Does Obstructive Sleep Apnea cause Sexual Dysfunction?

Sleep disordered breathing (SDB) has the potential to cause sleep deprivation, fatigue, stress, and remains a potential cause of erectile dysfunction in men, as the effect on the normal production of  testosterone during healthy sleep which can result in poor erections and decreased libido.

Sexual dysfunction in men

Adequate oxygenation is also important for healthy erections, so any deficiency can cause a problem – although it is more likely that the effect on the walls of the blood vessels (endothelial lining) causing blood vessel constriction (vasoconstriction) decreasing blood flow. That’s how Viagra works – it increases blood flow by vasodilation (blood vessel relaxation).

Quick recap – the stimulation of the autonomic nervous system, which influences the penile blood vessels, causes the erection.

The parasympathetic nervous system (relaxing) is pro-erectile; the sympathetic nervous system (fight or flight) is anti-erectile. Sexual function, as we all know, is a complex matter anyway.

Hormone, chemical, nerves and transmitters (nitric oxide and acetylcholine), modulators, reflexes and psychology all play parts in the big picture.

Ejaculation itself is a process involving sympathetic and parasympathetic effects during different stages – emission and ejection.

Some conditions of ejaculation dysfunction are associated with autonomic nerves. However, the exact effects of autonomic nerves on ejaculation are not well defined.

Autonomic agonists induce different recorded trace patterns of seminal vesicular contraction. The different traces contain different components of phasic and tonic contraction, which may have physiological implications too.

Suffice it to say that while this is a complex subject, the effects of obstructive sleep apnea all stack the cards against you. Either the sleep deprivation as a result of fragmented sleep leading to tiredness, irritability and loss of libido – or the potential effects of sleep apnea on a man’s testosterone levels to dip – It may also restrict oxygen and even potentially affect nitric oxide.


Good sleep is crucial to good health and longevity.

Dr. Stephen Bray 2019

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