The Effect of Sleep on Your Hormones, Erections, Body and Quality of Life

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Nelson Vergel

Founder, ExcelMale.com
Why is that some people can sleep through the night while others toss and turn? No matter how early or late you get to bed, you can't seem to get a full night of rest? You've tried just about everything to improve your sleep--sleeping pills, valerian root, napping, eating before bedtime, not eating before bedtime, cutting coffee, and the list goes on--but nothing seems to work! What can you do to solve your sleep problem?

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The truth is that more than 27 million Americans are at risk for this problem, thanks to the fact that they follow an irregular schedule. They switch back and forth between day and night shifts, always forcing their bodies to change with their shifting work schedule. This can throw off your internal body clock.

Your body has been designed for maximum efficiency. During the daylight hours, it's easy to see what you're doing, meaning daylight is the time for productivity. Darkness makes it easier to sleep, rest, and recover, so the human body has adapted to this relaxation during the night hours. This is your body's way of making the most of every hour in the day and night.


The central feature of sleep is an alteration in brain function that's associated with changes in the rest of our bodies. Just what effects the alterations and changes have on us both physically and mentally are still topics of intensive investigations.

There are two types of sleep in humans and these are described as differences in the frequency and amplitude of brain (EEG) waves. In healthy adult human non-rapid eye movement or NREM sleep (made up of 4 stages ranging from light sleep to slow wave sleep (SWS) or deep sleep phases), and rapid eye movement or REM (dreaming phase) sleep succeed each other in 90-110 min intervals. A prominent view is that SWS is involved in restorative functions and that REM sleep is involved in information processing. However, recent studies show that it's not that simple.

This ultradian pattern of NREM/REM succession is cyclical, although the amount of time spent in each phase may vary throughout the night. Early in the night light sleep alternates with SWS sleep while later on light sleep alternates mainly with REM sleep. This cyclical pattern may have its roots in danger detection throughout the night and this is felt to have survival value.

The alternation of phases can be influenced by a variety of factors, including age and gender.


SLEEP AND YOUR HORMONES:

Recent research has given us new insights into the regulation of sleep and wakefulness and how this regulation might relate to energy homeostasis, the control of hunger and satiety, and body composition.

We know that the amount of energy we have and the amount of exertion we can put out is strictly limited. And if we don't “recharge” adequately at night we won't have our full complement to be used during the day.

Chronic sleep loss causes excessive sleepiness and decreased mental and physical performance. It also has a negative effect on mood, autonomic and immune functions and increases the risk of physical and mental health problems. These effects by themselves, by increasing our risk of getting viral and bacterial infections, and other health problems, are enough that they would impact on your ability to train effectively.

But that's not all. Sleep deprivation has also been shown to reduce anabolic and fat burning hormone levels, including thyroid, testosterone, growth hormone, insulin-like growth factor I (IGF-I) and leptin, and to increase the catabolic hormone cortisol.

For example, sleep deprivation adversely affects testicular function and this leads to lower levels of serum testosterone in the body. Cortisol impairs sleep. In healthy young and old subjects cortisol (and IL-6) plasma concentrations were positively associated with total wake time and negatively with rapid eye movement (REM; dreaming phase) sleep; and in turn, insomnia is associated with an overall increase in ACTH and cortisol secretion.

As well, sleep deprivation disturbs the levels and effects of ghrelin and leptin. While the details and specific effects on both of these hormones have yet to be detailed, it's a sure bet that the changes in their levels and interplay have profound effects on fat metabolism.

While the specifics of ghrelin regulation and functions are still being worked out, it is known that it is involved in sleep regulation, increases food intake in both rodents and humans, and conserves fat by reducing fat utilization. It would appear that the result of increased levels of ghrelin is an increase in appetite, body weight, and body fat.

In contrast to ghrelin, leptin, which is reduced in sleep deprivation, is an anorexigenic (decreases appetite) factor and it is thought that ghrelin and leptin regulate the energy balance in a reciprocal fashion.

Several studies have found that sleep deprivation is a risk factor for obesity and for insulin resistance and diabetes.

One study looked at the effects of sleep duration on body weight and metabolism. The authors concluded that in persons sleeping less than eight hours increased BMI and obesity was proportional to decreased sleep. Several other studies have backed up these claims.

