Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui province, China.
Department of Urology, Peking University First Hospital, Beijing, China.
J Sex Med. 2022 Sep;19(9):1387-1396. doi: 10.1016/j.jsxm.2022.07.002. Epub 2022 Jul 29.
Many studies have reported a possible strong relationship between poor sleep quality, sleep disruption, sleep disorders, and erectile dysfunction (ED).
This study aimed to investigate the relationship between sleep quality and ED.
Patients diagnosed with ED by the International Index of Erectile Function-5 (IIEF-5) questionnaire and 72 healthy adult men were included. Participants completed the questionnaire, underwent a detailed physical examination, and provided blood samples. All enrolled subjects then wore the Fitbit Charge 2 that monitored sleep throughout the night.
Primary outcome measures included scores on the IIEF-5, General Anxiety Disorder-7 (GAD-7) scale, Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and sleep monitoring parameters obtained from Fitbit Charge 2.
Finally, a total of 107 ED patients and 72 healthy adult men were enrolled in this study. Univariate analysis indicated that the GAD-7 (P < .001), PHQ-9 (P < .001), and PSQI scores (P < .001) significantly differed according to the presence/absence of ED. Further multiple logistic regression analysis showed that the PHQ-9 (odds ratio [OR]: 1.227, 95% confidence interval [CI]: 1.070-1.407; P = .003) and PSQI scores (OR: 1.220, 95%CI: 1.116-1.334; P < .001) were independent risk factors for ED. Analysis of objective sleep monitoring parameters showed that total sleep time (TST) (P = .001), sleep onset latency (SOL) (P = .026), deep sleep (N3) duration (P = .011) and rapid eye movement (REM) sleep duration (P < .001) were significantly differed between the 2 groups, with durations in the ED group significantly lower than those in the non-ED group. In addition, receiver operating characteristic (ROC) curve analysis indicated that the REM sleep duration had the highest area under the curve (AUC: 0.728) of all sleep parameters, with a P value < .001, a sensitivity of 72.2% and a specificity of 73.8%.
Urologists and andrologists should be aware of impacted sleep quality and depression in ED patients.
STRENGTHS & LIMITATIONS: The strength of this study is that the relationship between sleep quality and ED was assessed with both a subjective scale and an objective sleep monitoring tool. However, our study only described an association between sleep quality and ED and did not establish a causal relationship.
Sleep parameters are strongly associated with ED, indicating that poor sleep quality may increase the likelihood of ED. Wu X, Zhang Y, Zhang W, et al. The Association Between Erectile Dysfunction and Sleep Parameters: Data from a Prospective, Controlled Cohort. J Sex Med 2022;19:1387-1396.
许多研究报告称，睡眠质量差、睡眠中断、睡眠障碍与勃起功能障碍（ED）之间可能存在很强的关系。
本研究旨在探讨睡眠质量与 ED 之间的关系。
本研究纳入了通过国际勃起功能指数-5 （IIEF-5）问卷和 72 名健康成年男性诊断为 ED 的患者。参与者完成了问卷调查，接受了详细的身体检查，并提供了血液样本。所有入组的受试者随后都佩戴了 Fitbit Charge 2，整晚监测睡眠情况。
最终，共有 107 名 ED 患者和 72 名健康成年男性被纳入本研究。单因素分析表明，广泛性焦虑症-7 （GAD-7）量表（P <.001）、患者健康问卷-9 （PHQ-9）（P <.001）和匹兹堡睡眠质量指数（PSQI）（P <.001）评分根据 ED 的有无存在显著差异。进一步的多因素逻辑回归分析表明，PHQ-9（比值比[OR]：1.227，95%置信区间[CI]：1.070-1.407；P =.003）和 PSQI 评分（OR：1.220，95%CI：1.116-1.334；P <.001）是 ED 的独立危险因素。对客观睡眠监测参数的分析表明，总睡眠时间（TST）（P =.001）、入睡潜伏期（SOL）（P =.026）、深睡眠（N3）持续时间（P =.011）和快速眼动（REM）睡眠持续时间（P <.001）在两组之间存在显著差异，ED 组的持续时间明显低于非 ED 组。此外，受试者工作特征（ROC）曲线分析表明，在所有睡眠参数中，REM 睡眠持续时间的曲线下面积（AUC）最高（AUC：0.728），P 值<.001，灵敏度为 72.2%，特异性为 73.8%。
泌尿科医生和男科医生应该意识到 ED 患者的睡眠质量和抑郁问题。
本研究的优势在于，使用主观量表和客观睡眠监测工具评估了睡眠质量与 ED 之间的关系。然而，我们的研究仅描述了睡眠质量与 ED 之间的关联，并未建立因果关系。
睡眠参数与 ED 密切相关，表明睡眠质量差可能增加 ED 的可能性。
