Subjective sleep quality, unstimulated sexual arousal, and sexual frequency

The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age

Research about the effects of hormonal contraceptives on sleep has been performed but is subjected to important levels of methodological heterogeneity. Hormonal contraceptives impact sleep, but the direction of this association is not clear. Most studies describe a negative sleep profile among contraceptive users, including increased sleepiness, insomnia symptoms, decreased sleep efficiency, and a reduced overall sleep quality. Hormonal intrauterine contraceptives are associated with less negative effects. More research on the field, especially randomized controlled trials, is needed to increase the level and certainty of evidence about the effects of hormonal contraceptives on sleep.

Let's Talk about Sleep Baby: Sexual Activity Postpartum and Its Links with Room Sharing, Parent Sleep, and Objectively Measured Infant Sleep and Parent Nighttime Crib Visits

The postpartum period may pose a considerable challenge for both parent sleep and sexual activity. This study assessed the links between partnered sexual frequency and satisfaction postpartum and parent sleep, infant sleep, parent nighttime caregiving, and parent-infant room sharing. Participants were 897 parents of infants aged 1-18-months (M = 8.8 ± 4.3, 49% girls). Parents completed an online survey about their sexual frequency and satisfaction, sleep, relationship satisfaction, depression, and demographic characteristics. Infant sleep and parent nighttime crib visits were measured objectively using auto-videosomnography during 2-weeks, with 8,460 nights assessed. Results indicated that the frequency of partnered sexual activity was 3.8 ± 4.2 times per month. Frequency of sexual activity increased with infant age, yet increases beyond the first 6 months postpartum were non-significant. Adjusted GEE modeling revealed that more parent nighttime crib visits were significantly associated with lower sexual frequency, regardless of infant age. Other parent and infant sleep-related factors were not significantly linked with sexual frequency in adjusted models. Moreover, sexual satisfaction was not associated with parent nighttime caregiving, parent or infant sleep, or parent-infant sleeping arrangements in adjusted models, suggesting that it may not be susceptible to the effects of disrupted sleep in the postpartum period. These findings suggest that it is not infant or parent sleep disruption per se, but rather parent nighttime engagement with the infant that is associated with parent sexual activity frequency. Longitudinal investigations are warranted to examine the directional pathways of these links.

The effects of hormonal contraceptive use on sleep in women: A systematic review and meta-analysis

Hormonal contraceptives are some of the most widely used medications worldwide, but studies on their effects on sleep are contradictory, with some reporting a sleep-promoting effect, while others a sleep-inhibiting effect. Our objective was, therefore, to undertake a systematic review and meta-analysis of the literature on this subject to try to clarify their effects. A search was conducted in three databases (PubMed, Scopus and Web of Science). Only studies evaluating hormonal contraception use were considered eligible, and both objective and subjective sleep-related outcomes were considered. Individual effect size was calculated for each article, and meta-analyses were performed using a DerSimonian and Laird random effects method. The initial search identified 2076 articles, of which 13 met the criteria for the study after full text evaluation. A total of 33 meta-analyses were performed, three of them related to subjective measures and 30 considering data from polysomnography. The only statistically significant result between contraceptive users and non-contraceptive users was observed in respect of wake after sleep onset, which was 7 min shorter among contraceptive users (-7.12 [-12.80; -1.44]; I²  = 65%; p = 0.01). In conclusion, hormonal contraceptives are not associated with clinically relevant changes in sleep patterns in women.

Improvement of Sexual Function and Sleep Quality in Patients with Atopic Dermatitis Treated with Dupilumab: A Single-Centre Prospective Observational Study

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.

Variable Sexual Satisfaction in Pregnancy: A Latent Profile Analysis of Pregnant Wives and Their Husbands

Although not all couples achieve high levels of sexual satisfaction during pregnancy, evidence of variability in couple sexual satisfaction during pregnancy indicates that sexual dissatisfaction in pregnancy does not apply to all. Subsequently, the current study examined whether a nationally representative U.S. sample of wives and husbands (N = 523 couples) fell into subgroups in terms of their sexual satisfaction during pregnancy and to what degree biopsychosocial factors distinguish potential subgroups. Latent profile analyses, adjusted for pregnancy-related biological factors, indicated that couples could be classified into two subsets - a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset - the only significant group membership predictor among a variety of other factors. Implications include notions that couples and practitioners should consider women's depressive symptoms throughout pregnancy in addition to the perinatal period, and that most U.S. newly married pregnant couples do well navigating sexual satisfaction challenges during pregnancy.

Associations between tactile intimacy and sleep quality in healthy adults: A systematic review

Prior research suggests that different types of touch can affect sleep, but whether there is a consistent association between tactile intimacy and sleep quality is unclear. Here, we report a pre-registered systematic review (International Prospective Register of Systematic Reviews [PROSPERO], CRD42020158683) of studies examining the association between tactile intimacy and sleep quality in healthy adults. The databases PsycINFO, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and EMBASE were searched on August 7, 2020. A total of 13 studies met the inclusion criteria and were synthesised qualitatively. Most commonly, articles researched sexual intimacy in relation to sleep quality, but some studies also investigated non-sexual affective touch and emotionally neutral touch. Some evidence for a connection between sexual function, sexual satisfaction and masturbation with sleep quality was found; however, no evidence for an association between sexual frequency or sexual positions and sleep was found. Interestingly, studies employing more subjective approaches were more likely to report an association between touch and sleep, potentially highlighting a discrepancy between self-reported and the objectively measurable association between touch and sleep.

Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction

PURPOSE

Mild obstructive sleep apnea (OSA) is more prevalent than moderate and severe OSA and is more frequent in men than women. The association between OSA and female sexual dysfunction (FSD) is still poorly explored in published studies. Our aim was to investigate the prevalence of FSD in women with mild OSA and assess the impact of OSA on FSD, as well as to determine the predictors for FSD risk.

METHODS

The sample comprised 70 women aged 26-65 years: a control group (N = 28) with no sleep complaints, and a group with mild OSA (an apnea-hypopnea index of  5 or more and less than 15 events/hour, N = 42), who had been diagnosed using polysomnography performed in the sleep laboratory of a sleep research institute. All participants volunteered to take part in the study and completed the female sexual function index (FSFI), the Beck depression index (BDI), the Kupperman menopausal index (KMI), and the Epworth sleepiness scale (ESS). Their socioeconomic group was assessed using the Brazilian Economic Classification Criterion. Polysomnography and serum levels of free testosterone and total testosterone were analyzed.

RESULTS

We found low FSFI scores (< 26.55) in the mild OSA (18.1) and control (21.7) groups (p = 0.97). There was no statistically significant difference between the mild OSA group and the control group. However, a higher BMI (p = 0.04), a higher BDI (p = 0.02), and being sexuality inactive (p = 0.001) were risk factors for FSD.

CONCLUSION

There was a high prevalence of FSD in the entire sample. The presence of mild OSA did not affect sexual function in this sample. Depressive symptoms and a high BMI were associated risk factors for FSD. Being sexually active may protect female sexual function.

Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial

BACKGROUND

Poor sleep quality consequences among shift working nurses are well recognized.

AIM

To investigate the impact of sleep improvement on sexual quality of life.

METHODS

The study was a parallel randomized controlled trial, conducted among 120 female nurses in 2 educational hospitals in the Northeast of Iran, Shahroud. Using random blocks of four, 120 eligible participants were randomly assigned to study groups. Data collecting tools included a demographic data questionnaire, Pittsburgh Sleep Quality Index to assess sleep quality, and the survey of sexual quality of life-female and Sexual Self-Efficacy Questionnaire to evaluate level of sexual quality of life and sexual self-efficacy, respectively. The intervention consisted of 3 weekly sleep intervention sessions that lasted from 90 to 120 minutes.

OUTCOMES

The study's primary and secondary outcomes were sleep quality, and the level of sexual self-efficacy and sexual quality of life, respectively.

RESULTS

By 3-month follow-up, the loss to follow-up rate was 5.9%. The mean sleep quality score was 7.61 ± 2.26 in the recruited participants. Following the intervention, the sleep quality score showed statistically significant differences compared to the control group [mean difference (CI 99.98%), -1.89 (-2.40, -1.38)]. Participants in the intervention group showed modest increases in both measures; sexual self-efficacy [mean difference (CI 99.98%), 8.82 (6.83, 10.81)] and sexual quality of life [mean difference (CI 99.98%), 19.64 (18.08, 21.20)].

CLINICAL IMPLICATIONS

These findings suggest that sleep improvement could promote the sexual quality of life among shift working nurses.

STRENGTHS & LIMITATIONS

Strengths of this study include the use of a validated outcome measure. Focusing the study on female nurses and the small size of the study population are the limitations.

CONCLUSION

Improved sleep showed an impact on sexual quality of life among rotating female shift workers. Khastar H, Mirrezaie SM, Chashmi NA, et al. Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial. J Sex Med 2020;17:1467-1475.

[Sleep quality and sexual functioning in healthy adults]

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.

Effects of experimental sleep deprivation on aggressive, sexual and maternal behaviour in animals: a systematic review protocol

Objective

Because of the relevance for the research on sleep deprivation and human behaviour, many preclinical studies have been conducted on aggressive, sexual and maternal behaviours in this field. Considering the available data and the complexity of the factors involved, the most appropriate way to summarise the effects of sleep deprivation on these behaviours is through systematic reviews and meta-analyses. This article describes the protocol for three independent systematic reviews and meta-analyses, evaluating the effects of sleep deprivation on aggressive, sexual and maternal behaviours in animals.

Search strategy

A bibliographic search will be performed in four databases: Pubmed, Scopus, Web of Science and Psychinfo, searching for three domains: sleep deprivation (as the intervention), animals (as the population) and behaviour (as the outcome).

Screening and annotation

Titles and abstracts will first be screened, followed by analysis of the full text and data extraction.

Data management and reporting

SYstematic Review Centre for Laboratory Animal Experimentation ’s risk of bias tool will be used to evaluate risk of bias; visual analysis of funnel plots, Egger’s regression and trim-and-fill will be employed to evaluate publication bias. Effect sizes will be calculated from the articles by either direct or standardised mean difference, depending on the nature of the data. Overall estimates will then be calculated using a random effects model. Heterogeneity will be assessed using both I² index and Cochran’s Q test. These meta-analyses should be useful to summarise the available data on the relationship between sleep deprivation and behaviour, providing a solid background for future behavioural sleep deprivation experiments, improving their validity.