The relationship between sleep disorders, quality, and duration and sexual dysfunction: a systematic review and meta-analysis

Associations between the risk of LUTS/BPH and the number and class of chronic diseases among middle-aged and elder men

We explored the associations between the risk of lower urinary tract symptoms suggestive of benign prostatic hyperplasia(LUTS/BPH) and the number and class of chronic diseases via cross-sectional and longitudinal studies.This study included 5197 men aged ≥ 45 years from the China Health and Retirement Longitudinal Study(CHARLS) 2011 with a 7-year follow-up. We multidimensionally investigated the relationships between LUTS/BPH and multimorbidity via latent class analysis, generalized additive analysis and causal mediation analysis. Latent class analysis identified four morbidity classes as follows: minimal or least common diseases (class 1, N = 4160, reference), dominant chronic lung diseases(class 2, N = 152), multiple chronic diseases(class 3, N = 387), and dominant heart diseases or risks(class 4, N = 498). In both the cross-sectional and cohort studies, the risk of LUTS/BPH increased in a dose-dependent manner with the number of chronic diseases. All multivariable-adjusted analyses suggested that three other classes had significantly greater risks of LUTS/BPH than did class 1. In the cross-sectional study, the risk of LUTS/BPH increased by 3.19 times(95%CI: 2.41 to 4.21) in class 3 than in class 1. Causal mediation analyses revealed that depression significantly mediated the association between LUTS/BPH and multimorbidity. Our results suggest that both the number and class of chronic diseases significantly affect the risk of LUTS/BPH.

Socio-Demographic, Nutritional, and Lifestyle Factors Influencing Perceived Sleep Quality in Spain, with a Particular Focus on Women and Young People

Objectives: This study examines the relationship between nutrition, lifestyle habits, and perceived sleep quality in a cross-sectional analysis of 22,181 Spanish adults. Methods: Data were collected between August 2020 and November 2021 using the Nutritional and Social Healthy Habits (NutSo-HH) questionnaire, which assessed variables such as sleep duration, self-perceived restfulness, dietary patterns, and physical activity. Results: Findings indicate that 48.9% of participants sleep 7-8 h per night, while 8.6% sleep less than 6 h. Approximately 50% report frequently feeling rested, whereas 45.4% seldom or sometimes feel rested. Non-parametric Mann-Whitney and Kruskal-Wallis tests with Dwass-Steel-Critchlow-Fligner (DSCF) correction revealed that perceived sleep quality had an average score of 3.39 on a 0-5 scale, with significant differences based on socio-demographic and lifestyle factors (p < 0.001 for sex, age, education, income, and living in a family). Participants with sufficient sleep reported a lower BMI, a higher nutritional index, and more weekly physical activity. A network analysis demonstrated strong clustering between sleep variables and eating behaviors. Although causality cannot be established in this observational study, the results suggest that better sleep is associated with the lower consumption of sugary drinks and ultra-processed foods, as well as improved body image and mental health. Conclusions: These findings highlight the interconnectedness of sleep, nutrition, and lifestyle habits, suggesting that targeted interventions in any of these areas could positively influence the others, ultimately improving overall health outcomes.

Investigating the relationship between prenatal androgen exposure and sleep quality: a comprehensive study using anthropometric measurements, questionnaires, actigraphy, and polysomnography

Background

The 2D:4D digit ratio (DR), representing the relative length of the index finger to the ring finger, is an anthropometric marker that shows sexual dimorphism, with males typically having a lower ratio than females. This parameter is linked to prenatal androgen exposure (PAE), which influences sexual differentiation of the brain and behavior. This study aimed to investigate the correlation between PAE and sleep among young adults.

Methods

Anthropometric measurements were used to assess PAE, while sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), actigraphy, and polysomnography (PSG). Data was collected from 720 participants via surveys, with 290 completing all questionnaires. Of these, 138 underwent anthropometric measurements, and 38 were further recruited for actigraphy, PSG.

Results

Men exhibited a lower 2D:4D ratio than women, indicating higher PAE. The average PSQI score was 6.94 ± 2.98, and the MEQ score was 35.43 ± 19.59, with no significant gender differences in sleep quality or chronotype. Low PAE was associated with better sleep efficiency and a morning chronotype, but worse sleep quality in males. Actigraphy results showed no significant differences based on PAE. PSG data revealed that males with longer 2nd fingers and higher 2D:4D ratios were more likely to suffer from mild sleep apnea, a pattern not observed in women. PAE did not significantly impact other sleep architecture parameters.

