The Link Between Erectile Dysfunction and Sleep Apnea : Causes, Symptoms, and Treatment

1. Introduction — The Link Between Erectile Dysfunction and Sleep Apnea

   1. Definition of Erectile Dysfunction (ED)

      Erectile dysfunction is defined as a sign experienced in men which is marked by difficulty in getting and keeping an erection for attaining sexual satisfaction. This is also known as impotence and can be a sign of a physical or psychological condition.

      Erectile dysfunction can cause stress, strain, and low self-confidence in males. This can also lead to relationship issues.

   2. Definition of Sleep Apnea

      Sleep apnea is a serious sleep disorder in which the affected individual’s breathing stops repeatedly and starts while sleeping. You might have sleep apnea if you snore loudly and feel tired even after having a full night’s sleep.

   3. The Increasing Prevalence of Erectile Dysfunction and Sleep Apnea

      Continued research has found that having sleep apnea can also result in erectile dysfunction in men and cause loss of libido in women.

      Researchers have found evidence that males who have obstructive sleep apnea are more likely to suffer from erectile dysfunction and vice versa. A study from 2009 published in the “Journal of Sexual Medicine” has mentioned that 69% of men who were diagnosed with obstructive sleep apnea also had erectile dysfunction.⁽¹⁾

      A study from 2016 has mentioned that ED has been found in around 63% of study participants with sleep apnea.⁽²⁾ However, in contrast, only 47% of male participants in the study without obstructive sleep apnea had erectile dysfunction.

      Furthermore, in a survey from 2016 that include more than 120 men with erectile dysfunction, it was found that 55% of them reported symptoms related to sleep apnea.⁽²⁾

      These findings suggest that men with erectile dysfunction also suffer from sleep apnea and vice versa.

   4. Purpose of the Article: Exploring The Potential Link Between Erectile Dysfunction and Sleep Apnea

      The prime purpose of this article is to explore the potential link between erectile dysfunction and sleep apnea. To know about the same, we will have a look at the symptoms and causes of both these conditions and also take a deeper look at the link between these two conditions with significant evidence and studies.

2. Background on Erectile Dysfunction

   1. Overview of Erectile Dysfunction

      Erectile dysfunction (ED) is the inability to attain or keep an erection firm enough to have sex. ED might be occasional or frequent.

      Many people experience symptoms of erectile dysfunction, especially during stressful times or due to a change in their nutrition or lifestyle. However, having frequent ED can be a sign of health issues that require strict medical attention and treatments. This can also be a symptom of relationship or emotional difficulties that you need to address.

      Apart from getting an erection, erectile dysfunction can also be related to other sexual disorders like delayed ejaculation, premature ejaculation, and anorgasmia or the inability to achieve orgasm. If you are experiencing these symptoms, that last more than 3 months, then you should speak with your doctor and go according to their prescribed treatment.

   2. Causes of Erectile Dysfunction

      There are several possible causes of erectile dysfunction, and these causes could be both, physical and emotional.

      Some common physical conditions that can cause erectile dysfunction includes diabetes, cardiovascular disease, high cholesterol, hypertension, obesity, hypothyroidism, low testosterone levels, aging, sleep disorders, drug overuse, relationship issues, some prescription medication, epilepsy, liver cirrhosis, multiple sclerosis, Parkinson’s disease, and damage to the pelvic are.
      Some common emotional conditions that can lead to ED are stress, anxiety, depression, relationship strain, and performance anxiety.

      It should be noted that erectile dysfunction in men can be caused by only one of these above-mentioned factors or by several of them. So, it is important to consult with your doctor and treat any underlying medical condition that might be causing erectile dysfunction.

   3. Prevalence of Erectile Dysfunction in the General Population

      As mentioned by the National Institute of Diabetes and Digestive and Kidney Diseases, about 30 million men in the U.S. have erectile dysfunction.⁽³⁾

      The prevalence of erectile dysfunction increases with age. It has been estimated by The University of Wisconsin that mild or moderate erectile dysfunction affects 10% more men in each decade of their life.⁽⁴⁾

      However, younger men can also suffer from ED. A study from 2013 found that 1 in 4 men seeking their first treatment for erectile dysfunction was below 40 years of age. ⁽⁵⁾ There is a stronger correlation between smoking, substance abuse, and erectile dysfunction in these younger men when compared with older ones. Thus, it suggests that lifestyle choices are also an essential factor for erectile dysfunction in younger men.

      Apart from all these, if you have diabetes, or suffer from other physical or psychological issues that could lead to ED, you should work with your doctor and manage your health condition.

3. Background on Sleep Apnea

   1. Overview of Sleep Apnea

      The word, “apnea” comes from a Greek word for ‘breathless”. Sleep apnea is a sleep disorder that can stop breathing while you are asleep. Your brain tries to protect you by waking you up enough to properly breathe, and this prevents restful and sound sleep. Sleep apnea occurs either due to blockage of the airway or because your brain does not control your breathing correctly.

