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. 2023 Nov 27;33(1):31.
doi: 10.1186/s12610-023-00206-x.

Association between sleep quality and nocturnal erection monitor by RigiScan in erectile dysfunction patients: a prospective study using fitbit charge 2

Yuyang Zhang #  1   2   3 , Wei Zhang #  1   2   3 , Xingliang Feng  4   5 , Guodong Liu  1   2   3 , Xu Wu  1   2   3 , Hui Jiang  6 , Xiansheng Zhang  7   8   9
Affiliations

Association between sleep quality and nocturnal erection monitor by RigiScan in erectile dysfunction patients: a prospective study using fitbit charge 2

Yuyang Zhang et al. Basic Clin Androl. .

Abstract
in English, French

Background: Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality and nocturnal erection monitor when conducting nocturnal erection monitor. All erectile dysfunction (ED) patients underwent sleep monitors using Fitbit Charge 2™ (Fitbit Inc.) and nocturnal penile tumescence and rigidity (NPTR) monitors using RigiScan® (GOTOP medical, Inc., USA) for two nights. Subsequently, the patients were divided into two groups: Group A included patients who experienced effective erections only on the second night, while Group B included patients who had effective erections on both nights. To explore the associations between NPTR parameters and sleep parameters, a comparative analysis was performed between Group A and Group B for both nights.

Results: Finally, our study included 103 participants, with 47 patients in Group A and 56 patients in Group B. Notably, the Group A patients showed significant improvements in NPTR parameters on the second night compared to the first night. Conversely, the NPTR parameters on Group B of the second night did not demonstrate a superior outcome when compared to the second night of Group A. Interestingly, it was found that only the disparities in sleep parameters accounted for the variation in NPTR parameters between the two groups on the first night. After correlation and ROC analysis, we identified the rapid eye movement (REM) sleep time and wake after sleep onset (WASO) time monitoring by the Fitbit Charge 2 as the primary parameters for predicting abnormal NPTR results in the first night.

Conclusions: Therefore, our study strongly suggests a close association between sleep parameters and NPTR parameters. It emphasizes the importance of incorporating sleep monitoring alongside nocturnal erection monitoring to enhance the reliability of the NPTR results.

RéSUMé: CONTEXTE: Peu d’études ont été menées pour explorer l’association entre la qualité du sommeil et l’érection nocturne. Dans cette étude, notre but était d’explorer l’association entre la qualité du sommeil et le moniteur d’érection nocturne lors de l’utilisation d’un moniteur d’érection nocturne. Tous les patients atteints de dysfonction érectile (DE) ont été soumis à des moniteurs de sommeil utilisant Fitbit Charge 2™ (Fitbit Inc.) et à des moniteurs de tumescence et de rigidité péniennes nocturnes (NPTR) utilisant RigiScan® (GOTOP medical, Inc., États-Unis) pendant deux nuits. Par la suite, les patients ont été divisés en deux groupes: le groupe A comprenait les patients qui n’avaient eu des érections efficaces que la seconde nuit, tandis que le groupe B comprenait les patients qui avaient des érections efficaces à chacune des deux nuits. Pour explorer les associations entre les paramètres du NPTR et les paramètres du sommeil, une analyse comparative a été effectuée entre le groupe A et le groupe B pour les deux nuits. RéSULTATS: Au final, notre étude a inclus 103 participants, dont 47 patients dans le groupe A et 56 patients dans le groupe B. Les patients du groupe A ont montré des améliorations significatives des paramètres de NPTR la seconde nuit par rapport à la première nuit. À l’inverse, les paramètres de NPTR de la seconde nuit pour le groupe B n’ont pas donné de résultats supérieurs à ceux de la seconde nuit du groupe A. Fait intéressant, il a été constaté que seules les disparités dans les paramètres de sommeil expliquaient la variation des paramètres de NPTR entre les deux groupes lors de la première nuit. Après corrélation et analyse ROC, nous avons identifié le temps de sommeil paradoxal et la surveillance du temps de réveil après l’endormissement monitorés par le Fitbit Charge 2 comme les principaux paramètres de prédiction des résultats de NPTR anormaux au cours de la première nuit. CONCLUSIONS: Par conséquent, notre étude suggère fortement une association étroite entre les paramètres de sommeil et les paramètres de NPTR. Elle souligne l’importance d’intégrer la surveillance du sommeil parallèlement à la surveillance de l’érection nocturne pour améliorer la fiabilité des résultats de NPTR. MOTS-CLéS: Dysfonction érectile, Qualité du Sommeil, Moniteur d’Erection nocturne, RigiScan, Fitbit Charge 2™.

