Increased Risk of ED Among Patients With Sleep Disorders
Demographic Characteristics and Comorbidity in SD Patients and Non-SD Individuals
Eligible study participants included 34,548 patients in the SD cohort and 138,192 individuals in the comparison cohort. The proportion of age stratification was the same in both cohorts, with the mean age of the participants being 48.9 ± 15.8 years. SD patients exhibited a significantly greater proportion of prevalent comorbid diseases than did the comparison cohort ( Table 1 ). The mean follow-up time was 7.21 years for the SD cohort and 7.46 years for the non-SD cohort (data not shown).
Comparison of Incidence and Hazard Ratios of ED Between SD Patients and Comparison Cohort
Compared with the comparison cohort, the SD patients displayed greater incidence rates of ED (18.9 vs. 8.33 per 10,000 person-years), with an adjusted HR of 2.11 (95% CI = 1.03–1.73), after we controlled for age and comorbidities. When stratified by age, the incidence density rates of ED increased with age but moderately declined in the group ≥ 65 years. After adjusting for covariates, the risk of ED was the highest in the group aged 55–64 years, with an adjusted HR of 4.77 (95% CI = 3.73–6.10), compared with the group ≤ 34 years of age. The individuals with any comorbidity had a higher incidence rate of ED than did those without any comorbidity at both cohorts, and after adjusting for covariates, the individuals presented with any comorbidity exhibited a 1.66-fold increased risk of ED compared with that of the individuals without any comorbidity (95% CI = 1.47–1.87) ( Table 2 ).
Interaction of SD and Any Comorbidity on the Risk of ED
The interaction measurements between SD and any comorbidity on the risk of ED are shown in Table 3 . Compared with the participants without SD or comorbidities, patients without SD with comorbidities exhibited a 1.79-fold risk of developing ED (95% CI = 1.54–2.09); the highest risk was for those with both SD and comorbidities (adjusted HR = 3.34, 95% CI = 2.82–3.95).
Risk of ED Associated With the Number of Comorbidities
Table 4 lists the incidence and risk of ED in SD patients having a diverse number of comorbidities. Compared with non-SD participants without comorbidities, the SD patients displaying a number of comorbidities exhibited a dose–response effect of ED development.
Probability of Being ED-free for SD Cohort and Non-SD Cohort During Follow-up Periods
Figure 1 shows the Kaplan–Meier curve of ED-free survival for the SD patients and non-SD individuals. The results indicate that the ED-free rate was significantly lower for SD patients compared with that of the non-SD cohort (log-rank p < 0.0001).
Kaplan–Meier analysis comparing probabilities free of ED between SD patients and Non-SD cohort