      Sleep apnea, if left untreated, over time can result in serious complications. However, with proper medical attention, the condition can be managed effectively.

   2. Causes of Sleep Apnea

      Sleep apnea has specific causes. Primarily, there are three forms of sleep apnea, namely, obstructive sleep apnea (OSA), central sleep apnea (CSA), and mixed/complex sleep apnea.

      Obstructive Sleep Apnea

      It is the most common form of sleep apnea. It occurs when muscles in your neck and head relax when you are asleep, thus causing the surrounding tissue to press the windpipe, that in turn, obstructs the ability of air to pass through it.

      Central Sleep Apnea

      Central sleep apnea happens due to a problem in the brain. Under normal circumstances, your brain manages your breathing every time, including while you are sleeping. However, when you suffer from central sleep apnea, your brain fails to send signals to keep the breathing-related muscles working.

      Central sleep apnea can occur due to several reasons like low blood oxygen levels, heart failure, nervous system damage, and nervous system conditions like ALS (Amyotrophic Lateral Sclerosis).

      Mixed/Complex Sleep Apnea

      There is a mixed or complex type of sleep apnea and it has a combination of both central and obstructive events.

   3. Prevalence of Sleep Apnea an the General Population

      Sleep apnea is prevalent in 18 million Americans.⁽⁶⁾ This statistic says that approximately 1 in every 15 Americans (6.62% of the total population of America) have sleep apnea.

      Two to four percent of all people in America have an undiagnosed case of sleep apnea, and this accounts for 1 in every 50 individuals being undiagnosed.

      Obstructive sleep apnea is the most common type of sleep apnea and it is most common among elderly males. However, it can also affect children and females.⁽⁷⁾

4. The Link Between Erectile Dysfunction and Sleep Apnea

   1. The Physiological Connection Between Erectile Dysfunction and Sleep Apnea

      Sleep apnea can cause a reduction in the levels of testosterone, which in turn, can cause erectile dysfunction. That is why many individuals with sleep apnea experience ED. Both, the quality and quantity of sleep affect testosterone levels.

      Patients with obstructive sleep apnea have less REM sleep, reduced time of deep sleep, increased awakenings during the night, sleep fragmentation, and also reduced sleep efficiency, which ultimately causes a low level of testosterone.⁽⁸⁾ This can lead to erectile dysfunction.

   2. Evidence for a Causal Relationship Between The Two Conditions

      Researchers have found evidence that males who suffer from obstructive sleep apnea are more likely to have erectile dysfunction (ED). However, scientists are still unaware of why exactly men with obstructive sleep apnea have higher rates of erectile dysfunction.

      Because of sleep deprivation, the testosterone level would dip in men and this might also restrict oxygen. For a healthy erection, both testosterone and oxygen are essential. Researchers have also mentioned that fatigue and stress caused due to lack of sleep can also worsen sexual problems.

      Research has shown an association between dysfunction in the endocrine system and sleep disorders.⁽⁹⁾ A study from 2014 has also found that low levels of testosterone can cause poor sleep.⁽¹⁰⁾ However, there is no significant evidence that obstructive sleep apnea impacts the production of testosterone.

   3. Common Symptoms of Erectile Dysfunction and Sleep Apnea That May Overlap

      Though ED and sleep apnea are different conditions, there is a link between them. It is also important to note that some symptoms of erectile dysfunction and sleep apnea might overlap. Some of these common symptoms include irritability, mood changes, feeling exhausted, stress, strain, and anxiety. This, in turn, can put a lot of strain on your relationship with your partner.

5. Diagnosis and Treatment of Erectile Dysfunction and Sleep Apnea

   1. Importance of Proper Diagnosis

      A proper diagnosis is always the first step toward creating an appropriate treatment plan and healing. Both conditions are needed to be diagnosed. If you are diagnosed with ED but continue to have undiagnosed sleep apnea, you might not see much improvement.

      ED and sleep apnea, both have specific treatments. However, some of the best and most effective means to manage both are maintaining a healthy weight, proper diet, and reducing stress. Apart from these, some various medicines and devices can help in treating erectile dysfunction, while continuous positive airway pressure (or CPAP), which delivers a steady air pressure while you are asleep, could be the primary treatment for sleep apnea too.⁽¹¹⁾

   2. Diagnostic Tools For Erectile Dysfunction And Sleep Apnea

      Diagnosis Tools For ED

      Apart from being examined physically by your doctor, you will also have to go through some questionnaires that would involve your psychosocial and sexual history. However, apart from all these common formalities, you would also have to undergo other procedures so that your ED could be diagnosed properly and treatment can begin accordingly.

