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Andersen ML, Lavigne G, Dal Fabbro C, Tufik S. Erectile dysfunction and sleep related bruxism: An exploratory review of an improbable association. Sleep Med Rev 2024; 77:101970. [PMID: 38964237 DOI: 10.1016/j.smrv.2024.101970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/26/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
The World Health Organization recognizes sexual health as not merely the absence of disease, but a state of physical, mental, and social well-being in relation to one's sexuality. Achieving sexual satisfaction is pivotal for many individuals, as it significantly contributes to their quality of life. Among various sexual disorders, erectile dysfunction (ED) is notably prevalent, affecting an estimated 10-20 million men in the United States alone. This condition impacts not just the person experiencing it but also significantly influences their intimate connections with partners. Although the causes of ED are multifactorial, recent research highlights a compelling association between sleep disorders, such as sleep deprivation, obstructive sleep apnea (OSA), and insomnia, and the incidence of ED. Furthermore, engaging in night work has been observed to exacerbate the risk of developing ED. One common sleep disorder, sleep related bruxism (SRB), despite its prevalence, has not generally been associated with ED. However, there is some interesting evidence hinting at a potential relationship, including a few studies reporting a high prevalence of ED in individuals with SRB. This review delves into the epidemiological, etiological, and mechanistic links between ED and SRB, aiming to uncover potential intersections between these two conditions. These insights could pave the way for innovative research avenues, possibly exploring treatments like vasodilation medication, that might concurrently address both ED and SRB.
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Affiliation(s)
- Monica Levy Andersen
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil.
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Cibele Dal Fabbro
- Sleep Institute - São Paulo, Brazil; Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Sergio Tufik
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil
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Gutierrez-Velarde P, Valladares-Garrido MJ, Peralta CI, Vera-Ponce VJ, Grandez-Urbina JA. Poor sleep quality and erectile dysfunction in students from a Peruvian University: A cross-sectional study. Front Public Health 2023; 11:932718. [PMID: 36817877 PMCID: PMC9928877 DOI: 10.3389/fpubh.2023.932718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
Objective We aimed to evaluate the association between sleep quality and erectile dysfunction in young university students. Methods A cross-sectional survey was conducted in men aged 18-30 years from Universidad Ricardo Palma, Lima, Peru. The survey comprised the International Index of Erectile Function, Pittsburgh Sleep Quality Index, Berlin questionnaire, and questions related to sociodemographic data. Prevalence ratios were estimated with generalized linear models. Results Of 381 participants, the median age was 23 years. Half of the students (50.9%) had poor sleep quality, of which 72.7% had mild erectile dysfunction and 20.6% mild to moderate dysfunction. Prevalence of erectile dysfunction was significantly higher in students with poor sleep quality than in students with good sleep quality (aPR = 6.48; 95% CI: 4.58-9.17) after adjusting for age, academic year, nutritional status, and sleep apnea. In a subsequent exploratory analysis, sleep apnea was associated with a higher prevalence of erectile dysfunction (aPR = 1.19; 95% CI: 1.01-1.39), while overweight (aPR = 0.85; 95% CI: 0.76-0.95) and obesity (aPR = 0.65; 95% CI: 0.52-0.82) were associated with a lower prevalence of this condition. Conclusion Poor sleep quality was independently associated with erectile dysfunction in young university students. This finding suggests that male students are at risk for sexual problems due to possible academic demands and relationship issues.
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Affiliation(s)
| | - Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru,Epidemiology Office, Hospital Regional Lambayeque, Chiclayo, Peru,*Correspondence: Mario J. Valladares-Garrido ✉
| | - C. Ichiro Peralta
- School of Medicine, Universidad Nacional Federico Villarreal, Lima, Peru,C. Ichiro Peralta ✉
| | - Victor J. Vera-Ponce
- Facultad de Medicina, Instituto de Investigación en Ciencias Biomédicas de la Universidad Ricardo Palma, Lima, Peru,Universidad Tecnológica del Perú, Lima, Peru
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Peng J, Zhang J, Wang B, He Y, Lin Q, Fang P, Wu S. The relationship between sleep quality and occupational well-being in employees: The mediating role of occupational self-efficacy. Front Psychol 2023; 14:1071232. [PMID: 36777224 PMCID: PMC9911531 DOI: 10.3389/fpsyg.2023.1071232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Objective This study aimed to examine the impact of sleep quality on occupational well-being in employees by primarily focusing on the mediating role of occupational self-efficacy. Methods A total of 487 junior staff completed a set of questionnaires comprised Pittsburgh Sleep Quality Index scale, Occupational Self-efficacy Scale, and occupational well-being measurements. Results The results revealed that both sleep quality and occupational self-efficacy were significantly correlated with occupational well-being. The structural equation modeling analysis and the bootstrap test indicated that occupational self-efficacy partially mediated the effect of poor sleep quality on occupational well-being. Discussion These findings expand upon existing research on the relationship between sleep quality and well-being among occupational workers, shed light on the correlation of poor sleep quality with occupational well-being, and are valuable in promoting the occupational well-being of employees.
