Performance in the bedroom is something that a lot of men struggle with. Furthermore, because this is a sensitive topic, a lot of men have trouble discussing this, even when they go to the doctor. The reality is that a lot of men suffer from erectile dysfunction, and one of the possible causes could be obstructive sleep apnea (OSA). Obstructive sleep apnea is one of the most common forms of sleep apnea. Depending on the severity of this condition, it could be very serious. Individuals who suffer from obstructive sleep apnea can stop breathing repeatedly when they sleep at night. Furthermore, snoring can often keep them awake as well as their partners.
What is the link between sleep apnea and erectile dysfunction? There are a few important points people should keep in mind.
Sleep Disorders Impact Oxygen and Testosterone Levels
One of the biggest links between sleep apnea and erectile dysfunction has to do with testosterone. Testosterone levels are very important for producing an erection. In addition, oxygen is important for blood flow. Sleep apnea has the potential to impact both of these components. Therefore, sleep apnea can lead to a variety of medical problems, including erectile dysfunction.
For example, researchers have conducted trials showing that individuals who suffer from obstructive sleep apnea are more likely to have erectile dysfunction. In addition, individuals with erectile dysfunction are more likely to suffer from sleep apnea. For example, one research study published in 2009 found that close to 70 percent of men diagnosed with obstructive sleep apnea also suffer from erectile dysfunction. Another study published in 2016 demonstrated similar results. Therefore, it is important for everyone to understand sleep apnea can lead to erectile dysfunction.
What Are the Symptoms of Sleep Apnea?
Similar to other medical conditions, obstructive sleep apnea can range widely in terms of its scope and severity. A few of the most common symptoms of obstructive sleep apnea include:
- Loud snoring at night, which can make it difficult for you to fall asleep and stay asleep
- Instances in the middle of the night where you stop breathing, particularly if it of witnessed by someone else
- Waking up periodically throughout the night with abrupt shortness of breath
- Waking up with a dry mouth or sore throat
- Recurrent morning headaches
- Hypersomnia, which is defined as feeling sleepy during the day
- Difficulty concentrating or paying attention at work or in school
- Emotional irritability
Individuals with obstructive sleep apnea often wake up with severe headaches in the morning because their brain has been exposed to lower oxygen levels at night. Because people with sleep apnea have a difficult time getting restful sleep, they are often tired and irritable during the day.
How Is Erectile Dysfunction Diagnosed?
If doctors believe that erectile dysfunction is directly related to obstructive sleep apnea, they may order something called a nocturnal penile tumescence (NPT) test. When men and boys fall asleep at night, they often have higher levels of hormones, which can trigger an erection. This is one of the most common reasons why boys and men often wake up with erections in the morning.
This mostly happens during REM sleep, which is when someone is in their deepest sleep. This is also the point in the night a person would be experiencing their dream state.
If your doctor orders an NPT test, he or she is trying to figure out if there is organic dysfunction, meaning that there is something biologically wrong with your ability to sustain an erection, or if there is a psychogenic reason behind your ED, such as performance anxiety.
An NPT test involves placing multiple bands around the penis when patients go to sleep at night. This is normally one for several nights in a row. If an erection occurs, its force and duration are measured on a graph. If there are no erections at night, this suggests an organic or biological issue behind your ED.
If there are erections during the test, this would imply that the ED problems are more of a psychological issue rather than biological. If someone gets an erection during this test, it doesn’t mean that they don’t have sleep apnea. It just means that the ED problems they have is not caused by the sleep apnea.
An NPT test is not very common in a sleep test anymore. If you want to have an NPT test done with your sleep study, this is something you will want to talk to your doctor about ahead of time. If they are only aware of your sleep issues and not your ED, they will only order testing to test for sleep apnea.
What Are the Treatment Options?
There are several treatment options available for obstructive sleep apnea. If it is possible to address OSA, then oxygen and testosterone levels should normalize, correcting ED issues. The preferred treatment option for OSA is CPAP, which stands for continuous positive airway pressure.
A CPAP is a small machine that has a hose which connects to a mask that patients wear when they go to sleep at night. Then, there is positive pressure from the machine to the mask that keeps the airway open. This makes it easier for patients to breathe as they sleep, preventing the airway from collapsing. By maintaining oxygen levels, patients can stay asleep at night, produce more testosterone, and correct ED issues.
