Sleep disorders and male sexual dysfunction: a meta-analysis of hormonal and erectile outcomes.

Authors

Muath Almurayyi, Saad Thamer Alshahrani, Waleed Ibrahim Alshardi, Mohammed Ali Alshahrani, Abdullah Ali Asiri, Kheder Mabrook ALGhamdi, Mohammed Abdulrahman Alhifthi, Mana Alshahrani, Omar Safar

Published in

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. Pages 15659. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

Sleep disruptions, including insomnia and obstructive sleep apnea (OSA), are strongly linked to male sexual dysfunction, affecting libido, erectile function, and hormonal balance. This metaanalysis aimed to evaluate the relationship between sleep disorders and male sexual function.
A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect through September 2025 identified 9 peer-reviewed studies examining the impact of sleep disorders on male sexual health. The Newcastle-Ottawa Scale was used to assess the risk of bias. A meta-analysis was performed to evaluate outcomes, including the International Index of Erectile Function (IIEF), testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels, with a subgroup analysis comparing OSA and shift work sleep disorder (SWSD). Statistical analyses were conducted using R version 4.2.2.
Across seven studies (n = 913), the pooled mean IIEF score was approximately 16, indicating moderate erectile dysfunction, though heterogeneity was high (I² = 97.3%). Subgroup analysis revealed lower IIEF scores in OSA patients (≈14.4) compared to SWSD patients (≈17.5), suggesting more severe dysfunction in OSA. Hormonal analysis (n = 325) showed significantly lower testosterone levels in OSA (≈7-9 nmol/L) versus SWSD (≈20 nmol/L). FSH and LH were elevated in OSA (≈3.8-5.8 IU/L and 3.3-3.9 IU/L, respectively) compared to SWSD (≈2.2 IU/L and 1.8 IU/L). High heterogeneity indicated substantial variation in study design and populations.
Both OSA and SWSD impair sexual and hormonal function, but OSA causes greater erectile and endocrine disruption. Even mild OSA was associated with reduced erectile performance, with the severity worsening dysfunction. Despite consistent trends, high heterogeneity warrants cautious interpretation. Future research should employ standardized tools and uniform populations to clarify mechanisms linking sleep disorders to male sexual health.

PMID:
42707009
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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