Conclusions

PAE, indicated by the 2D:4D ratio, is linked to sleep efficiency and chronotype, with significant gender differences. Men with lower PAE exhibited poorer sleep quality, and those with certain finger length patterns were more prone to mild sleep apnea. These findings underscore the potential long-term impacts of PAE on sleep health and emphasize the need for further research into gender-specific sleep regulation mechanisms.

Relationship between triglyceride levels and different snoring states: a systematic review and meta-analysis

OBJECTIVE

High triglyceride (TG) levels are important risk factors for cardiovascular disease (CVD). Some recent studies have shown that snoring is also closely related to elevated TG levels. The specific pathogenesis of elevated TG levels in snoring patients is still unclear. Therefore, we performed this meta-analysis to evaluate the relationship between snoring and elevated TG levels.

MATERIALS AND METHODS

A systematic search was conducted in four online electronic databases as of Jul 1, 2024. The standardized mean difference (SMD) and corresponding 95% confidence interval (CI) for TG levels in each study were pooled. Moreover, we performed subgroup analysis according to snoring status and body mass index (BMI). All the data were pooled and analysed with Review Manager 5.3.

RESULTS

The meta-analysis included five studies with 39,102 participants. Our results revealed that snoring was associated with elevated TG levels, with a pooled SMD of 0.23 (95% CI 0.14 to0.32; P < 0.00001). We found that occasional snoring and habitual snoring were associated with high TG levels, with pooled SMD of 0.26 (95% CI 0.04to0.49; P = 0.002) and 0.29 (95% CI 0.16to0.43; P < 0.0001), respectively. According to the subgroup analysis of BMI, BMI < 25 kg/m2 and BMI ≥ 25 kg/m2 were associated with increased TG levels, with pooled SMD of 0.13 (95% CI 0.04 to 0.22; P = 0.004) and 0.24 (95% CI 0.10 to 0.39; P = 0.0007), respectively.

CONCLUSIONS

Our meta-analysis revealed that both occasional and habitual snoring were associated with elevated TG levels. More importantly, our findings also revealed that the relationship between snoring-induced elevated TG levels and BMI was fragile.

Mechanisms of erectile dysfunction induced by aging: A comprehensive review

BACKGROUND

With the increasing trend ofpopulation aging, erectile dysfunction (ED) among elderly men has emerged as apressing health concern. Despite extensive research on the relationship betweenED and aging, ongoing discoveries and evidence continue to arise.

OBJECTIVE

Through this comprehensiveanalysis, we aim to provide a more nuanced theoretical framework for thedevelopment of preventive and therapeutic strategies for senile ED, ultimatelyenhancing the quality of life for elderly men.

METHODS

This review delves deeper into thecore mechanisms underlying ED in the context of aging and offers acomprehensive overview of published meta-analyses and systematic reviewspertinent to these conditions.

RESULTS AND CONCLUSION

Our findings revealthat local structural damage to the penis, vascular dysfunction, neuronalinjury, hormonal alterations, other physiological changes, and psychologicalbarriers all play pivotal roles in the pathogenesis of aging-related ED.Furthermore, more than 20 diseases closely associated with aging have beenimplicated in the occurrence of ED, further compounding the complexity of thisissue.

Prevalence of sexual dysfunction in health care workers: a systematic review and meta-analysis

INTRODUCTION

Health care workers represent a substantial demographic whose welfare and work efficiency are crucial to public health and societal well-being. However, the prevalence of sexual dysfunction within this group is often overlooked, despite its significant occurrence.

OBJECTIVE

To evaluate the worldwide prevalence of sexual dysfunction among health care workers.

METHODS

A comprehensive systematic review and meta-analysis of observational studies ranging from 2003 to 2023 were performed to compile prevalence estimates of sexual dysfunction among health care workers. A random effects model was implemented to amalgamate the prevalence analysis. Study heterogeneity was discerned by I2 and χ2 statistics. To assess potential publication bias, an Egger's test and a funnel plot were employed.

