Erectile Dysfunction and Sleep Related Disorders

Purpose

There are reported links between erectile dysfunction and sleep disorders. We reviewed the physiology of penile erection during sleep and the possible links between the pathophysiology of erectile dysfunction and the most commonly diagnosed sleep disorders.

Materials and Methods

A MEDLINE® search using the identifiers erectile dysfunction, sleep, sleep disorders, sleep apnea, insomnia and narcolepsy was performed to identify the current literature pertaining to erectile dysfunction and sleep disorders. The peer reviewed literature and relevant surveys from 1985 to 2006 were subsequently reviewed.

Results

An association between erectile dysfunction and sleep disorders appears to exist in survey studies relying on self-report and in small case series. Hormonal, neural and endothelial mechanisms have been implicated in linking sleep disorders with erectile dysfunction. Treatment of sleep disorders, specifically sleep apnea with continuous positive airway pressure, has been shown to improve patient erectile function.

Conclusions

Clinicians should consider concomitant sleep disorders when evaluating patients with erectile dysfunction, especially in those refractory to routine therapy. Further studies are necessary to clearly define the causative link between sleep disorders and erectile dysfunction.

Key Words: penis, impotence, dyssomnias, sleep apnea syndromes, continuous positive airway pressure

Abbreviations and Acronyms: BCR, bulbocavernosus reflex, CPAP, continuous positive airway pressure, ED, erectile dysfunction, LH, luteinizing hormone, NO, nitric oxide, NPT, nocturnal penile tumescence, NREM, nonREM, OSA, obstructive sleep apnea, PSG, polysomnogram, REM, rapid eye movement, RLS, restless leg syndrome