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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. [PMID: 35670262 DOI: 10.1111/jsr.13664] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 02/03/2023]
Abstract
Sleep is essential for the maintenance of health and systemic homeostasis. Decreased sleep time and sleep quality have been associated with a wide range of diseases. To evaluate the effects of obstructive sleep apnea (OSA) and total or selective rapid eye movement (REM) sleep deprivation on male reproductive function, we performed a three-arm parallel study with one pre-defined OSA group and a group of healthy volunteers who were then randomised into total or REM sleep deprivation groups. Questionnaires were completed and overnight polysomnography was undertaken, and blood and sperm samples were collected at the Sleep Institute, São Paulo, Brazil. OSA was diagnosed using questionnaires and polysomnography. Male sexual function was assessed through the questionnaires, blood tests, and semen samples. Data showed an association between OSA and lower circulating levels of total and free testosterone and high-density lipoproteins, as well as a lower proportion of healthy sperm cells and decreased sperm concentration, in comparison to volunteers. Volunteers subjected to either total or REM sleep deprivation had increased circulating levels of thyroid-stimulating hormone, insulin, and higher homeostatic model assessment of insulin resistance (HOMA-IR) values. Both sleep-deprived groups also shown decreased cholesterol, and low-density lipoproteins when compared to their baseline levels, but had no alterations in their spermograms. We observed a reduction in total testosterone following total sleep deprivation, but no effect after REM sleep deprivation. OSA was associated with a hormonal imbalance, which is probably linked with impaired reproductive function and associated comorbidities, such as sleep fragmentation/loss and obesity.
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Affiliation(s)
- Tathiana A Alvarenga
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Guilherme L Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Lia R Bittencourt
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
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Amini M, Saboory E, Derafshpour L, Fakhari A, Wu JC, Bruggeman R, Asgharzadeh F, Ahmadalipour A. The impact of sleep deprivation on sexual behaviors and FAAH expression in the prefrontal cortex of male rats. Neurosci Lett 2020; 735:135254. [PMID: 32682844 DOI: 10.1016/j.neulet.2020.135254] [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: 05/08/2020] [Revised: 06/27/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022]
Abstract
Sleep deprivation (SD) causes alterations in the function of the endocannabinoid (EC) system and also results in alteration in many behaviors such as increased anxiety, deteriorated alertness, memory deficits, as well as sexual behaviors. Controversial data about the effects of SD on sexual response are provided. Fatty acid amide hydrolase (FAAH), the enzymes involved in the degradation of the EC system play an important role in the function of the EC system. This study aimed to investigate the effect of REM SD (RSD) and total SD (TSD) on the sexual behaviors and FAAH expression in the prefrontal cortex (PFC) of male rats. RSD was carried out through the flower pot technique for 24 h and 48 h, and TSD also was induced by keeping awake the rats by gentle handling for 6 h. Immediately after RSD and TSD, sexual behaviors were recorded for 45 min. Sexual behaviors were reduced by both types of RSD and TSD. The deleterious effects of 24 h RSD were more severe compared with 6 h of TSD. Serum testosterone concentration was significantly higher after TSD but not RSD compared to the normal sleep (NS) group. FAAH expression in the PFC was significantly reduced after both RSD and TSD compared to the NS group. Given that the function of the EC system has been previously shown to change different behaviors such as sexual activity, our results could suggest that behavioral effects of both types of SD on sexual behavior may partially result from activation of this signaling pathway by the reduction of FAAH in the PFC.