A recent paper summarized the metabolic and endocrine effects of sleep deprivation as follows:

• Sleep deprivation has multiple physical and psychological effects.
• Sleep restriction is accompanied by increased cortisol levels in the afternoon and early evening
• Sleep restriction is associated with an increase in insulin resistance and may increase the risk for diabetes.
• Sleep plays an important role in energy balance. Partial sleep deprivation was found to be associated with a decrease in plasma levels of leptin and a concomitant increase in plasma levels of ghrelin; subjective ratings of hunger and appetite also increased.
• Moreover, a correlation was found between the increase in hunger and the increase in the ghrelin: leptin ratio.
• Thus, the neuroendocrine regulation of appetite and food intake appears to be influenced by sleep duration, and sleep restriction may favor the development of obesity.

The bottom line is that all of these negative hormonal changes impacts on your ability to maximize body composition even if your training and diet are up to par.

How Much Sleep Do You Need?


More information:

Sleep is Anabolic- By Dr Mauro Di Pasquale


How Your Circadian Rythm Rules Your Life


Sleep: Its Impact on T-Levels, ED, BMI, and Nocturia


An Extra Hour of Sleep Equals 12% More Testosterone?


Does Testosterone Worsen Sleep Apnea?: It Depends on the Dose
______________________________


SLEEP AND ERECTILE FUNCTION STUDIES:



DECREASE OF NOCTURNAL PENILE TUMESCENCE DUE TO REM SLEEP
DEPRIVATION IN YOUNG HEALTHY MALES: YOUNG,
HEALTHY...IMPOTENT?

Kamp S., Ott R., Hatzinger M., Knoll T., Juenemann K.P., Alken P., Bross S.
University Hospital, Department of Urology, Mannheim, Germany

INTRODUCTION & OBJECTIVES: To determine the influence of a
disturbance of the physiological sleep pattern on Nocturnal Penile Tumescences
(NPT) in young healthy males and to evaluate the significance of NPT measurement
for the diagnostic of erectile dysfunction under in patient-conditions.

MATERIAL & METHODS: 10 healthy young males, mean age 25.2 years (25-
32) were examined on 3 nights under sleep laboratory conditions. A 12-channel polysomnography was performed to register the sleep stages, NPT were
continuously measured with the RigiScan-device in all three nights. In night 2
we performed additional measurement of vital parameters as heart rate and blood
pressure. In night 3, in addition, sleep was interrupted and blood was drawn via an
i.v.-line every two hours to determine the serum levels of testosterone, FAI (free
androgen index), estradiol, LH, FSH, prolactin, DHEA-S, and SHBG.

RESULTS: We found a significant decrease of REM-sleep in night 3 versus night
1 (8 vs. 17%, p>O.O5) and a significant reduction of the total time length
of erections (50.2 vs. 98.8 min, p>O.O3). Phase 3 and 4 sleep was also decreased,
whereas Sl and S2 sleep was increased. The total number of events was
significantly decreased in night 3 (3.7 vs. 5.5, p>O.O5). The amount of NPT
correlated to REM-sleep decreased from 80% in night 1 to 53% in night 3
(p>O.O3). There was no disturbance of the circadian rhythm and pulsatile
secretion of the measured sexual hormones in this study.

CONCLUSIONS: The disturbance of the physiological sleep pattern leads to a
significant reduction of REM and S3/4 sleep combined with a significant decrease
in the number and total length of nocturnal erections in young healthy adults, with
some showing the pattern similar to patients with erectile dysfunction. Therefore, a
normal sleep pattern is crucial for the evaluation of NPT-measurements in the
diagnostics of erectile dysfunction and a combination with polysomnography should
be performed to exclude the diagnosis of erectile dysfunction in healthy men.

_______________________________


Defining association between sleep apnea syndrome and erectile dysfunction


Abstract

Objectives
To conduct a study using validated sexual function and sleepiness inventories to define whether sleep apnea syndrome (SAS) is associated with erectile dysfunction and whether any correlation exists between the severity of SAS and the severity of erectile dysfunction. Previous work has suggested that sleep disorders are associated with erectile dysfunction.

