Erectile dysfunction (ED) is considered a condition with a broad range of etiologies. Obstructive sleep apnea (OSA) syndrome is one
of the lesser studied risk factors for ED. We intend to summarize the current evidence on the relationship between OSA and sexual
impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients. A systematic
review was conducted, selecting articles related to the physiology of OSA and ED, and to the treatments of OSA syndrome and their
reported outcomes in erectile and sexual function. Higher prevalences of ED in the OSA groups have been published. However,
whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear. Several hypotheses were
proposed to explain the physiology of this association. Continuous Positive Airway Pressure as a treatment for OSA patients with ED
has achieved a significative improvement in the sexual parameters in most of the studies. Phosphodiesterase type 5 inhibitors (iPDE5)
on demand are useful as a treatment for ED in this subgroup of patients, with high satisfaction rates. The surgical treatment for
the OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular
Advancement Devices is still undefined.
Asian Journal of Andrology (2016) 18, 1–

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