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Affiliation(s)
- Jiaxi Peng
- Mental Health Education Center & College of Teachers, Chengdu University, Chengdu, China
| | - Jiaxi Zhang
- Xi’an Research Institute of High-Technology, Xi’an, China
| | | | - Yanchen He
- Mental Health Education Center & College of Teachers, Chengdu University, Chengdu, China
| | - Qiuying Lin
- Mental Health Education Center & College of Teachers, Chengdu University, Chengdu, China
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, Shaanxi, China,*Correspondence: Peng Fang, ✉
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, Shaanxi, China,Shengjun Wu, ✉
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Ureña-Paniego C, Montero-Vílchez T, Sanabria-de-la-Torre R, Soto-Moreno A, Molina-Leyva A, Arias-Santiago S. Improvement of Sexual Function and Sleep Quality in Patients with Atopic Dermatitis Treated with Dupilumab: A Single-Centre Prospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1918. [PMID: 36767285 PMCID: PMC9914896 DOI: 10.3390/ijerph20031918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease presenting as xerosis, eczema and intense pruritus. These symptoms negatively impact patients' quality of life. However, the effect of AD on sexual function and sleep quality and how treatment with dupilumab could modify them have not been explored in depth. The aim of this study is to assess the effects of dupilumab on sexual and sleep quality in patients with AD. For that purpose, an observational prospective study was designed. Patients were evaluated at baseline and after 16 weeks of dupilumab treatment. Disease severity was assessed by Eczema Area and Severity (EASI) and SCORing Atopic Dermatitis index (SCORAD). Sexual function was evaluated using validated questionnaires, for men via the International Index of Erectile Dysfunction 5 (IIEF-5) and for women via the Female Sexual Function Index (FSFI). Sleep impairment was recorded through Pittsburgh Sleep Quality Index (PSQI). Thirty-two patients, with a mean age of 30.53 ± 14.48 years old, were included. Regarding sex, 59.8% (20) were female. Most patients had a severe disease reflected in a mean basal EASI of 23.24 ± 6.74 and a SCORAD of 54.07 ± 13.89. Clinical scores improved after dupilumab treatment. At baseline, 47.37% women presented sexual dysfunction and 66.67% men had erectile dysfunction. FSFI improved from 23.51 to 27.93 points (p = 0.008) after dupilumab. Desire, arousal, satisfaction and pain were the components with great improvement. Women with a great improvement in FSFI showed greater clinical results and increased quality of life. At first, 96.9% (31/32) of participants presented with poor sleep quality. After treatment with dupilumab, sleep quality was enhanced and PSQI scores decreased from 12.8 points at baseline to 7.73 points (p < 0.001). In conclusion, dupilumab is associated with reduced sexual dysfunction, mainly in women, and sleep quality.