      Some of the most common diagnostic procedures for erectile dysfunctions include ultrasound, injection test, nocturnal penile tumescence test, blood tests, and urine tests.

      Ultrasound can be done using an ultrasound machine.

      A portable, battery-powered device would be required for the nocturnal penile tumescence test. This device is to be worn on the thigh. The device stores data that your doctor can access later.

      In case of an injection test, a medicine will be injected into your penis that would stimulate an erection. This will help the doctor to evaluate the firmness of your erection and also how long it last.

      Urine tests and blood tests can help your doctor to check for other underlying health issues like diabetes, heart disease, thyroid problems, and more.

      Diagnostic Tools For Sleep Apnea

      The most common diagnostic test for sleep apnea is an overnight sleep study (Polysomnogram). This test is often done in a laboratory with appropriate medical facilities, tools, and equipment. The test is an overnight test where you sleep in the laboratory, called a ‘sleep lab’ in a comfortable position and your sleep would be monitored.

      The test involves sensors that monitor your heart rate, blood oxygen levels, breathing, brain waves, and more. This is the finest standard of diagnosis for sleep apnea.

   3. Available Treatment Options For Both Conditions

      Treatment For Sleep Apnea

      Sleep apnea can be generally treated by opening up the airways so that the affected individual can breathe more easily at night while asleep. However, the appropriate treatment for the condition would depend on the underlying problem and this could include lifestyle changes, such as reducing smoking, losing weight, and eating healthy.

      In certain cases of sleep apnea, doctors might recommend sleeping with specific devices, like a mouthpiece. These devices allow for more natural breathing while you are asleep at night. In addition to this, physical therapy for the face and mouth can also be beneficial.

      Surgery would be an option for you if sleep apnea is quite severe and other treatments not work for you. This surgery could be to move the jaw, adjust your airways, or even remove tonsils.

      Treating sleep apnea can also help with erectile dysfunction. Having enough sound sleep might restore testosterone levels to normal, and this might reduce ED.

      Treatments For Erectile Dysfunction

      Apart from treating the underlying health issue that could be responsible for ED, it is also possible to directly treat erectile dysfunction.

      Sildenafil (sold as Viagra) and other medications that increase blood flow to the penis, could be helpful. Apart from this, there are also penile implants and other surgical procedures available to treat ED.

      Sometimes, ED could be due to psychological issues like stress and anxiety. In such a case, counseling, or therapy could be beneficial.

      Moreover, some natural remedies can help manage the condition. However, it is always advisable to visit your doctor and go with their treatment plan.

   4. The Potential Benefits Of Treating Both Conditions Concurrently

      Treating ED and sleep apnea concurrently could be more effective and can help you get rid of the problems with your sleep as well as sexual function. There is a significant association between erectile dysfunction and sleep apnea. Studies have shown that the risk of erectile dysfunction is higher in patients with obstructive sleep apnea.

      Treatments like Nasal CPAP (continuous positive airway pressure) and obstruction-relieving surgery can help in improving sexual performance and also the overall quality of life. This could help in improving your condition and also strengthening your relationship with your partner.

6. Conclusion

1. Summary of the Potential Link Between Erectile Dysfunction and Sleep Apnea

   Though erectile dysfunction and sleep apnea are two different health conditions, their occurrence at the same time in men indicates that there is some sort of link between the two conditions. Males with sleep apnea have higher rates of ED. However, there are only a few explanations for why this happens.

2. Importance of Recognizing and Treating Both Conditions

   It is important to visit your doctor if you are suffering from any of the two conditions and get yourself properly diagnosed and treated appropriately at the earliest possible time. Both these conditions are usually treatable and the treatment primarily depends on the cause.

3. Future Research Needed To Further Understand The Relationship Between Erectile Dysfunction and Sleep Apnea

   To conclude, it can be said that further research is required to understand the relationship between ED and sleep apnea. However, it can be said that if you are experiencing any of these conditions or both of them simultaneously, you should visit your doctor.

4. Final Thoughts and Recommendations For Those Affected By Both Conditions

   Feel free to talk about your sleep issue or your sexual problem with your doctor and get the best advice from them to improve your sleep quality and also address any of the two conditions which might affect your relationship if left untreated.

References:

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• What Causes Erectile Dysfunction in Young Men?
• How Stress Causes Erectile Dysfunction & Treatment for Stress Induced Erectile Dysfunction
• Is Niacin Good for Erectile Dysfunction?
• How Common is Erectile Dysfunction?|Physical & Psychological Causes of ED
• Is Occasional Erectile Dysfunction Normal & What is its Treatment?
• Ways to Make Erectile Dysfunction Meds Work Better
• Erectile Dysfunction: Causes, Treatment, How Common Is It, Can Young Men Suffer From Erectile Dysfunction