Has your partner ever complained that you snore loudly? Just like erectile dysfunction, you shouldn’t sweep this under the drug! Snoring is the first sign of sleep apnoea, a condition that reduces quality of life and may lead to mortality. It’s so pervasive that even your erection isn’t spared. To rectify this, let’s unpack the connection between sleep apnoea and erectile dysfunction.
An Overview of Sleep Apnea
Sleep apnea is a condition wherein you stop breathing in the middle of sleep. It can be because of a literal blockage or ‘obstruction’ in your airway hence the name obstructive sleep apnea (OSA). It can also be due to a neurological issue where your brain is unable to transmit the signals needed for you to breathe as in the case of central sleep apnea (CSA). Some individuals have both factors present which classifies them under mixed sleep apnea (MSA), but most men experience OSA.
Regardless of cause, all types of sleep disorder share the same symptoms which are:
- Loud snoring
- Long pauses when breathing
- Disrupted sleep
- Shortness of breath upon waking
- Headaches
- Irritable mood
- Mental fog
- Constant fatigue
- Restlessness
- Low libido
- Erectile dysfunction (ED)
How Sleep Apnoea Causes Erectile Dysfunction
As you’ve noticed in the previous section, erectile dysfunction (ED) is listed as a symptom of OSA/CSA. This is because these can directly cause ED through these factors:
Low Testosterone
A restful night of sleep is needed to regulate testosterone which is crucial for all male sexual function (not just erection). Did you know that your testosterone tends to be at its highest after you’ve just woken up? However, if a man has OSA/CSA/MSA, there’s lesser testosterone. This is because the circadian rhythm affects testosterone production. Instead, what spikes is cortisol, the stress hormone. Cortisol and testosterone have an inverse relationship which means the higher your cortisol levels, the lesser your circulating testosterone will be.
Chronic Inflammation
Since you’re constantly flooded with testosterone and your immune system is unable to properly do its job when you sleep (it becomes naturally active at night), you get chronic inflammation. This means that you are experiencing persistent widespread inflammation. Just like stress, inflammation has its purpose. But when it becomes prolonged, you start to develop chronic diseases that can be dangerous. A lot of chronic diseases can cause ED. In fact, chronic inflammation alone can weaken erections.
Cardiovascular Toll
Cortisol and inflammation are known to raise blood pressure, but the cardiovascular issues caused by OSA/CSA do not stop at that. Heart failure, stroke, and atrial fibrillation (irregular heartbeat) are all connected to OSA/CSA. This is because of the blood pressure and frequent dips in blood oxygen levels that strain the heart. Note that blood flow is one of the most crucial components of the erectile process. This means that having a cardiovascular disease predisposes you to ED.
Nerve Damage
Inflammation and excess cortisol can lead to oxidative stress which can damage the nerves. Hypoxia, which happens due to oxygen deprivation, can also kill your nerves. If your nervous system isn’t working properly, your erections may suffer as a result. Blood can’t fill the corpora cavernosa if the brain is unable to properly signal your reproductive system to jump start the erectile process. Often, your erectile strength is the first casualty of a progressed cardiovascular or nerve issue.
Obesity
Obesity is one of the conditions that can cause OSA. Excess fat around the neck and abdomen can put pressure in your airways. It also indirectly worsens OSA by limiting your chest expansion when you’re breathing which means your lung can’t effectively supply oxygen to your blood. Obesity also triggers chronic inflammation which can exacerbate the effects of OSA. Just like OSA, obesity can also lead to ED by itself. Men with obesity are also likely to have the metabolic syndrome which can lead to metabolic diseases like diabetes, kidney disease, and liver disease.
Smoking & Drinking
Cigarettes and alcohol are often the top culprits in most disorders, not just OSA/CSA and ED. Both contain toxins that cause cellular damage (and increase your risk of cancer). Cigarettes cause massive inflammation that can make your upper airways swell which means air can’t pass properly while alcohol depresses your nervous system. If you have CSA, alcohol consumption is going to exacerbate it since your brain is already struggling with sending nerve signals. Nicotine and alcohol are also muscle relaxants which may affect your throat and contribute to more constriction.