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Affiliation(s)
- Mohammad Amini
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ehsan Saboory
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Leila Derafshpour
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Fakhari
- Research Center of Psychiatry and Behavioral Sciences, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Joseph C Wu
- UC Irvine Department of Psychiatry and Human Behavior, Irvine, CA 92697, United States
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Rob Giel Research Center, the Netherlands
| | - Fatemeh Asgharzadeh
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Ahmadalipour
- Research Center of Psychiatry and Behavioral Sciences, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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Xia DP, Wang X, Zhang QX, Sun BH, Sun L, Sheeran LK, Li JH. Progesterone levels in seasonally breeding, free-ranging male Macaca thibetana. MAMMAL RES 2017. [DOI: 10.1007/s13364-017-0342-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Walther A, Mahler F, Debelak R, Ehlert U. Psychobiological Protective Factors Modifying the Association Between Age and Sexual Health in Men: Findings From the Men's Health 40+ Study. Am J Mens Health 2017; 11:737-747. [PMID: 28413941 PMCID: PMC5675228 DOI: 10.1177/1557988316689238] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Sexual health severely decreases with age. For males older than 40 years, erectile dysfunction (ED) is the most common sexual disorder. Although physical and psychological risk factors for ED have been identified, protective factors are yet to be determined. To date, no study has examined endocrine and psychosocial factors in parallel with regard to their modifying effect on the age-related increase in ED. Two hundred and seventy-one self-reporting healthy men aged between 40 and 75 years provided both psychometric data on sexual function and a set of potential psychosocial protective factors, and saliva samples for the analysis of steroid hormones and proinflammatory cytokines. Around 35% of the participants reported at least a mild form of ED. Direct associations with ED were identified for perceived general health, emotional support, relationship quality, intimacy motivation but not for steroid hormones or proinflammatory markers. Moderation analyses for the association between age and ED revealed positive effects for testosterone (T), dehydroepiandrosterone (DHEA), perceived general health, emotional support, intimacy motivation, and a negative effect for interleukin-6 (all p < .05; f2 > .17). Group differences between older men with and without ED emerged for T, DHEA, and psychometric measures such as perceived general health, emotional support, satisfaction with life, and intimacy motivation (all p < .05; d > .3). Both psychosocial and endocrine parameters moderated the association between age and sexual health. Perceived general health, emotional support, intimacy motivation, and relationship quality emerged as psychosocial protective factors against ED. Higher T and DHEA and lower interleukin-6 levels also buffered against an age-related increase in ED.
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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. [DOI: 10.1016/j.fertnstert.2015.02.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 01/16/2015] [Accepted: 02/04/2015] [Indexed: 11/17/2022]
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Torres M, Laguna-Barraza R, Dalmases M, Calle A, Pericuesta E, Montserrat JM, Navajas D, Gutierrez-Adan A, Farré R. Male fertility is reduced by chronic intermittent hypoxia mimicking sleep apnea in mice. Sleep 2014; 37:1757-65. [PMID: 25364071 DOI: 10.5665/sleep.4166] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and oxidative stress. However, it is unknown whether intermittent hypoxia mimicking OSA modifies male fertility. We tested the hypothesis that male fertility is reduced by chronic intermittent hypoxia mimicking OSA in a mouse model. DESIGN Case-control comparison in a murine model. SETTING University research laboratory. PARTICIPANTS Eighteen F1 (C57BL/6xCBA) male mice. INTERVENTIONS Mice were subjected to a pattern of periodic hypoxia (20 sec at 5% O2 followed by 40 sec of room air) 6 h/day for 60 days or normoxia. After this period, mice performed a mating trial to determine effective fertility by assessing the number of pregnant females and fetuses. MEASUREMENTS AND RESULTS After euthanasia, oxidative stress in testes was assessed by measuring the expression of glutathione peroxidase 1 (Gpx1) and superoxide dismutase-1 (Sod1) by reverse-transcription polymerase chain reaction. Sperm motility was determined by Integrated Semen Analysis System (ISAS). Intermittent hypoxia significantly increased testicular oxidative stress, showing a reduction in the expression of Gpx1 and Sod1 by 38.9% and 34.4%, respectively, as compared with normoxia (P < 0.05). Progressive sperm motility was significantly reduced from 27.0 ± 6.4% in normoxia to 12.8 ± 1.8% in the intermittent hypoxia group (P = 0.04). The proportion of pregnant females and number of fetuses per mating was significantly lower in the intermittent hypoxia group (0.33 ± 0.10 and 2.45 ± 0.73, respectively) than in normoxic controls (0.72 ± 0.16 and 5.80 ± 1.24, respectively). CONCLUSIONS These results suggest that the intermittent hypoxia associated with obstructive sleep apnea (OSA) could induce fertility reduction in male patients with this sleep breathing disorder.
