What is considered to be appropriate sleep?
The average number of hours of sleep required for an adult is between 7–9 for optimal health. However, a considerable number of adults do not meet this requirement.
A study conducted in 2012 demonstrated that 29.2% of men achieved an average of 6 hours or less of sleep each evening. the institute of Medicine further estimates that between 50 and 70 million Americans suffer from a chronic sleep disorder; this epidemic is associated with societal changes which include increased reliance on technology, increased working hours, and poor sleep hygiene.
In addition, non-standard shift working patterns can divulge significantly from circadian patterns which further increases the risk of impaired sleep quality.
The relationship between health and sleep is bi-directional. There are several medical conditions associated with inadequate or disrupted sleep which include restless leg syndrome, insomnia, hypogonadism, sleep apnea, and depression.
Furthermore, several studies have revealed that short and sleep or disrupted sleep can produce health conditions including diabetes, coronary heart disease, hypertension, heart attacks, stroke, and several endocrine and cardiovascular disorders. Moreover, poor sleep also impacts the patients’ perception of symptoms and their severity alongside the clinical responses observed.
Combined with independent risk factors such as age, body mass in tax, mental health conditions that affect the perception of symptoms such as depression, and clinical characteristics, sleep functioning can moderate clinical symptoms and impact the quality of life experienced by patients.
In the general population, longitudinal studies have revealed that approximately 50% of men experienced erectile dysfunction to some degree. Several studies have reported that sleep can affect erectile dysfunction. For example, a cross-sectional analysis of 2676 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 condition that disrupts sleep, sleep apnea, was studied in relation to erectile dysfunction. In a randomized sham-controlled 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 who suffered from both erectile dysfunction and obstructive sleep apnea.
Overall, men who were randomized to CPAP showed no change in erectile dysfunction; however, when further examined in terms of patients who used the CPAP machine for over four hours per night, those who did so experienced a significant improvement. A placebo trial showed that a medication commonly used to treat erectile dysfunction did not significantly improve erectile dysfunction in these men.
These results 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 impairment could produce more significant improvement in erectile dysfunction.
Alongside obstruction to 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 the correction of poor sleep in isolation may lead to a clinical improvement in manifestations of erectile dysfunction. This body of research continues to grow.