal of Urology. 1988;140;61-63.
  21. Zhang X.B., Jiang X.T., Du Y.P., Yuan Y.T., Chen B. Efficacy of Continuous Positive Airway Pressure on Testosterone in Men with Obstructive Sleep Apnea: A Meta-Analysis. PLoS ONE. 2014;9(12):115033. doi: 10.1371/journal.pone.0115033/
  22. Zhuravlev N., Frank M.A. Gomzhin A.I. Sexual functions of men with obstructive sleep apnoea syndrome and hypogonadism may improve upon testosterone administration: a pilot study. Andrology. 2009;41:193-195. doi: 10.1111/j.1439-0272.2008.00914.x.

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