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Affiliation(s)
- Marta Torres
- CIBER Enfermedades Respiratorias, Bunyola, Spain ; Laboratori de la Son, Servei de Pneumologia, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Ricardo Laguna-Barraza
- INIA, Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Madrid
| | - Mireia Dalmases
- CIBER Enfermedades Respiratorias, Bunyola, Spain ; Laboratori de la Son, Servei de Pneumologia, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Alexandra Calle
- INIA, Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Madrid
| | - Eva Pericuesta
- INIA, Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Madrid
| | - Josep M Montserrat
- CIBER Enfermedades Respiratorias, Bunyola, Spain ; Laboratori de la Son, Servei de Pneumologia, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain ; Institut Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Daniel Navajas
- CIBER Enfermedades Respiratorias, Bunyola, Spain ; Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Spain ; Institut Bioenginyeria Catalunya, Barcelona, Spain
| | - Alfonso Gutierrez-Adan
- INIA, Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Madrid
| | - Ramon Farré
- CIBER Enfermedades Respiratorias, Bunyola, Spain ; Institut Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain ; Unitat Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Spain
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Maggio M, Colizzi E, Fisichella A, Valenti G, Ceresini G, Dall’Aglio E, Ruffini L, Lauretani F, Parrino L, Ceda GP. Stress hormones, sleep deprivation and cognition in older adults. Maturitas 2013; 76:22-44. [DOI: 10.1016/j.maturitas.2013.06.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/05/2013] [Indexed: 12/20/2022]
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Affiliation(s)
| | - Kanchan Chitaley
- Department of Urology, University of Washington, Seattle, Washington
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Abstract
Many patients with prostate cancer for whom androgen deprivation therapy (ADT) is indicated are young and desire to remain sexually active. In such patients, the side effects of androgen therapy on sexual function can be a source of serious reduction in overall quality of life. Providing the appropriate treatment options in this patient population is therefore essential. Nevertheless, treating such patients is challenging and an understanding of the underlying mechanisms of sexual physiology and pathophysiology is crucial to optimal patient care. In this paper, we reviewed what was known regarding the effects of ADT on sexual function in animal models and we also provided a detailed review on the effects of ADT on sexual health in humans and its treatment.
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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. [PMID: 21890115 DOI: 10.1016/j.brainres.2011.07.060] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 07/29/2011] [Accepted: 07/30/2011] [Indexed: 11/29/2022]
Abstract
Testosterone has been the focus of several investigations and review studies in males, but few have addressed its effects on sleep and sexual function, despite evidence of its androgenic effects on circadian activity in both sexes. Studies have been conducted to understand how sleeping increases (and how waking decreases) testosterone levels and how this rhythm can be related to sexual function. This review addresses the inter-relationships among testosterone, sexual function and sleep, including sleep-disordered breathing in both sexes, specifically its effects related to sleep deprivation. In addition, hormonal changes in testosterone that occur in the gonadal and adrenal axis with obstructive sleep apnea and other conditions of chronic sleep deprivation, and which consequently affect sexual life, have also been explored. Nevertheless, hormone-associated sleep disruptions occur across a lifetime, particularly in women. The association between endogenous testosterone and sex, sleep and sleep disturbances is discussed, including the results of clinical trials as well as animal model studies. Evidence of possible pathophysiological mechanisms underlying this relationship is also described. Unraveling the associations of sex steroid hormone concentrations with sleep and sexual function may have clinical implications, as sleep loss reduces testosterone levels in males, and low sex steroid hormone concentrations have been associated with sexual dysfunction.
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Affiliation(s)
- Monica L Andersen
- Departmento de Psicobiologia, Universidade Federal de São Paulo, Brazil.
