Men’s Wellness & Prevention

What is the Effect of Sleep Apnea on Men’s Health?

Sleep apnea significantly harms men's urological health by causing Erectile Dysfunction (ED) through reduced testosterone and nitric oxide, worsening Lower Urinary Tract Symptoms (LUTS), and lowering overall testosterone levels due to interrupted sleep cycles.
By - Russel H Williams, MD

Sleep plays an important role in the health of your body. Many studies have shown that sleep disorders are directly associated with conditions including coronary artery disease, diabetes, hypertension, stroke, and heart attacks. What if by correcting these conditions you could delay or improve your overall health? We will take this time to focus on the urological effects that sleep apnea has on your body but keep in mind its comprehensive effect as well.

Did you know that sleep apnea can be a significant factor in erectile dysfunction (ED)? There have been many studies indicating the correlation between sleep apnea and ED. Several theories have been proposed as to why but the leading theories are:

  1. That sleep apnea can lower testosterone levels and thereby lead to erectile dysfunction.
  2. That the circulating levels of nitric oxide (NO) in the bloodstream decrease in sleep apnea and NO is a key role in obtaining an erection (Burnett, 2004).

Furthermore, when men are referred for sleep apnea testing only 50% of men will actually follow up on this referral. The correction of sleep apnea alone may be sufficient enough to improve erectile dysfunction (Kohn et. Al, 2020). We want to urge our patients to no longer delay their medical care.

Are you having lower urinary tract symptoms?

This group of symptoms can include incomplete bladder emptying, weak stream, straining to urinate, hesitancy, frequency and night time urination. There is evidence that these symptoms, coupled with sleep apnea, will worsen your symptoms when compared with men who do not have sleep apnea. The physiology behind why this occurs is poorly understood but hypotheses are that sleep apnea leads to increased circulating inflammatory markers; worsening conditions such as cystitis or prostatitis, which are inflammatory in nature (Alber & Vezina, 2018). Studies show that with patients whose sleep apnea was corrected, they experienced an improvement in their lower urinary tract symptoms (Kohn et. Al, 2020).

How does sleep affect my testicular function?

In the case of fertility, too much or too little sleep can cause impaired sperm production. There has also been studies that have evaluated intratesticular melatonin, an antioxidant, and its antagonistic effect on inflammatory markers in the testicle tipping spermatogenesis one way or another. There is, however, more research that needs to be done in this area (Kohn et. Al, 2020).

Patients with sleep apnea have lower levels of testosterone due to having delayed REM sleep. When you fall asleep, the testosterone levels begin to rise and peak at the first REM cycle, which should be less than 100 minutes. When a REM cycle is delayed, the rise is much slower, thereby leading to a lower daily operating testosterone level. Furthermore, obesity is common among patient with sleep apnea.  Adipose tissue, commonly known as fat, causes testosterone to be converted to estradiol and also decreases circulating testosterone levels. Vice versa, in certain populations, patients with low testosterone levels with sleep apnea showed an improvement in their sleep score when testosterone was corrected (Kim & Cho, 2019).

As you can see, screening for these conditions are important to your health. It is better to find a condition early and make changes now before damage occurs. Here at The Y Factor, men’s health is our top priority. We offer all-encompassing health screening exams which include the newest, state-of-the-art, in-home, next day result sleep studies. If you have questions or concerns, schedule your appointment today.

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