Sexual Dysfunction in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

IntroductionSexual dysfunction is an under-recognized problem in men and women with obstructive sleep apnea (OSA). Epidemiologic findings were inconclusive regarding the risk for sexual dysfunction associated with OSA. AimThe aim of this study was to examine the association between OSA and sexual dysfunction. MethodsThe PubMed, Cochrane Library, and Embase databases were searched for observational studies on the OSA and the risk of sexual dysfunction. The methodologic quality of the case-control and cohort studies was assessed with Newcastle-Ottawa Scale (NOS). The cross-sectional study quality methodology checklist was used for cross-sectional study. Data were pooled for the random-effects model. Sensitivity analyses were conducted to assess potential bias. Main Outcome MeasureThe association between OSA and sexual dysfunction was summarized using relative risk (RR) with a 95% confidence interval (CI). ResultsThis meta-analysis included 1,275 participants from nine studies. Five studies reported the incidence of erectile dysfunction (ED); the remaining four studies reported the incidence of female sexual dysfunction (FSD). Pooled results demonstrated that OSA was associated with increased risk of ED (pooled RR=1.82, 95% CI: 1.12-2.97) as well as FSD (pooled RR=2.00, 95% CI: 1.29-3.08). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. ConclusionsEvidence from the observational studies suggested that OSA individuals might have an increased incidence of sexual dysfunction despite significant heterogeneity. More researches are warranted to clarify the relationship between OSA and the increased risk of sexual dysfunction. Liu L, Kang R, Zhao S, Zhang T, Zhu W, Li E, Li F, Wan S, and Zhao Z. Sexual dysfunction in patients with obstructive sleep apnea: A systematic review and meta-analysis. J Sex Med 2015;12:1992-2003.