Room 518 | Male - Sexual Dysfunction Tuesday, July 12, 2005 Time: 2:30 PM-4:30 PM |
REM-sleep deprevation leads to a Decrease of Nocturnal Penile Tumescence (NPT) in young healthy males: The significance of NPT-measurements.
Kamp, Stefan *,1, Ott, Richard, Knoll, Thomas, Juenemann, Klaus-Peter, Michel, Maurice-Stephan, Alken, Peter, Bross, Stephan , 1 Mannheim University Hospital, Mannheim, Baden-Württemberg, Germany
ABSTRACT- Objective: Measurement of Nocturnal Penile Tumescences (NPT) is an established tool in the diagnostics of erectile dysfunction. This study was performed to determine the influence of a disturbance of the physiological sleep pattern on NPT in young healthy males and to evaluate the significance of NPT-measurement for the diagnostics of erectile dysfunction under in patient-conditions. Patients and methods: 10 healthy young males, mean age 25.2 years (25-32) were examined during 3 nights under sleep laboratory conditions. A 12-channel-polysomnography was performed to record the sleep stages, NPT were continuously measured with the RigiScan™-device in all three nights. In night 2 we performed additional measurement of vital parameters as heart rate and blood pressure. In night 3, in addition sleep was interrupted and blood was drawn via an i.v.-line every two hours to determine the serum levels of testosterone, FAI (free androgene index), estradiole, LH, FSH, prolactine, DHEA-S and SHBG. Results: We found a significant decrease of REM-sleep in night 3 versus night 1 (8 vs 17%, p>0.05) and a significant reduction of the overall duration of erections (50.2 vs 98.8 min, p>0.03). Phase 3 and 4 sleep was also decreased, whereas S1 and S2 sleep was increased. Analogue, the total number of events was significantly decreased in night 3 (3.7 vs 5.5, p>0.05). The amount of NPT, correlated to REM-sleep, decreased from 80% in night 1 to 53% in night 3 (p>0.03). There was no impairment of the circadiane rhythm and pulsatile secretion of the measured sexual hormones seen in this study. Conclusion: The disturbance of the physiological sleep pattern leads to a significant reduction of REM and S3/4 sleep combined with a significant decrease in the number and overall duration of nocturnal erections, with young heathy adults showing a pattern similar to patients with erectile dysfunction. Therefore, a normal sleep pattern is crucial for the evaluation of NPT-measurements in the diagnostics of erectile dysfunction and a combination with polysomnography should be performed to exclude false positive results. ®™
Key words: NPT, REM-sleep, erectile dysfunction, circadiane rhythm, hormons