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October 12th, 2011
01:06 PM ET
How sleep apnea can wreck your sex lifeLisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
When he began to tell me how happy his wife was, I thought that he was going to say, as many men do, that she was glad that he was no longer snoring or that she was relieved that he no longer stopped breathing during the night. Instead, he grinned as he related how, in the past month, he and his wife had more sex than they had had in the past two years. “Hey doc, if you want men to use this thing, just get the word out that it helps with ED (erectile dysfunction). They’ll be in here begging you for a CPAP.” Sexual dysfunction can be embarrassing and demoralizing to many people. Therefore, physicians often see a hesitation in bringing this topic up so we think Kurt’s experience is not unique; there is a growing body of research that shows a strong correlation between sleep apnea and erectile dysfunction in men. There is even evidence that sleep apnea is linked to a higher prevalence of sexual dysfunction in women. One study found that men with RLS (restless legs syndrome) were 78% more likely to have ED. The common mechanism here might be that both disorders involve a malfunction of the neurotransmitter, dopamine. Experimental research that used a sleep deprivation protocol to study the effects of sleep on the hormones and metabolism. Healthy young men found a decrease in testosterone when there were several nights of short sleep times (five hours or less) for a week or less. If sleep deprivation is chronic, as it often is in real life, then it may be that milder levels of sleep deprivation have a cumulative effect and could lead to adverse hormonal consequences such as decreased testosterone. Testosterone is produced during the night; the levels climb steadily throughout the night and peak in the morning. There are studies showing not only that a decrease in the total amount of sleep can lower a man’s testosterone, but also that REM sleep is important to the production and release of testosterone. We know that REM sleep is often decreased or absent in patients with sleep apnea. Therefore, it seems that both the quantity and quality of sleep are important for testosterone production. However, with sleep apnea, there is another reason that there could be erectile dysfunction: the low oxygen levels that are often associated with apnea, especially when it is severe. In some studies, the severity of the sleep apnea was the greatest predictor of ED while in others it was how low the oxygen went. We have known for years that chronically low oxygen levels at night adversely affects the vasculature of the heart, lungs, brain, and now we can add the penis. The good news is that often with treatment of the sleep disorder, the sexual dysfunction improves dramatically, thereby enhancing energy, mood and overall quality of life. The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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It was a normal follow-up to see how Kurt was adjusting to his 
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