Sleep disorders, male sexual and fertile function: a cellular and molecular approach

• Grant number: 23/11995-5
• Support Opportunities: Scholarships in Brazil - Support Program for Fixating Young Doctors
• Start date: September 01, 2023
• End date: August 31, 2024
• Field of knowledge: Health Sciences - Medicine
• Agreement: CNPq
• Principal Investigator: Monica Levy Andersen
• Grantee: Luana Nayara Gallego Adami
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated research grant: 23/01555-8 - Sleep disorders, male sexual and fertile function: a cellular and molecular approach, AP.R

Abstract

Objective: To assess the trilateral relationship between obstructive sleep apnea (OSA), erectile dysfunction (ED) and male fertility potential. Method: With this goal, the project proposes 5 sub-studies. Seventy-one men between 18 and 60 years old will be recruited for each of the 4 groups, resulting in 284 volunteers total, being the groups: 1) Without OSA and without ED; 2) With OSA and without ED; 3) Without OSA and with ED; and 4) With OSA and with ED. Volunteers will answer the erectile function questionnaire (IIEF15), will be evaluated for sleep disorders, being diagnosed with OSA if the apnea and hypopnea index is (AHI)e15, and will be sent for blood and seminal collection. Blood samples will be analyzed according the hormonal profile and the semen will be analyzed for spermogram and sperm functionality by analyzing acrosomal integrity, mitochondrial activity, intracellular superoxide anion presence and sperm DNA fragmentation. Another seminal aliquot will be centrifuged to separate the plasma to be used in the proteomic and confirmatory analysis of proteins. In one of the sub-study, CPAP treatment will be applied on volunteers with OSA, and the same protocols will be performed after 3 and 6 months of treatment. Finally, the fifth sub-study will recruit 71 adolescents between 15 and 17 years old with sexual maturation according to Tunner V criterion, for seminal analysis in order to address ED and/or OSA future occurrence in these patients. After performing sample size calculation and considering an effect size (Cohen's f2) of 0.20, type 1 error of 0.05 and statistical power of 0.80, the data analysis will proceed withgeneralized linear models (GzLM) and mixed (GzMM) tests. The probability distribution of the dependent variables will be determined by the Akaike information criterion (AIC), adopting a p<0.05. Expected results: Confirm the hypothesis that OSA interferes on hormonal profile, on male sexual and fertile potential, mainly in sperm global, functional and molecular features. Finally, ensure that in addition to improving OSA, CPAP treatment consequently produces positive effects on fertility parameters.