Keywords: Erectile dysfunction; Fitbit Charge 2™; Nocturnal erection monitor; RigiScan; Sleep quality.

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Conflict of interest statement

No conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram for patient selection process. ED: Erectile Dysfunction, IIEF-5: International Index of Erectile Function-5, RigiScan: device for detecting Nocturnal Penile Tumescence and Rigidity (NPTR), Fitbit: Fitbit Charge 2™ for sleep monitor; Group A and Group B were the two groups based on the NPTR results
Fig. 2
Fig. 2
Comparisons of NPTR and Fitbit parameters in two nights between Group A and Group B. A NPTR parameters of Group A in two nights; B NPTR parameters of Group B in two nights; C Fitbit parameters of Group A in two nights; D Fitbit parameters of Group B in two nights. NPTR: Nocturnal Penile Tumescence and Rigidity; Fitbit: Fitbit Charge 2™; TTT: total test time; EEE: effective erectile events; TET: total erection time; D60%: duration of erectile episodes with rigidity ≥ 60%; AER: average event rigidity; TST: total sleep time; SOL: sleep onset latency; WASO: wake after sleep onset; REM: rapid eye movement; Group A and Group B were the two groups based on the NPTR results; N1 and N2 were the first night and the second night for participants’ examination; Differences between the first night and the second night within Group A and Group B were assessed by paired sample t tests; *: P < 0.05 when measurement on the second night was compared with that on the first night; ns: P > 0.05 when measurement on the second night was compared with that on the first night
Fig. 3
Fig. 3
Comparisons of NPTR and Fitbit parameters in two groups between first night and second night. A NPTR parameters of the first night in Group A and Group B; B NPTR parameters of the second night in Group A and Group B; C Fitbit parameters of the first night in Group A and Group B; D Fitbit parameters of the second night in Group A and Group B. NPTR: nocturnal penile tumescence and rigidity; TTT: total test time; EEE: effective erectile events; TET: total erection time; D60%: duration of erectile episodes with rigidity ≥ 60%; AER: average event rigidity; TST: total sleep time; SOL: sleep onset latency; WASO: wake after sleep onset; REM: rapid eye movement; Group A and Group B were the two groups based on the NPTR results; N1 and N2 were the first night and the second night for participants’ examination; Differences between Group A and Group B within the first night and the second night were assessed by independent t tests; *: P < 0.05 when measurement on Group A was compared with that on Group B; ns: P > 0.05 when measurement on Group A was compared with that on Group B
Fig. 4
Fig. 4
Correlations between changes of sleep parameters and changes of NPTR parameters in Group A. A Correlation between changes of WASO and changes of Tip D60% in Group A for two nights; B Correlation between changes of REM and changes of Tip D60% in Group A for two nights; C Correlation between changes of WASO and changes of TET in Group A for two nights; D Correlation between changes of REM and changes of TET in Group A for two nights. NPTR: nocturnal penile tumescence and rigidity; TET: total erection time; D60%: duration of erectile episodes with rigidity ≥ 60%; WASO: wake after sleep onset; REM: rapid eye movement; Group A was the group included participants presenting effective erectile events only on the second night; Correlation analyses were evaluated by Spearman’s and Pearson’s method as appropriate; *: P < 0.05 for the correlation analysis; ns: P > 0.05 for the correlation analysis
Fig. 5
Fig. 5
Receiver operator characteristic curves of sleep parameters for predicting abnormal NPTR in Group A. A ROC curve of WASO for abnormal NPTR test of N1 in Group A, B ROC curve of REM for abnormal NPTR test of N1 in Group A. ROC: Receiver Operator Characteristic curves, REM: Rapid Eye Movement, WASO: Wake After Sleep Onset, AUC: Area Under Curve, N1: the first night; Group A: included participants presenting effective erectile events only on the second night
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