RESULTS

This meta-analysis incorporated 39 studies from 16 countries, encompassing 44 017 health care workers. The pooled prevalence of sexual dysfunction among health care workers was 46.79% (95% CI, 38.09%-55.68%), with a slightly higher prevalence of 49.57% (95% CI, 38.18%-61.01%) among clinical health care workers. The most prevalent forms of sexual dysfunction identified were loss of libido (51.26%), erectile dysfunction (36.99%), sexual dissatisfaction (36.90%), pain during intercourse (28.23%), orgasmic disorders (25.13%), low sexual arousal (23.54%), and lubrication disorders (22.62%). Among various health care professions, nurses exhibited the highest prevalence of sexual dysfunction (56.29%), followed by doctors (37.63%) and other health care workers (24.96%). Additionally, female health care workers experienced a higher prevalence of sexual dysfunction (47.61%) as compared with their male counterparts (32.01%).

CONCLUSION

This study indicates that nearly half of health care professionals report experiencing sexual dysfunction, with loss of libido being the most common manifestation. Addressing this issue requires a multistakeholder approach.

Causal associations between prostate diseases, renal diseases, renal function, and erectile dysfunction risk: a 2-sample Mendelian randomization study

BACKGROUND

Previous observational studies have found a potential link between prostate disease, particularly prostate cancer (PCa), and kidney disease, specifically chronic renal disease (CKD), in relation to erectile dysfunction (ED), yet the causal relationship between these factors remains uncertain.

AIM

The study sought to explore the potential causal association between prostate diseases, renal diseases, renal function, and risk of ED.

METHODS

In this study, 5 analytical approaches were employed to explore the causal relationships between various prostate diseases (PCa and benign prostatic hyperplasia), renal diseases (CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, and kidney ureter calculi), as well as 8 renal function parameters, with regard to ED. All data pertaining to exposure and outcome factors were acquired from publicly accessible genome-wide association studies. The methods used encompassed inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode residual sum and outlier techniques. The MR-Egger intercept test was utilized to assess pleiotropy, while Cochran's Q statistic was employed to measure heterogeneity.

OUTCOMES

We employed inverse variance weighting MR as the primary statistical method to assess the causal relationship between exposure factors and ED.

RESULTS

Genetically predicted PCa demonstrated a causal association with an elevated risk of ED (odds ratio, 1.125; 95% confidence interval, 1.066-1.186; P < .0001). However, no compelling evidence was found to support associations between genetically determined benign prostatic hyperplasia, CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, kidney ureter calculi, and the renal function parameters investigated, and the risk of ED.

CLINICAL IMPLICATIONS

The risk of ED is considerably amplified in patients diagnosed with PCa, thereby highlighting the importance of addressing ED as a significant concern for clinicians treating individuals with PCa.

STRENGTHS AND LIMITATIONS

This study's strength lies in validating the PCa-ED association using genetic analysis, while its limitation is the heterogeneity in study results.

CONCLUSION

The results of this study suggest a potential link between PCa and a higher risk of ED.

Relationship of insomnia to sexual function and sexual satisfaction: Findings from the sleep and sex survey II

OBJECTIVE

Research suggests that healthy sleep is a key component of sexual function. When evaluating sexual function, however, poor sleep is often overlooked as a contributing factor. This cross-sectional survey expands prior work by exploring relationships among insomnia severity, sexual satisfaction, and sexual function with an updated battery of measures for the Sleep and Sex Survey.

METHOD

The sample (N = 1266) consisted of 618 men, 648 women recruited via Prolific, an online survey platform. The Sleep and Sex Survey II included measures addressing insomnia, fear of sleep, nightmares, sexual function, sexual satisfaction, sexual activity, depression, anxiety, posttraumatic stress, and alcohol use.

RESULTS

Recent sexual activity was correlated with better sleep, lower anxiety, and lower scores on a posttraumatic stress disorder screener. Insomnia severity was negatively correlated with sexual satisfaction (r = 0.22, p < .001) and the presence of insomnia was associated with higher rates of sexual dysfunction in women (53.8% vs. 31.8%; p < .001) and men (22.7% vs. 12.5%; p = .036). In regression analyses, after accounting for depression and anxiety, insomnia had a statistically significant association with sexual function for women (β = 0.12; p < .01) but not men (β = 0.11; p = .60).

CONCLUSION

Findings support a relationship of insomnia to sexual function and satisfaction with some gender differences. Future work may be enhanced by assessing these relationships in a gender diverse population including objective sleep measures and addressing contributing mechanisms. Clinically, findings support the assessment of sleep when evaluating patients for sexual dysfunction.