Can Sleep Apnea Cause Erectile Dysfunction?

Some conditions, like sleep apnea, can take a toll on the hormonal balances in your body, leading to problems including erectile dysfunction. In this article, we'll discuss why this happens and what you can do about it.

Man Wearing Cpap Mask While Suffering From Sleep Apnea On Bed At Home

Somsak Bumroongwong / EyeEm / Getty Images

Sleep Disorders and Testosterone 

Sleep plays an important role in your overall physical and mental health. While you sleep, tissues grow and are replenished, and balance is achieved. Sleep deprivation can alter the brain, causing a cascade of problems.

Numerous studies have linked healthy sleep to healthy sex. While sleep deprivation can cause mood and relationship problems, the bigger issue is how sleep disorders can affect the production of hormones like testosterone. Sleep disorders are a leading cause of sexual problems.

Sleep apnea causes you to stop breathing when you are sleeping. When this happens, it may disturb you enough to wake you up completely, but your sleep is usually disturbed whether you fully wake up or not. Testosterone production rises when you fall asleep and peaks during rapid eye movement (REM) sleep. Research points to the fragmented sleep of people who suffer from sleep apnea as being a contributor to sexual problems like erectile dysfunction.

Around 4% of men ages 30–60 experience erectile dysfunction. Erectile dysfunction is more common in men with obstructive sleep apnea (OSA) than those without OSA.

What Is Sleep Hygiene? 

Sleep is especially important as we age since it becomes more difficult for many people to fall asleep and stay asleep. Since poor sleep contributes to a number of problems, including erectile dysfunction, it's important to understand what you can do to promote a good night's sleep.

Sleep hygiene is a general term used to refer to all the elements that can promote a healthy rest. You can practice good sleep hygiene by trying some of the following tips:

  • Have a light snack at bedtime.
  • Avoid stimulants for three to four hours before you want to sleep.
  • Avoid taking naps in the daytime.
  • Exercise regularly, but not within three hours of bedtime.
  • Cut back on stimulation from television and video games before you sleep.
  • Engage in relaxation techniques like meditation when you are ready for bed.
  • Don't use a television, computer, or phone in your bedroom.
  • Try to stick to regular times for going to sleep and waking up.
  • Review your medications with your doctor to see if anything you take may contribute to sleep problems.
  • Try getting out of bed to do a quiet activity if you can't fall asleep for 30 minutes.
  • Avoid alcohol before bedtime.

A good night's sleep can improve your health in many ways, but for men, it can be particularly helpful. Testosterone levels can fluctuate throughout the day and with weight changes, but these levels can also drop naturally with age. Poor sleep and medical problems like sleep apnea may just make the problem even worse.

Symptoms

Symptoms of Sleep Apnea

Sleep apnea is a disorder in which your breathing is interrupted while you sleep. This can happen with obstructive sleep apnea or a problem with your central nervous system's signals (central sleep apnea).

Symptoms can vary based on the severity of your sleep apnea and what type you have, but generally include:

  • Snoring
  • Fatigue
  • Daytime sleepiness
  • Restlessness
  • Difficulty staying asleep
  • Dry mouth or sore throat when you wake up
  • Forgetfulness or irritability
  • Depression
  • Anxiety
  • Night sweats
  • Having to urinate frequently at night
  • Sexual dysfunction
  • Headaches

Symptoms of Erectile Dysfunction

The symptoms of erectile dysfunction are generally straightforward. It's important to note that erectile dysfunction is more often a sign of other problems rather than an isolated issue.

Common symptoms include:

  • Not being able to achieve an erection when you want to
  • Not being able to maintain an erection
  • Not being able to achieve an erection at all

Causes

Causes of Sleep Apnea

The top causes of sleep apnea are obesity and structural obstructions in the throat or nose. The main cause of OSA is obesity, and it is modifiable.

Causes of Erectile Dysfunction

There are a number of things that can cause erectile dysfunction. Like sleep apnea, obesity can be a major contributor to erectile dysfunction. Other causes include:

  • Atherosclerosis (a buildup of plaques in your blood vessels)
  • Obesity
  • Stress
  • Depression
  • Neurological diseases (diseases affecting the nervous system)
  • Injury and other trauma
  • Some prescription medications
  • Alcohol and drug use
  • Smoking

Diagnosis

Sleep apnea and erectile dysfunction are two very different but closely related conditions. Diagnosis for each can involve different blood and clinical tests, but each will start with a discussion with a healthcare professional. If you are experiencing symptoms of either condition, talk to your healthcare provider.

