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Computed tomography cephalometric and upper airway measurements in patients with OSA and erectile dysfunction

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Erectile dysfunction (ED) has been linked to obstructive sleep apnea (OSA). This study used computed tomography (CT) to identify cephalometric and upper airway anatomic features in patients with OSA that correlate with the presence of ED.

Methods

In this prospective study, 20 CT cephalometric and upper airway measurements, most commonly associated with OSA, were analyzed in 53 age- and BMI-matched consecutive eligible subjects. Twenty-two were diagnosed with OSA and ED (OSA+/ED+), 17 with OSA without ED (OSA+/ED−), and 14 without OSA and ED (OSA−/ED−) serving as a control group.

Results

Although OSA+/ED+ did not differentiate significantly in CT measurements from OSA+/ED−, they showed more alterations when compared to OSA−/ED−, which included narrower bony oropharynx, longer soft palate and uvula (PNS-P), and narrower retropalatal and retrolingual airway diameter (p < 0.05). Binary forward stepwise model analysis showed that PNS-P was the only significant variable in the predictive model for ED in patients with OSA (OR = 1.129, 95 % CI = 1.0005–1.268, p = 0.041). In the OSA+/ED+ group, PNS-P correlated with the percentage of total sleep time with oxygen saturation <90 % (r = 0.61, p < 0.01) and was the only determinant in the relevant predictive model (n = 22, model R = 0.612, adjusted R 2 = 0.337, F = 10.167, p < 0.005).

Conclusions

Characteristics of the craniofacial and upper airway structures suggest that a longer soft palate and uvula may be important risk factors for the concurrence of ED in patients with OSA. Only OSA+/ED+ showed significant narrowing in the retropalatal, retrolingual, and bony oropharynx level when compared with BMI-matched OSA−/ED−.

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Acknowledgments

We would like to thank Brian Kent for his help in the discussion of this article.

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Authors and Affiliations

  1. Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece

    Panagis Drakatos, Kiriakos Karkoulias, Dimosthenis Lykouras, Fotis Sampsonas & Konstantinos Spiropoulos

  2. Department of Urology, University Hospital of Patras, Rio, Greece

    Konstantinos Giannitsas & Petros Perimenis

  3. Department of Radiology, University Hospital of Patras, Rio, Greece

    Christina Kalogeropoulou, Nikos Papapanagiotou & Theodoros Petsas

Authors
  1. Panagis Drakatos
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  2. Kiriakos Karkoulias
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  3. Konstantinos Giannitsas
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  10. Konstantinos Spiropoulos
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Correspondence to Panagis Drakatos.

Ethics declarations

Ethical approval for this study was granted by the Human Research Ethics Committee of the University Hospital of Patras and therefore was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

All persons gave their informed consent prior to their inclusion in the study.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Drakatos, P., Karkoulias, K., Giannitsas, K. et al. Computed tomography cephalometric and upper airway measurements in patients with OSA and erectile dysfunction. Sleep Breath 20, 769–776 (2016). https://doi.org/10.1007/s11325-015-1297-5

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  • DOI: https://doi.org/10.1007/s11325-015-1297-5

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