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Sleep Disorders

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Managing Psychosexual Consequences in Chronic Diseases

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Abstract

Pieces of evidence support the association between sleep disorders and sexual dysfunctions. The main biological link between these two conditions is related to the circadian secretion of testosterone. Indeed, nocturnal testosterone secretion is modulated by the sleep stages, starting to rise at sleep onset and reaching a peak during the first REM sleep cycle. Thus, it is possible to speculate that sleep disorders could adversely affect serum testosterone levels. There is a convergence that sleep loss, especially during the second part of the night, in the early awakening, and wakefulness, reduces its morning circulating concentrations. Considering the clinical relevance of the association between sleep disorders and sexual dysfunctions, this chapter has the ambition to summarize and discuss the cross-sectional and longitudinal studies on the main sleep disorders occurring in the most common urological and sexual disorders. Obstructive sleep apnea is more likely associated with the development of erectile dysfunction (ED) and nocturia, insomnia disorder is frequently concurrent with ED, and restless legs syndrome may often exhibit premature ejaculation and reduced libido. Emphasis is placed on the early detection of sleep disorders in urological patients in order to provide them with timely treatment for overall health. Although a beneficial effect of continuous positive airway pressure treatment on sexual dysfunctions and quality of life has been also reported, confirmatory studies should be performed for evaluating the influence of sleep on testosterone concentrations over time and the efficacy of treatments. Conversely, caution should be considered in treating patients affected by sleep disorders with testosterone.

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Authors and Affiliations

  1. Department of Clinical Neurosciences, Vita-Salute San Raffaele University, Milan, Italy

    Luigi Ferini-Strambi

  2. Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Luigi Ferini-Strambi

  3. Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy

    Maria Salsone

  4. Department of Sexual Medical Center, San Raffaele Hospital, Milano, Italy

    Elena Vittoria Longhi

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  1. Luigi Ferini-Strambi
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  2. Maria Salsone
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  3. Elena Vittoria Longhi
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Correspondence to Luigi Ferini-Strambi .

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  1. Department of Sexual Medical Center, San Raffaele Hospital, Milano, Italy

    Elena Vittoria Longhi

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Ferini-Strambi, L., Salsone, M., Longhi, E.V. (2023). Sleep Disorders. In: Longhi, E.V. (eds) Managing Psychosexual Consequences in Chronic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-31307-3_22

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  • DOI: https://doi.org/10.1007/978-3-031-31307-3_22

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