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A Review of Sleep Disturbance and Sexual Function: the Effect of Sleep Apnea on Erectile Function

Abstract

Purpose of the Review

We sought to produce a review of studies that examine how lack of sleep can modulate male sexual function, with a particular focus on recent findings about sleep apnea and erectile dysfunction (ED) and to examine novel therapeutic approaches proposed in the literature to provide literature on novel therapeutic approaches.

Recent Findings

Studies have shown that continuous positive airway pressure (CPAP), − used as standard therapy for obstructive sleep apnea (OSA) – is associated with a clinically significant improvement in the following sexual issues: erectile function, total erectile events, night penis stiffness, overall sexual satisfaction. Recent research has indicated that insufficient sleep, interrupted sleep, and sleep disorders affect sexual function. Sleep is fundamental for quality of life, but with the increasing pressures exerted by modern life there is a tendency for a reduction in sleep time. The resulting sleep debt can have a significant impact on health, including on sexual health.

Summary

Penile erection is essential for reproductive success and depends on the integration of psychological, vascular, endocrine, neurological, and myogenic mechanisms, triggered by a reflexive response or by psychogenic stimuli of central origin. During sleep, erections can occur through impulses sent through the descending pathway, via spinal medulla that activate the penile system reflex in healthy males from birth until old age, independent of the dream content. OSA is associated with an increased risk of ED and/or other urological disorders. Patients with severe OSA have low testosterone concentrations and a higher prevalence of ED.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Funding

Our studies are supported by the Associação Fundo de Incentivo à Pesquisa (AFIP). S.T. and M.L.A. receive CNPq fellowships. No sponsorship was received for the publication of this manuscript. All named authors take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

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Correspondence to Monica L. Andersen.

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This article is part of the Topical Collection on Sleep and Sleep Apnea at the Extremes

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Andersen, M.L., Tufik, S. A Review of Sleep Disturbance and Sexual Function: the Effect of Sleep Apnea on Erectile Function. Curr Sleep Medicine Rep 6, 55–60 (2020). https://doi.org/10.1007/s40675-020-00171-1

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Keywords

  • Sleep
  • Sleep apnea
  • Penile erection
  • Erectile dysfunction
  • Sexual behavior
  • Sexual function