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Affiliation(s)
- Clara Ureña-Paniego
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain
| | - Trinidad Montero-Vílchez
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | | | - Alberto Soto-Moreno
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain
| | - Alejandro Molina-Leyva
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network, 18014 Granada, Spain
- Department of Dermatology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
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Sivaratnam L, Selimin DS, Abd Ghani SR, Nawi HM, Nawi AM. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2020; 18:121-143. [PMID: 33223424 DOI: 10.1016/j.jsxm.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Erectile dysfunction (ED) is a common problem among men across the world. It is usually multifactorial in origin. Behavioral factors can be related to the development of ED and related to many other chronic diseases. It impacts not only the sexual function but also the psychology and their overall quality of life. AIM To determine the association of the behavior factors in relation to ED and to identify the risk and protective factors. METHOD A systematic review search based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis was conducted. The primary databases PubMed, PlosOne, Oxford Academic, SCOPUS, and Ovid were accessed using specific keyword searches. Quality of articles was assessed by using Newcastle-Ottawa Assessment Scale according to the study design. OUTCOME Evaluation of the relationship between behavioral factors and ED. RESULTS 24 studies were identified from the 5 databases which met the predetermined criteria. Overall, the study population include adult male age between 18 and 80 years. The sample size of the studies ranges from 101 to the largest sample size of 51,329. Smoking, alcohol, and drugs usage are found to be risk factors for ED. Meanwhile, dietary intake, physical activity, and intimacy are the protective factors for ED. CLINICAL IMPLICATION The findings from this review may aid clinicians to aim for early detection of ED by screening their risk factors and providing early treatment. This can also be used to promote awareness to the community on the sexual health and factors that can affect their sexual function. STRENGTH & LIMITATION This study looks at all types of behavioral factors that may affect ED; however, there was a substantial heterogeneity detected across the selected study factors. Furthermore, the lack of PROSPERO registration is also a limitation in this study. CONCLUSION Overall, smoking, dietary intake, alcohol consumption, drugs, and physical activities are modifiable risk factors for ED in men. Therefore, it is crucial to promote healthy lifestyle and empower men to prevent ED and early detection of ED for early treatment. Sivaratnam L, Selimin DS, Abd Ghani SR, et al. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2021;18:121-143.
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Affiliation(s)
- Lavanyah Sivaratnam
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Diana Safraa Selimin
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Siti Rasidah Abd Ghani
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Haniff Mohd Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
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Liao ZC, Li XC, Tang YX, Li DJ, Tang ZY. Is milder psychological stress responsible for more severe erectile dysfunction? Andrologia 2020; 52:e13550. [PMID: 32149423 DOI: 10.1111/and.13550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
China is a sexually conservative country compared with Western countries. To evaluate the psychological characteristics of Chinese erectile dysfunction (ED) patients, we conducted a cross-sectional study of 153 ED outpatients. Patients were interviewed with the Structured Interview on Erectile Dysfunction (SIEDY) for pathogenic quantification. ED was measured by International Index of Erectile Function (IIEF). Depression and anxiety were evaluated with 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalised Anxiety Disorder Scale (GAD-7) respectively. Most patients (74.5%) were <40 years old. IIEF-5 were significantly correlated with SIEDY scale 3 (r = .16, p = .040) and GAD-7 (p = .15, p = .033). The SIEDY scale 1 increased with age, but the IIEF-5, SIEDY scale 3, PHQ-9 and GAD-7 decreased with age. A negative correlation was observed between ED and psychological stress, which conflicts with many Western-country studies. Younger patients were characterised by milder ED but more psychological stress, while older patients were characterised by worse ED but less psychological stress. Which may be responsible for the conflicting result. Meanwhile, the much younger age distribution among Chinese ED outpatients may indicate that quite a few older ED patients (≥40 years) in China do not seek outpatient service which should merit more attention.
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Affiliation(s)
- Zhang-Cheng Liao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiu-Cheng Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu-Xin Tang
- Department of Urology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Dong-Jie Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, China.,Department of Geriatric urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China
| | - Zheng-Yan Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.,Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha, China