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Andersen ML, Alvarenga TA, Mazzotti DR, Guindalini C, Pellegrino R, Barrueco KF, Santos-Silva R, Bittencourt LR, Tufik S. Hormonal profile, the PROGINS polymorphism, and erectile dysfunction complaints: data from a population-based survey. Fertil Steril 2011; 95:621-4. [DOI: 10.1016/j.fertnstert.2010.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 09/25/2010] [Accepted: 10/12/2010] [Indexed: 12/20/2022]
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Alvarenga TA, Andersen ML, Tufik S. Influence of Progesterone on Sexual Performance in Male Rats. J Sex Med 2010; 7:2435-44. [DOI: 10.1111/j.1743-6109.2010.01851.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Andersen ML, Santos-Silva R, Bittencourt LRA, Tufik S. Prevalence of erectile dysfunction complaints associated with sleep disturbances in Sao Paulo, Brazil: a population-based survey. Sleep Med 2010; 11:1019-24. [PMID: 20427234 DOI: 10.1016/j.sleep.2009.08.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 07/28/2009] [Accepted: 08/21/2009] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The aims of this study were to estimate the prevalence of erectile dysfunction (ED) complaints in a population-based sample from Sao Paulo and to determine the associations of ED prevalence with sleep disturbances, testosterone levels, age, body mass index (BMI), socioeconomic factors and selected medical history indicators. METHODS The Epidemiologic Sleep Study (EPISONO) is a population-based study of sleep and risk factors for sleep disturbances in Brazil's largest city, Sao Paolo. This study adopted a probabilistic three-stage cluster sampling approach for the city of Sao Paulo. Questionnaires that covered medical conditions and sexual and erection complaints were administered and polysomnographies and fasting blood samples were collected. The patient cohort of the current study of ED consisted of 467 men, aged 20-80 years at the time of their enrollment in EPISONO. The percentage of men who participated in EPISONO but refused to participate in our study was 2.3%. RESULTS The prevalence of ED complaints in the study cohort was 17.08% overall. ED complaints ranged from 7.3% in younger men (20-29 years old) to 63.25% in older men (>50years old) (adjusted odds ratio [OR]=21.65). The logistic regression model showed that both reduced time spent in REM sleep and fragmented sleep had significant effects as risk factors for ED complaints. Obesity (OR=1.8), low testosterone levels (OR=4.28), low quality of life (OR=4.4), an apnea-hypopnea index over 15 (OR=2.75), and obstructive sleep apnea syndrome (OR=2.13) were also significantly associated with a higher risk of ED complaints. CONCLUSION EPISONO study indicates that ED complaints are relatively common phenomena, especially among older men. Adequate sleep patterns and normal or high levels of testosterone, which serve as markers for sexual motivation, may be protective against ED. The prevalence of sleep apnea showed a strong impact on erectile function and subsequently negatively affects sexual activity.
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Affiliation(s)
- Monica L Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), Brazil.
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Andersen ML, Alvarenga TA, Guindalini C, Perry JC, Silva A, Zager A, Tufik S. Paradoxical Sleep Deprivation Influences Sexual Behavior in Female Rats. J Sex Med 2009; 6:2162-72. [DOI: 10.1111/j.1743-6109.2009.01339.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schütz TCB, Andersen ML, Silva A, Tufik S. Distinct gender-related sleep pattern in an acute model of TMJ pain. J Dent Res 2009; 88:471-6. [PMID: 19493893 DOI: 10.1177/0022034509334618] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Since it is recognized that acute inflammation of the temporomandibular joint results in sleep disturbances in male rats, and that the orofacial region may display a site-specific effect of ovarian hormones on nociception, we hypothesized that distinct genders would respond differently when subjected to this inflammatory acute orofacial pain. Sleep was monitored after injection of saline/Freund's adjuvant into the temporomandibular joint in male and female (proestrus and diestrus phases) rats. Progesterone and stress-related hormones were also assessed. In males, Freund's adjuvant induced a significant nociceptive response and sleep disturbances. Behavior and sleep architecture in the females remained unaffected. Our results suggest that females and males present distinct responses to an acute model of orofacial pain.
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Affiliation(s)
- T C B Schütz
- Department of Psychobiology, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Napoleão de Barros, 925, Vila Clementino, SP-04024-002, São Paulo, SP, Brazil.
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Bibliography. Current world literature. Adrenal cortex. Curr Opin Endocrinol Diabetes Obes 2008; 15:284-299. [PMID: 18438178 DOI: 10.1097/med.0b013e3283040e80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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