March 5, 2024

Insights from recent meta-analysis of 43 studies

A review published in the Journal of Sexual Medicine elucidated the intricate relationship between sleep and sexual dysfunction, demonstrating that sleep disorders and poor sleep quality could elevate the risk of developing sexual dysfunction.

Sleep is a vital and complex process that impacts various aspects of human health, including metabolism, hormone secretion, and the inflammatory response. On the other hand, sexual dysfunction is a negative effect on sexual behavior due to various factors like psychological, endocrine, and vascular issues.

Previous research has shown that sleep disorders and lack of sleep can negatively affect sexual function, but there is a lack of comprehensive and high-level evidence to evaluate this relationship properly. The study aims to address this gap by conducting a systematic review and meta-analysis of available studies on the topic.

A meta-analysis is a statistical technique that combines the results of multiple independent studies to obtain a more robust and precise estimate of the relationship between variables. This allows the researchers to draw more significant conclusions and identify patterns that may not have been apparent in individual studies alone.

Based on an analysis of 43 articles, the review highlighted significant associations between sleep quality, duration, and sleep disorders with sexual dysfunction in both men and women. Notably, obstructive sleep apnea emerged as a prominent contributor to sexual dysfunction, particularly in individuals experiencing related symptoms such as aging, obesity, hypoxia, and sleep fragmentation. These factors can disrupt the hypothalamic pituitary-gonadal axis, leading to reduced testosterone and luteinizing hormone levels, which are confirmed to be related to severe erectile dysfunction in men.

For women, the most prevalent sleep disorder identified was insomnia, which was linked to hormonal fluctuations, especially during pregnancy and menopause. This hormonal imbalance directly impacted women’s psychological state and indirectly contributed to issues like vaginal contraction, reduced lubrication, decreased libido, and dyspareunia.

In men, not getting enough sleep and having disturbances in their sleep patterns, especially reduced rapid eye movement (REM) sleep, can affect their normal androgen levels and cause peripheral nerve damage in their sexual organs. Studies indicates that men who experience insomnia in the second half of the night might have lower testosterone levels in the morning. Similarly, sleep deprivation caused by a deficiency in androgen is believed to play a significant role in female sexual dysfunction.

Additionally, the review explored the association between restless legs syndrome and sexual dysfunction. Although the exact mechanisms remain unclear, some research suggests that dopamine function in the central nervous system may be diminished in these patients, affecting libido and potentially contributing to sexual dysfunction.

While the study provides valuable insights into the intricate relationship between sleep and sexual function, it is essential to recognize certain limitations.  For instance, research on female sexual dysfunction is relatively scarce and requires further investigation. Additionally, more comprehensive studies are needed to understand the independent effects of sleep disorders on sexual dysfunction.

In light of these findings, it becomes crucial for clinicians to include common sleep disorder screening tools in their basic assessments at sexual dysfunction clinics. Understanding and addressing sleep disruptions may play a significant role in promoting sexual well-being.

The study, “The relationship between sleep disorders, quality, and duration and sexual dysfunction: a systematic review and meta-analysis“, was authored by Diliyaer Dilixiati, Kaisaierjiang Kadier, Duolikun Laihaiti, Jian-De Lu, Remila Rezhake, Baihetiya Azhati, and Mulati Rexiati.

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