How can sleep affect men’s health?


Sleep is known to affect different systems and processes in the body. In general, sleep deprivation is associated with negative health consequences.

Men’s sleep and health. Image Credit: Gorodenkoff / Shutterstock.com

Regarding the specific effects of sleep on men’s health, dysfunctional sleep patterns have been shown to impact erectile dysfunction, lower urinary tract symptoms, hypogonadal symptoms, low testosterone and male infertility. .

What is considered appropriate sleep?

The average number of hours of sleep required for an adult is between 7 and 9 for optimal health. However, a considerable number of adults do not meet this requirement.
A study conducted in 2012 showed that 29.2% of men achieved an average of 6 hours or less of sleep each night. the Institute of Medicine also estimates that between 50 and 70 million Americans suffer from chronic sleep disorders; this epidemic is associated with social changes that include increased dependence on technology, increased working hours and poor sleep hygiene.

Furthermore, non-standard shift work patterns can reveal themselves significantly from circadian patterns, which further increases the risk of reduced sleep quality.

The interrelation between interrupted or inadequate sleep and the manifestation of the disease

The relationship between health and sleep is two-way. There are several medical conditions associated with inadequate or interrupted sleep which include restless legs syndrome, insomnia, hypogonadism, sleep apnea, and depression.

Additionally, several studies have revealed that short or interrupted sleep can produce health conditions including diabetes, coronary heart disease, high blood pressure, heart attacks, strokes, and various endocrine and cardiovascular disorders. Furthermore, poor sleep also affects patients’ perception of symptoms and their severity along with observed clinical responses.

Combined with independent risk factors such as age, taxed body mass, mental health conditions that affect the perception of symptoms such as depression and clinical features, sleep functioning can moderate clinical symptoms and affect quality of life experienced by patients.

Sleep and erectile dysfunction

In the general population, longitudinal studies revealed that around 50% of men had erectile dysfunction to some degree. Several studies have reported that sleep can affect erectile dysfunction. For example, a cross-sectional analysis of 2,676 men over the age of 67 found that those with a sleep dysfunction called nocturnal hypoxemia were more likely to experience moderate or complete erectile dysfunction.

In the same study, a similar sleep-disturbing condition, sleep apnea, was studied in relation to erectile dysfunction. In a randomized controlled sham trial, a total of 61 men were assigned to groups to investigate whether the use of continuous positive airway pressure (CPAP) could improve erectile function in men suffering from both erectile dysfunction and apnea. obstructive sleep.

Overall, men randomized to CPAP showed no change in erectile dysfunction; however, when examined further in terms of patients who used the CPAP machine for over four hours per night, those who did found significant improvement. A placebo study showed that a drug commonly used to treat erectile dysfunction did not significantly improve erectile dysfunction in these men.

These findings suggest that in men with obstructive sleep apnea, sleep quality contributes to the condition and may not respond to first-line treatment for erectile dysfunction with a PDE5 inhibitor; suggesting that, in fact, correcting the underlying sleep disorder could produce a more significant improvement in erectile dysfunction.

In addition to obstruction of breathing, non-standard shift work that has a significant effect on sleep has been shown to impact erectile dysfunction. A correlation between insomnia and erectile dysfunction has been confirmed by several studies. Some of these studies suggest that isolated correction of poor sleep can lead to clinical improvement of the manifestations of erectile dysfunction. This body of research continues to grow.

Men

Men’s health. Image Credit: Tyler Olson / Shutterstock.com

Sleep and lower urinary tract symptoms

Aging male populations commonly experience lower urinary tract symptoms. This is often associated with benign prostatic hypertrophy. Symptoms include poor urine flow, incomplete emptying of the bladder, tension, changes in urination frequency, hesitation in urination, and nocturia.

The urge to urinate is often exacerbated during the night, which leads to sleep disturbances and a decrease in overall sleep quality. A survey of 5,335 men diagnosed with lower urinary tract symptoms showed that only 13% reported continuous sleep periods of more than two to three hours, illustrating the degree to which urinary tract symptoms can affect sleep. .

Other studies have looked for an association between lower urinary tract symptoms and other conditions that affect sleep. For example, men with obstructive sleep apnea are more likely to experience urinary tract symptoms than those who don’t. The severity of obstructive sleep apnea in this setting was found to be more related to the daytime frequency, urgency and frequency of nocturia.

CPAP machines have been found to reduce lower urinary tract symptoms in those with obstructive sleep apnea. For example, a man with lower urinary tract symptoms and obstructive sleep apnea who implemented CPAP for 12 months showed a significant increase in bladder compliance as well as a decrease in nocturia frequency and nocturnal urination volumes.

Insomnia is also considered an aggravating circumstance of lower urinary tract symptoms and non-standard shift work.

Sleep and male fertility

Several studies have shown that sperm count has decreased over the past 40 years (from 50 to 60%). Unlike the linear correlation between erectile dysfunction and sleep, the relationship between sleep and male fertility is less clear.

Evidence suggests that there is an inverted U-shaped relationship, which means that excessive and insufficient sleep are equally associated with impaired fertility. In a study of 198 infertile men, this relationship was found. However, it is interesting to note that no differences were observed in sperm volume, sperm motility, luteinizing hormone, or follicle-stimulating hormone.

A further study found through testicular biopsies in idiopathic infertile men that complete circadian disruption – manifested by too little or too much sleep – can affect the oxidation state of the testis, displacing spermatogenesis.

Despite these correlative studies, no studies have evaluated the impact of obstructive sleep apnea on fertility. Regarding non-standard shift work that alters sleep quality, it has been suggested that this impairs spermatogenesis, although the results of the studies have been inconsistent: some studies have shown that men doing shift work were more likely to experience infertility, while others have seen no effect.

Conclusion

Poor sleep affects men and women equally. However, the unique effects in men relate to urological problems, including erectile dysfunction, lower urinary tract symptoms, hypogonadism, and male infertility.

Alongside these, poor sleep is associated with an increased risk of several health problems that affect quality of life including, but not limited to, cognitive impairment, social deterioration, mood disorders and an increased risk of disease cardiovascular and associated manifestations such as atrial fibrillation.

References

  • Irer B, Celikhisar A, Celikhisar H, et al. (2018) Assessment of sexual dysfunction, lower urinary tract symptoms and quality of life in men with obstructive sleep apnea syndrome and the efficacy of CPAP therapy. Urology. doi: 10.1016 / j.urology.2018.08.001.
  • Soterio-Pires JH, Hirotsu C, Kim LJ, et al. (2016) The Interaction of Erectile Dysfunction Disorders and Depression in Men: A Cross-Sectional Study of Sleep, Hormones, and Quality of Life. Int J Res. doi: 10.1038 / ijir.2016.4.
  • McBride JA, Kohn TP, Rodriguez KM, et al. (2018) Incidence and characteristics of high-risk men for sleep apnea in a high-volume andrology clinic. JUrol. 10.1016 / j.juro.2018.02.1358.

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