Managing Sleep Apnoea and Erectile Dysfunction
Now that you understand the intricate connection between OSA/CSA and ED, it’s time to take action. We’ve crafted a step-by-step strategy to serve as your gentle guide in tackling both OSA/CSA and ED:
- Do a sleep test – the best way to diagnose OSA or CSA is to get a polysomnography, an overnight sleep test. While there are at-home tests available, they don’t monitor your brain which means you won’t be able to determine whether you have CSA or not. A polysomnography comes with sensors that track your heartbeat, oxygen levels, breathing, and brain waves. But at-home tests can be useful for ruling out OSA paired with video recordings of your breathing while asleep.
- Treat OSA/CSA first – once you have confirmed that you have either OSA, CSA or MSA, you should focus on treating this underlying condition first. Even if you use Viagra, it may not be able to fully negate the sexual consequences of being constantly sleep deprived. Not to mention, not being able to breathe properly can become lethal. This means, you must strictly follow the treatment plan of your doctor. Depending on your case, you may need a continuous positive airway machine (CPAP) or mouth guards while you sleep.
- Maintain sleep hygiene – while it’s true that OSA and CSA are caused by physical issues, there’s no harm in doing what you can to improve your sleep apart from the treatment. Even without a sleeping disorder, if you don’t have proper sleep hygiene, you may still end up struggling to fall asleep on time leading to a disrupted body clock or poor quality sleep. To start, you can eliminate blue light an hour before sleeping and wind down with relaxing ambient sounds or chamomile tea. Make sure you sleep in a dark cool room.
- Manage underlying conditions – CSA/OSA have multiple causes but some of them are other diseases. Being obese can cause excess weight around your neck area making it likelier for your upper airway to collapse and cause blocked breathing as you sleep. While you can use breathing assistance tools, coordinating with your doctor to lose weight will be more sustainable and better for both your sleep and overall health. CSA/OSA and ED also have cardiovascular issues as a shared risk which means, if this is your case, treating this may alleviate both.
- Have a healthy lifestyle – treatments become more effective when paired with a healthy lifestyle. Since some of the causes of CSA/OSA and ED are conditions that may be triggered by unhealthy choices, it’s best to eliminate this variable. This means it will be beneficial if you follow the right kind of diet. Stick to whole vegetables and fruits. Have a balanced mix of meat and seafood. If you can, pick organic meat. For beef, you’d want to see “pasture-raised” and “grass-fed” on the label. You may even opt to cultivate herbs and spices at home ensuring nutrition and freshness.
- Talk to a therapist – OSA/CSA and ED can lead to mental disorders. Always lacking sleep will mess the balance of your neurotransmitters and hormones. It will make you prone to negative mood swings and a shorter temper which can trigger conflicts furthering emotional dysregulation. ED can also be a source of misunderstanding between partners. To handle all this along with whatever struggle you may experience on the road to recovery, talking to an experienced therapist will help. They’ll be able to teach you how to cope and process better while steering you away from choices that lead to self-sabotage.
- Consult with ED specialists – while treating OSA/CSA is the priority, this doesn’t mean that you have no choice but to endure the effects of ED. Our trained ED specialists can provide complementary support to your sexual health as you go through with your OSA/CSA treatment. And since we use a comprehensive approach, we can also help identify and address other hidden causes of your erectile difficulties. We’ll also be happy to collaborate with your existing medical team to design the best ED treatment for you!
Conclusion
Snoring tends to be overlooked but it can be a sign of serious conditions like sleep apnoea which inhibits erection.
While OSA/CSA and ED can be dangerous when allowed to progress, they’re also all treatable. So, if you think you may have OSA/CSA, please speak to your general physician ASAP. And, to prevent your ED from getting worse, please book a FREE appointment with us.
Our team of ED experts will conduct a thorough examination to uncover everything that’s harming your sexual health and provide you with a tailored erectile rehabilitation plan!
