The role of sleep stages in the regulation of erectile function: impacts of REM sleep fragmentation

Irwin GM. Erectile dysfunction. Prim Care. 2019;46:249–55.

Article  PubMed  Google Scholar 

Andersson KE. Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev. 2011;63:811–59.

Article  PubMed  CAS  Google Scholar 

Schmidt MH, Schmidt HS. Sleep-related erections: neural mechanisms and clinical significance. Curr Neurol Neurosci Rep. 2004;4:170–8.

Article  PubMed  Google Scholar 

Schardein JN, Gross K. Nocturnal penile tumescence devices: past, present and future. Int J Impot Res. 2024;36:693–9.

Article  PubMed  Google Scholar 

Hirshkowitz M, Moore CA, O’Connor S, Bellamy M, Cunningham GR. Androgen and sleep-related erections. J Psychosom Res. 1997;42:541–6.

Article  PubMed  CAS  Google Scholar 

Giuliano F, Rampin O. Neural control of erection. Physiol Behav. 2004;83:189–201.

Article  PubMed  CAS  Google Scholar 

Hirshkowitz M, Moore CA. Sleep-related erectile activity. Neurol Clin. 1996;14:721–37.

Article  PubMed  CAS  Google Scholar 

Siegel JM. The neurobiology of sleep. Semin Neurol. 2009;29:277–96.

Article  PubMed  PubMed Central  Google Scholar 

Karacan I, Hursch CJ, Williams RL, Thornby JI. Some characteristics of nocturnal penile tumescence in young adults. Arch Gen Psychiatry. 1972;26:351–6.

Article  PubMed  CAS  Google Scholar 

Alvarenga TA, Fernandes GL, Bittencourt LR, Tufik S, Andersen ML. The effects of sleep deprivation and obstructive sleep apnea syndrome on male reproductive function: a multi-arm randomised trial. J Sleep Res. 2023;32:e13664.

Article  PubMed  Google Scholar 

Walia AS, Lomeli LJM, Jiang P, Benca R, Yafi FA. Patients presenting to a Men’s Health clinic are at higher risk for depression, insomnia, and sleep apnea. Int J Impot Res. 2019;31:39–45.

Article  PubMed  Google Scholar 

Adami LNG, Moysés-Oliveira M, Souza-Cunha LA, Vasco MB, Tufik S, Andersen ML. Lipid metabolism and neuromuscular junction as common pathways underlying the genetic basis of erectile dysfunction and obstructive sleep apnea. Int J Impot Res. 2023;36:614–20.

Article  PubMed  Google Scholar 

Shin HW, Rha YC, Han DH, Chung S, Yoon IY, Rhee CS, et al. Erectile dysfunction and disease-specific quality of life in patients with obstructive sleep apnea. Int J Impot Res. 2008;20:549–53.

Article  PubMed  Google Scholar 

Nebioğlu A, Başaranoğlu M, Çayan S Impact of sleep quality and chronotype on self-reported erectile function in young adults presenting with erectile complaints: a prospective observational study. Int J Impot Res. https://doi.org/10.1038/s41443-025-01089-4 2025.

Belladelli F, Li S, Zhang CA, Del Giudice F, Basran S, Muncey W, et al. The Association Between Insomnia, Insomnia Medications, and Erectile Dysfunction. Eur Urol Focus. 2024;10:139–45.

Demirci A, Hızlı F, Hamurcu HD, Başar H. Erectile dysfunction, anxiety, perceived stress, and insomnia are more common among acquired premature ejaculation patients compared to other premature ejaculation syndromes. Andrology. 2023;11:425–32.

Andersen ML, Alvarenga TF, Mazaro-Costa R, Hachul HC, Tufik S. The association of testosterone, sleep, and sexual function in men and women. Brain Res. 2011;1416:80–104.

Article  PubMed  CAS  Google Scholar 

Andersen ML, Antunes IB, Silva A, Alvarenga TA, Baracat EC, Tufik S. Effects of sleep loss on sleep architecture in Wistar rats: gender-specific rebound sleep. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:975–83.

Article  PubMed  CAS  Google Scholar 

Alvarenga TA, Hirotsu C, Mazaro-Costa R, Tufik S, Andersen ML. Impairment of male reproductive function after sleep deprivation. Fertil Steril. 2015;103:1355–62.e1.