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Pereira H, Fernandes S, Aurélio D, Benquerença J, Monteiro S, Afonso RM, Esgalhado G, Loureiro M, Ferro D, Garcia N, Serrano JP. [Sleep quality and sexual functioning in healthy adults]. Rev Int Androl 2019; 18:85-90. [PMID: 31445903 DOI: 10.1016/j.androl.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/21/2019] [Accepted: 01/27/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There are not enough scientific investigations, especially with a normative population, that show the association between sleep quality and sexual functioning. METHOD 945 healthy individuals, 62% female, 38% male, mean age 34.27 years (standard deviation=15.82), who completed a sociodemographic questionnaire, the Portuguese version of the Oviedo Sleep Questionnaire and the Portuguese version of the Massachusetts General Health Hospital-Sexual Functioning Questionnaire entered this study. RESULTS Moderate levels of subjective satisfaction with sleep and low levels of insomnia and hypersomnia were observed. However, women suffer more from these forms of sleep disorders. Subjective satisfaction with sleep quality is positively correlated with overall sexual functioning and all of its dimensions, and insomnia is negatively correlated with sexual functioning and all of its dimensions. From the linear regression analysis, the model of prediction of general sexual functioning was tested according to sleep quality variables, and a statistically significant model was obtained (p <0.001), with the variables in question explaining 7% of general sexual functioning, with β values ??for subjective satisfaction with sleep of 0.189 and for insomnia of -0.140. DISCUSSION Based on the results obtained, it is possible to demonstrate that the higher the quality of sleep, the greater the sexual functioning, and that it is negatively influenced mainly by insomnia.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Delfina Ferro
- Agrupamento de Centros de Saúde (ACeS) Cova da Beira, Covilhã, Portugal
| | - Nuno Garcia
- Universidade da Beira Interior, Covilhã, Portugal
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Smith L, Grabovac I, Veronese N, Soysal P, Isik AT, Stubbs B, Yang L, Jackson SE. Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings from the English Longitudinal Study of Ageing. J Sex Med 2019; 16:427-433. [DOI: 10.1016/j.jsxm.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/30/2018] [Accepted: 01/04/2019] [Indexed: 01/21/2023]
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Shigehara K, Konaka H, Sugimoto K, Nohara T, Izumi K, Kadono Y, Namiki M, Mizokami A. Sleep disturbance as a clinical sign for severe hypogonadism: efficacy of testosterone replacement therapy on sleep disturbance among hypogonadal men without obstructive sleep apnea. Aging Male 2018; 21:99-105. [PMID: 28920756 DOI: 10.1080/13685538.2017.1378320] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The present subanalysis of the EARTH study investigates the effects of one year testosterone replacement therapy (TRT) on sleep disturbance among hypogonadal men without obstructive sleep apnea. METHODS Sleep disturbance was defined as three or more points in question 4 of the aging males symptoms (AMS) questionnaire. All participants completed the AMS scale, International Prostatic Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) and Short Form 36 (SF-36) health survey at baseline and after 12 months. Sexual symptoms were also evaluated based on three AMS subscores (Q15, 16 and 17). RESULTS We identified 100 patients with sleep disturbance, of whom 48 (24 each in the TRT and control groups) were ultimately included for analysis. All SF-36 categories , AMS scale, IPSS and SHIM score subdomains were significantly worse in patients with sleep disturbance than in those without disturbance. Statistically significant differences in sleep disturbance, erectile symptoms, sexual desire and some domains of the SF-36 were observed between the TRT and control groups after 12 months. CONCLUSION Sleep disturbance may be one of the clinical signs for severe hypogonadism. Moreover, TRT improved sleep conditions, sexual function and quality of life among hypogonadal men with sleep disturbance.
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Affiliation(s)
- Kazuyoshi Shigehara
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Hiroyuki Konaka
- b Department of Urology , Kanazawa Red Cross Hospital , Kanazawa , Japan
| | | | - Takahiro Nohara
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Koji Izumi
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Yoshifumi Kadono
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Mikio Namiki
- d Department of Urology , Hasegawa Hospital , Toyama , Japan
| | - Atsushi Mizokami
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
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Costa R, Costa D, Pestana J. Subjective sleep quality, unstimulated sexual arousal, and sexual frequency. ACTA ACUST UNITED AC 2017; 10:147-153. [PMID: 29410746 PMCID: PMC5760048 DOI: 10.5935/1984-0063.20170026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction REM sleep deprivation increases unstimulated erections in rats, and total sleep deprivation increases erections during audiovisual sexual stimulation in men, but the effects of sleep problems on human unstimulated sexual arousal are unknown. Objective We examined the associations of subjective sleep quality with unstimulated sexual arousal, satisfaction with sex life, and sexual frequency and desire over the past month. Methods 275 Portuguese (169 women) reported their anxiety, sexual arousal and sexual desire during a resting state, and completed the Pittsburgh Sleep Quality Index, the sexual satisfaction subscale of the LiSat scale, the Desire dimensions of the Female Sexual Function Index (women only) and International Index of Erectile Function (men only). They additionally reported how many days in the past month they engaged in penile-vaginal intercourse, noncoital sex, and masturbation. Salivary testosterone (T) was assayed by luminescence immunoassays. Results Poorer sleep quality correlated with greater unstimulated sexual arousal in men with higher T levels and in women with higher T levels not taking oral contraceptives. In women with lower T, poorer subjective sleep quality correlated with greater sexual dissatisfaction. In both sexes, sleep quality was uncorrelated with sexual desire and sexual frequency over the past month. Discussion Consistently with other studies in humans and animals, the findings are congruent with the notion that lack of sleep can increase sexual arousal, but not sexual frequency. T might play a role in the sexual arousal caused by lack of appropriate sleep.
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Affiliation(s)
- Rui Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - David Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - José Pestana
- ISPA - Instituto Universitário, - Lisbon - Portugal
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