Although CPAP can be seen as an unattractive option, especially for younger patients, it is quite effective with most people. And CPAP is definitely more attractive than dealing with erectile dysfunction, which is a hundred more times more embarrassing and frustrating.
Most partners are going to be quite fine with a person using a CPAP. It can be an adjustment, but the modern machines are extremely quiet and don’t take up a lot of space. And when you are actually using it, you will both be asleep and unaware anyway.
How Long Does It Take For CPAP To Help Erectile Dysfunction?
This really depends on the patient and how well they respond to treatment. For me personally experiencing this issue, when I started CPAP I noticed a difference in a couple of weeks. However, I would say it took me almost 3 months before I felt 100%.
Even though I did my best to use CPAP every night, it took awhile for me to get used to. At night I would turn the machine off and take off my mask. I would then awake the next day with no memory of doing that and I only used CPAP for a few hours. But the more I used CPAP, the more my body seemed to accept it.
This may or may not be the reason why it took me 3 months to reach 100%. But it seems like a likely reason. From reading on forums and Facebook groups, I have seen people say they got better within one week and some saying they haven’t gotten any better. And as for what to do when CPAP doesn’t help the sleep apnea which in turn helps the ED, goes into my next section.
What If CPAP Doesn’t Help With Erectile Dysfunction?
If you have been using CPAP for several weeks and don’t notice any difference, there are a couple of things you can look into.
Is your REM sleep disrupted at all?
Maybe your CPAP is helping you get a better sleep, but you are experiencing hypopneas at night, especially during REM sleep. This is called REM Sleep Fragmentation. This is where you are using CPAP but you are still having hypopneas during REM sleep. You aren’t getting that deep sleep that gives you the most benefit because it is disrupted.
Some people will look at their CPAP stats and see their AHI at like a 3. Typically anything lower than a 5 is considered normal. However, this number is an average for your WHOLE night. if you have 0 apneas for your first 3 hours, then have 12 apneas for an hour, then 0 apneas for the next 3 hours, your stats might look pretty good when it averages out the full 7 hours.
When it comes the sleep apnea and erectile dysfunction, REM sleep is the key. You need your REM sleep undisrupted as much as possible.
This could be caused by pressure settings or mask leaks. It could also be mouth leaks, which is when you are using a nasal mask but sleep with your mouth open.
Using the apps that come from CPAP manufactures like Philips Respironics and Resmed aren’t going to tell you the whole story. if you use Oscar, which is a free tool that lets you view all your CPAP data, it can give you a better picture of when your apneas are occurring.
There is so much data with Oscar that it can be overwhelming. So if you don’t feel comfortable with what you are seeing, consulting with a doctor about this information would be the best idea. A doctor with knowledge of sleep medicine would be best like a pulmonologist or a doctor with a secondary specialty in sleep medicine.
And if for some reason you can’t or don’t want to see a doctor, there is another option. You can order a PAP Therapy Data Analysis online. This is a service provided by Jason Sazama, who is a registered Polysomnographic Technologist (sleep tech) and clinical sleep educator. He is also the popular YouTuber LankyLefty27.
Basically for his service, you would send in your data that was pulled using Oscar. He then looks over all the data and tells you what he is seeing and gives recommendations. This might be to adjust your pressure, change the mask, or other possibilities. This can be a good thing for anyone that wants to see how well CPAP is working for any reason.
Below is a video of Jason talking about this very topic of sleep apnea and erectile dysfunction that is super helpful when talking about the broad scope of how sleep apnea and ED are related. Everyone that uses PAP therapy to treat sleep apnea should follow his YouTube channel. He is always posting amazing content.
Psychological Or Not Sleep Apnea Related
If you are still experiencing ED and CPAP is working great, inlcuding during REM sleep, your issue might be psychological or something not related to sleep apnea. This would be a good time if you haven’t already to talk with your doctor. There are other testing and treatments your doctor can point you to. Even if it is psychological, there would still be treatments your doctor could recommend.
Professional Medical Care Is Available
In the end, there are lots of men who suffer from both sleep apnea and erectile dysfunction. Even though this can be a sensitive topic, it is important for everyone to remember that professional medical care is available. Obstructive sleep apnea is something that can be treated, and it can significantly improve someone’s overall quality of life.
If you are suffering from issues achieving or sustaining an erection, there is a chance you may be suffering from obstructive sleep apnea as well. Reach out to a doctor today, and make sure you know what your options are. This is not something you have to deal with on your own.