Article  PubMed  Google Scholar 

Trinder J, Kleiman J, Carrington M, Smith S, Breen S, Tan N, et al. Autonomic activity during human sleep as a function of time and sleep stage. J Sleep Res. 2001;10:253–64.

Article  PubMed  CAS  Google Scholar 

Saenz de Tejada I, Blanco R, Goldstein I, Azadzoi K, de las Morenas A, Krane RJ, et al. Cholinergic neurotransmission in human corpus cavernosum. I. Responses of isolated tissue. Am J Physiol. 1988;254:H459–67.

PubMed  CAS  Google Scholar 

Zhang Y, Zhang W, Feng X, Liu G, Wu X, Jiang H, et al. Association between sleep quality and nocturnal erection monitor by RigiScan in erectile dysfunction patients: a prospective study using fitbit charge 2. Basic Clin Androl. 2023;33:31.

Article  PubMed  PubMed Central  Google Scholar 

Johnson M, McNeillis V, Gutbier J, Eaton A, Royston R, Johnson T, et al. Differences in polysomnographic, nocturnal penile tumescence and penile doppler ultrasound findings in men with stuttering priapism and sleep-related painful erections. Int J Impot Res. 2022;34:603–9.

Article  PubMed  Google Scholar 

Cho JW, Duffy JF. Sleep, sleep disorders, and sexual dysfunction. World J Mens Health. 2019;37:261–75.

Article  PubMed  Google Scholar 

Maas R, Schwedhelm E, Albsmeier J, Böger RH. The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular function. Vasc Med. 2002;7:213–25.

Article  PubMed  Google Scholar 

de Souza ILL, Ferreira EDS, Vasconcelos LHC, Cavalcante FA, da Silva BA. Erectile dysfunction: key role of cavernous smooth muscle cells. Front Pharmacol. 2022;13:895044.

Article  PubMed  PubMed Central  Google Scholar 

Andersen ML, Tufik S. The effects of testosterone on sleep and sleep-disordered breathing in men: its bidirectional interaction with erectile function. Sleep Med Rev. 2008;12:365–79.

Article  PubMed  Google Scholar 

Babcock MC, DuBose LE, Witten TL, Stauffer BL, Hildreth KL, Schwartz RS, et al. Oxidative stress and inflammation are associated with age-related endothelial dysfunction in men with low testosterone. J Clin Endocrinol Metab. 2022;107:e500–e14.

Article  PubMed  PubMed Central  Google Scholar 

Begum M, Choubey M, Tirumalasetty MB, Arbee S, Sadik S, Mohib MM, et al. Exploring the molecular link between diabetes and erectile dysfunction through single-cell transcriptome analysis. Genes (Basel). 2024;15:1596.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Zhang Y, Su M, Liu G, Wu X, Feng X, Tang D, et al. Chronic sleep deprivation induces erectile dysfunction through increased oxidative stress, apoptosis, endothelial dysfunction, and corporal fibrosis in a rat model. J Sex Med. 2024;21:1098–110.

Article  PubMed  CAS  Google Scholar 

Lee DS, Choi JB, Sohn DW. Impact of sleep deprivation on the hypothalamic-pituitary-gonadal axis and erectile tissue. J Sex Med. 2019;16:5–16.

Article  PubMed  Google Scholar 

Dewan NA, Nieto FJ, Somers VK. Intermittent hypoxemia and OSA: implications for comorbidities. Chest. 2015;147:266–74.

Article  PubMed  PubMed Central  Google Scholar 

Badran M, Gozal D. Intermittent hypoxia as a model of obstructive sleep apnea: present and future. Sleep Med Clin. 2025;20:93–102.

Article  PubMed  Google Scholar 

Soukhova-O’Hare GK, Shah ZA, Lei Z, Nozdrachev AD, Rao CV, Gozal D. Erectile dysfunction in a murine model of sleep apnea. Am J Respir Crit Care Med. 2008;178:644–50.

Article  PubMed  PubMed Central  Google Scholar 

Campillo N, Falcones B, Montserrat JM, Gozal D, Obeso A, Gallego-Martin T, et al. Frequency and magnitude of intermittent hypoxia modulate endothelial wound healing in a cell culture model of sleep apnea. J Appl Physiol (1985). 2017;123:1047–54.

Article  PubMed  CAS  Google Scholar 

Matthews BJ, Crutchfield MB. Painful nocturnal penile erections associated with rapid eye movement sleep. Sleep. 1987;10:184–7.

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