Can Sleep Apnea Cause Impotence?
Yes it can…
Sleep apnea may seem like the Next Big Self-Diagnosed Thing, akin to gluten sensitivity from last decade or ADD in kids.
But for millions it’s a real and serious problem linked to all kinds of physical and psychological health problems.
For folks who aren’t sure what sleep apnea is, it’s when you stop breathing intermittently throughout a night of sleep.
Because that breathing cessation wakes you up just a little bit, even mild cases are the equivalent of getting jostled awake every few minutes all night long.
It’s pretty logical to assume that no parts of your health and wellbeing would be operating at peak performance after just a few weeks of this, and science supports that assumption.
Between the basic description of the affliction and the data surrounding it, it’s pretty clear that sleep apnea can cause erectile dysfunction.
But that information isn’t very useful. Luckily, research has also investigated how and why it impacts sexual health. And that information can tell us what we can do about it.
Nitric Oxide (NO) is a key substance in your body that helps with the blood flow part of getting and maintaining an erection.
Without it, one of the most important physical components of getting it up either doesn’t happen, or happens very weakly.
A pair of studies have conclusively linked sleep apnea to reduced production of NO.
In 2000, Dr. Mary of the University of Hong Kong’s Department of Medicine measured the serum NO levels in 30 men who received treatment for sleep apnea, finding that NO levels increased after successful therapeutic action that temporarily relieved sleep apnea symptoms.
Further, she found NO levels decreased as symptoms were more severe either at the outset of the study, or as treatment discontinued (source).
At Justus-Liebig University in Giessen, Germany, Shulz and Schmidt performed a similar study specifically using CPAP therapy for men with sleep apnea, also finding a direct correlation between sleep apnea symptoms and reduced NO content in the blood.
If you’re interested enough in erectile and sexual health to be reading this article, you already know that a healthy testosterone level is vital to your sexuality.
It’s the hormone most responsible for making males male, and the one at the heart of all of your sexual responses.
Too little and you’ll have trouble with your libido and your erection…
Put simply: you won’t want to have sex as often, and you won’t be able to even when you want to. As with the NO studies above, research has found that sleep apnea seriously impacts your ability to produce testosterone.
Rafael Luboshitzky of Israel’s Haemek Medical Center noted that many of her male patients with sleep apnea reported having a reduced libido (source).
In 2002, she took blood samples from 10 patients with sleep apnea and 5 without sleep-related breathing disorders, finding that the group with sleep apnea had significantly reduced testosterone levels, and significantly reduced levels of luteinizing hormone (a hormone that stimulates the body to produce testosterone).
Further work by Luboshitzky and her team in 2005 built on those findings by examining levels of testosterone and luteinizing hormone in subjects every 20 minutes throughout a night of sleep (or whatever passes for sleep among people with severe sleep apnea).
Her subjects included five obese, middle-aged men with sleep apnea, five control subjects matched to the sleep apnea patients in size and BMI but without suffering from sleep-related breathing disorders, and six lean men in their twenties.
Even after parsing out all of the variables for age and health, they found a definite correlation between sleep apnea and levels of both hormones and that the correlation increased gradually as the night went on (and the subjects with breathing problems had more trouble with their sleep).
It’s important to remember that none of Luboshitzky’s work looked at if sleep apnea impacted erectile health. She created the studies based on observing the link was already established.
She was looking into why, and found that sleep apnea’s direct impact on the body’s ability to produce testosterone was one of the ways.
You get your erection because blood flows into your penis when you’re aroused. As we’ve discussed many times before, anything that causes harm to your body’s circulatory system can therefore impact your ability to get an erection. Sleep apnea is no exception to this rule.
A pair of studies looked directly at the impact of sleep apnea on arterial health.
A pair of studies in Israel and Japan investigated the mechanics of how sleep apnea hurts arterial health after citing well-established earlier findings on how a link between damaged arteries and sleep apnea had been well established by researchers at Johns Hopkins and the Mayo Clinic.
The Japanese study looked specifically at the health of arteries feeding endothelial cells in the penis during erection, while the Israeli study investigated the biology of cells in arterial walls (source).
Both found that sleep apnea caused breakdown of arterial walls at the cellular level, and that such breakdown slows and can be reversed once treatment for sleep apnea begins.
The Israeli study also confirmed direct links between sleep apnea and a range of circulatory ailments, including hypertension and heart failure.
The bad news about sleep apnea’s impact on your sexual health is that the only real cure for this is to stop having sleep apnea (duh).
In the short term, you can get some of the benefit by taking on CPAP or similar therapies designed to give your body sufficient oxygen while you sleep, or mouthpieces that prevent obstructions that cause the apnea.
But those solutions are only partially beneficial, and only for as long as you continue them.
The good news about sleep apnea is that the overwhelming majority of cases are linked with being overweight or obese.
If you make the lifestyle, diet, and exercise changes necessary to lose weight you are equally likely to suffer less severe sleep apnea, and to eventually lose the symptoms altogether.
As a bonus, all of those changes also improve your general health…
Which also improves your sexual health, self-image, mood, circulatory health, hormonal balance, and all kinds of other factors which can lead directly or indirectly to ED.