Erection - desaturation - apneas. A story of nose ?

Initial observation : Video Polysomnography recording allowed us to bring to light at a 59-year-old man’s a characteristical sequence beginning with an erection followed by a fall of the saturation (which evolves from 97 % to 93 %) then of the appearance of obstructive respiratory events. This sequence is preceded by a period of REM sleep interrupted by an awakening followed by a passage by supine position. The analysis of the saturometry signal does not allow to put in relationship, in a simple way, the arisen of the episode of desaturation with respiratory sleep events nor with change of position.
We attempted to estimate the reproducibility of this observation on the occasion of polysomnography recordings coupled with a erectometry realized within the assessments of surgical.
Material and methods : 8 patients benefited from a coupling recording polysomnography ( MICROMED) and erectometry ( RIGISCAN).
Results : 7 patients on 8 presented episodes of night-erection. 16 episodes of erection were observed. 11 episodes of erection associated to desaturations were found at 5 patient’s. Both patients who did not present these phenomena were carrier of an important SAOS (IAH of 35 / hour for one of the patients and 70 / hour for the second). All in all 10 sequences associating erection- desaturation-apneas were identified on 16 observed erections (62 %)
Discussion : the notion of congestion nasal as side effect for inhibitors of the phosphodiestérase was reported as the sidenafil (1). The nasal tissue recovering cornets answers in a similar way corpora cavernosa. He can participate in the nasal obstruction during the usually observed episodes of erection dormant paradoxical. The global mechanism of the observed events requires a detailed research
Bibliographie : (1) Trimarchi & al Nasal congestion after visual sexual stimulation with and without sildenaWl (Viagra®) : a randomized placebo-controlled study, Eur Arch Otorhinolaryngol (2008) 265:303–306 DOI 10.1007/s00405-007-0452-4