You may be asked questions about your personal, family, and sexual health histories. Beyond that, blood testing may be used to examine the chemical balances in your body. For sleep apnea, your doctor may order sleep studies, while diagnosis for erectile dysfunction is based on tests that examine anatomy and function. This can include X-rays and other imaging studies.

Erectile Dysfunction Doctor Discussion Guide

Doctor Discussion Guide Old Man

Treatment

An accurate diagnosis is the first step toward creating a good treatment plan. If you are diagnosed with erectile dysfunction but continue to have undiagnosed sleep apnea, you may not see much improvement from your erectile dysfunction treatment. In fact, you could begin to experience a number of other issues from untreated sleep apnea, including:

Sleep apnea and erectile dysfunction each has specific treatments, but maintaining a healthy weight and diet can help both. Beyond that, there are a number of medications and devices that can help treat erectile dysfunction, while continuous positive airway pressure (CPAP)—which uses a hose and mask to delivery steady air pressure while you sleep—is the primary treatment for sleep apnea.

While CPAP doesn't treat erectile dysfunction or low testosterone directly, these machines have been linked to an improvement in erectile dysfunction in some people.

Prevention

If you have an anatomical problem that has led to the development of either sleep apnea or erectile dysfunction, there isn't much you can do to prevent these conditions. However, when these conditions develop over time, lifestyle choices play a major role.

Making sure that you exercise regularly and consume a balanced diet to maintain a healthy weight can help prevent both sleep apnea and erectile dysfunction, since both are linked to obesity.

Summary

Sleep apnea causes you to stop breathing while you sleep. It not only can disrupt sleep but also affect testosterone production, which can contribute to erectile dysfunction. Sleep apnea is commonly treated with CPAP, which can help you breathe while you sleep. Research has shown that it may also help with erectile dysfunction.

A Word From Verywell

Sleep apnea and erectile dysfunction are two very different conditions, but the occurrence of the two conditions at the same time in people indicate there is some link. Men with sleep apnea have higher rates of erectile dysfunction, and there are a few explanations for why this can happen. Obesity is one reason, and the impact of sleep deficits on testosterone production is another.

If you are struggling with sleep or with your sexual health, talk to your doctor about ways to improve your sleep quality and address any other conditions that may be contributing to the problem.

Frequently Asked Questions 

What is the link between testosterone and sleep?

Sleep is a vital part of hormonal balance, and testosterone levels rise during sleep. Sleep disruptions, caused by problems like sleep apnea, can lead to a drop in testosterone levels.

Why does lack of sleep cause erectile dysfunction?

As hormone levels drop, testosterone—the male sex hormone—can decrease. Low levels of testosterone are a primary contributor to erectile problems. Lack of sleep can also lead to sexual health problems stemming from mood disturbances or relationship problems.

Do CPAP machines help with low testosterone? 

CPAP machines have not been shown to have an effect on hormone levels like testosterone—at least not directly. What these devices can do is treat sleep apnea and improve sleep quality, which, in turn, can boost hormone levels.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institutes of Health. Symptoms and causes of erectile dysfunction.

  2. Cho JW, Duffy JF. Sleep, Sleep Disorders, and Sexual Dysfunction. World J Mens Health. August 14, 2018;37(3):261-275. doi:10.5534/wjmh.180045

  3. Kim SD, Cho KS. Obstructive Sleep Apnea and Testosterone Deficiency. World J Mens Health. May 16, 2018;37(1):12-18. doi:10.5534/wjmh.180017

  4. Taken K, Ekin S, Arısoy A, Günes M, Dönmez Mİ. Erectile dysfunction is a marker for obstructive sleep apnea. Aging Male. October 25, 2015;19(2):102-5. doi: 10.3109/13685538.2015.1131259.

  5. MedlinePlus. Aging changes in sleep.

  6. Cleveland Clinic. Low testosterone. Updated April 10, 2018.

  7. Cleveland Clinic. Sleep apnea.

  8. Cleveland Clinic. Erectile dysfunction.

  9. Cignarelli A, et al. Effects of CPAP on testosterone levels in patients with obstructive sleep apnea: A meta-analysis study. Front Endocrinol. August 21, 2019;10(551). doi:10.3389/fendo.2019.00551

By Rachael Zimlich, BSN, RN
Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.