142nd APHA Annual Meeting and Exposition

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308325
Association of Sleep-Disordered Breathing with Erectile Dysfunction in Community-Dwelling Older Men (for Osteoporotic Fractures in Older Men Study (MrOS))

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Shahab Bozorgmehri, MD, MPH, CPH , Department of Epidemiology, University of Florida, Gainesville, FL
Howard Fink, MD, MPH , Department of Medicine, and Division of Epidemiology & Health Community, School of Public Health, University of Minnesota, Minneapolis, MN
Neeta Parimi, MS , San Francisco Coordinating Center, San Francisco, CA
Benjamin Canales, MD, MPH , Department of Urology, University of Florida, Gainesville, FL
J.Kellogg Parsons, MD, MHS , Department of Urology, Division of Urologic Oncology, Moores UCSD Comprehensive Cancer Center, La Jolla, CA
Elizabeth Barrett-Connor, MD , Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
Kristine Ensrud, MD, MPH , Department of Medicine, and Division of Epidemiology & Health Community, School of Public Health, University of Minnesota, Minneapolis, MN
Muna Canales, MD, MS , Department of Medicine, Division of Nephrology, Hypertension & Renal Transplantation, University of Florida, Gainesville, FL
  
Background:Erectile dysfunction (ED) is common in older men. Sleep-disordered breathing (SDB) is hypothesized to increase risk of ED, but the association in older men is unclear. 

Objective:To investigate the association between SDB and prevalent ED in older men.  

Hypothesis:Men with worse SDB will have higher odds of ED compared to those without SDB. 

Methods:We performed a cross-sectional analysis of community-dwelling men aged ≥67 years who participated in the MrOS Sleep Study. Participants underwent overnight polysomnography and completed sexual health questionnaires. SDB was defined using the apnea-hypopnea-index (AHI) and classified as normal, mild, moderate or severe. ED was assessed using the Massachusetts Male Aging Study (MMAS) scale (n=2,676) and, in sexually active men, the five-item International Index of Erectile Function questionnaire (IIEF-5) (n=1,099). Logistic regression models were adjusted for age, clinical site, race, then body mass index (BMI).

Results:Mean(±SD) age of participants was 76±5 years. After adjusting for age, race, and clinical site, worse SDB was associated with greater odds of MMAS-defined moderate to complete ED (p-trend=0.01; OR=1.14[95%CI:0.93-1.39] for mild,  1.34[95%CI:1.03-1.73] for moderate and 1.37[95%CI:0.99-1.9] for severe SDB vs none, respectively). Further adjustment for BMI attenuated this association (p-trend=0.204). Higher AHI was not associated with greater odds of moderate to severe ED by IIEF-5 (p-trend=0.69).   

Conclusion: SDB is associated with increased odds of ED in older men but this relationship seems best explained by higher BMI among men with worse SDB.  Future studies should examine the association between SDB and incident ED, and the role of obesity as a confounder of this association.

Learning Areas:

Epidemiology

Learning Objectives:
Assess the association between sleep-disordered breathing (SDB) and prevalent erectile dysfunction (ED) in community-dwelling older men.

Keyword(s): Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Preparation of the analysis plan and abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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