Tuesday, August 26, 2014

Impotence and Sleep Apnea

Thus far, I've written quite a bit on the subject of obstructive sleep apnea (OSA). I've described many sequelae resulting from OSA. Some of these include diabetes, hypertension, obesity and many others. There are so many medical problems that are directly attributable to OSA and are therefore impossible to list them all here. Please read my other blogs regarding this topic to get a more thorough perspective on the subject.

This week I will discuss the link between OSA and impotence or erectile dysfunction (ED). Men that suffer from sleep apnea are twice as likely to experience ED. There are many potential reasons. We will focus our discussion on two major reasons. 

  • Vasculature to the penis
  • Hormonal regulation
Vasculature to the penis

Blood oxygen levels should be as close to 100% as possible. We start to worry when a person starts to drop into the low 90's. Amazingly, I've seen some of my patients drop into the 60's! They are dying every single night!

Sleep apnea decreases blood oxygenation levels. We have known for years that chronic low blood oxygenation levels adversely affects the vasculature of many organ systems such as the heart, lungs, kidneys, liver and brain. 

In the case of ED, the vasculature of the penis is greatly diminished. In order to have an erection, blood must flow to the penis. After many years of vascular damage from diabetes, hypertension and/or high cholesterol, the effects are quite predictable. By the way, I have written about these links (with sleep apnea) as well. There are many complicated interconnections with these disease processes.

Hormonal Regulation

Testosterone, estrogen and many other hormones are best regulated when we get into the deeper levels of sleep. A person that suffers from sleep apnea has difficulty getting to the deeper levels of sleep.

In order to have an erection, sex hormones must be finely regulated. We believe that when a person sleeps, at least 20% of the night should be at the REM (rapid eye movement) level. Just the other day, one of my patients was only there for approximately 1.7% of the night! That was the lowest I've seen with my patients. I was amazed.

Another consideration in the lack of testosterone is a decreased sex drive. No sex drive……no sex.


Fortunately, when sleep apnea is treated, a high percentage of men have their ED resolved. In fact, many couples report a significant increase in the frequency and quality of sex.

Women, pay attention……even though this blog was about men, women that suffer from sleep apnea also suffer from sexual dysfunction.

It is important to know that if you or a loved one has experienced ED, it certainly is a problem. But, please be aware that this may be the least of your worries since it may only be a warning sign for many more serious and potentially lethal medical conditions.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit www.advanced-smiles.com

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