Methods
Men presenting to a sleep clinic with symptoms consistent with SAS were given the Epworth Sleepiness Scale and an erectile dysfunction risk factor inventory, the International Index of Erectile Function. A database was constructed and statistical analysis conducted to define the correlation between the two entities.

Results
A total of 50 men met the criteria for inclusion. Of the 50 men, 60% had abnormal Epworth Sleepiness Scale scores and 80% of these patients had erectile dysfunction as determined by inventory scores compared with 20% of the men with normal Epworth Sleepiness Scale scores. There were statistically significant differences between men with normal and abnormal sleepiness scores for the total and erectile function domain of the International Index of Erectile Function. The correlation between the severity of the sleepiness and the severity of erectile dysfunction was good (r < 0.80, P = 0.012).

Conclusions
Men presenting with symptoms consistent with SAS have a significant risk of erectile dysfunction, and the correlation between the severity of sleep apnea and the severity of erectile dysfunction is strong.


Reference: Urology. Volume 67, Issue 5, May 2006, Pages 1033-1037
 
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Nelson Vergel

Founder, ExcelMale.com
The brain uses a quarter of the body's entire energy supply, yet only accounts for about two percent of the body's mass. So how does this unique organ receive and, perhaps more importantly, rid itself of vital nutrients? New research suggests it has to do with sleep.

 

Nelson Vergel

Founder, ExcelMale.com
The sleep and sex survey: Relationships between sexual function and sleep.

Distress and dysfunction in sleep and sex are both very common, and have been found to be separately related to anxiety, depression, and stress. Even so, and despite evidence linking obstructive sleep apnea and erectile disfunction, the connections between sleep and sex are largely understudied.

A large (N = 703) survey of people in the United States between 18 and 65 years old was conducted using Mechanical Turk, an on-line crowd-sourcing platform. Approximately 30% of participants were Black, Hispanic, Asian, or Native American, 8% identified as lesbian, gay or bisexual, and the sampling structure ensured an even gender distribution in each of 5 age strata. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), International Index of Erectile Function (IIEF), and Female Sexual Function Index (FSFI) assessed sleep and sexual dysfunction; the Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder scale (GAD-7) measured stress, depression, and anxiety to measure variance.

We found a significant connection between insomnia severity and sexual function. The relationship remained significant after accounting for the shared variability associated with depressive and anxious symptoms, and perceived stress.

Given this relationship, clinicians observing dysfunction in one area should routinely assess for dysfunction in the other. Further research will be required to determine (a) if treatment of one has an effect on the other, and (b) if this connection is related to a common psychopathological factor and/or is a conditioned association related to the commonly shared context of bed.

Journal of psychosomatic research. 2018 Jul 17
 

Nelson Vergel

Founder, ExcelMale.com
J Clin Sleep Med. 2018 Oct 15;14(10):1757-1764. doi: 10.5664/jcsm.7390.

Sleep Duration Is Associated With Testis Size in Healthy Young Men.

Zhang W1, Piotrowska K1, Chavoshan B2,3, Wallace J3,4, Liu PY1,3.


STUDY OBJECTIVES:
Sleep is increasingly recognized to influence a growing array of physiological processes. The relationship between sleep duration and testis size, a marker of male reproductive potential, has not been studied.

METHODS:
This was a preliminary cross-sectional analysis of the baseline data from 92 healthy men (mean ± standard deviation, age 33 ± 6 years, body mass index [BMI] 24.7 ± 6.1 kg/m2), of whom 66 underwent at-home actigraphy and 47 underwent in-laboratory polysomnography. Sleep duration and architecture were measured by actigraphy and polysomnography, testicular volume by Prader orchidometer, total testosterone by liquid chromatography tandem mass spectrometry, free testosterone by equilibrium dialysis, and luteinizing hormone and follicle-stimulating hormone (FSH) by immunochemiluminometric assay.

RESULTS:
Sleep duration was correlated with testicular volume (r = .31, P = .046) and with FSH (r = -.30, P = .035), and rapid eye movement sleep was correlated with FSH (r = .44, P = .006). The significance of these findings did not change after adjustment for age and BMI, and were confirmed nonparametrically by resampling. A putative inverse U-shaped relationship between testicular volume and sleep duration was observed by polynomial regression (P = .049), but not with resampling (P = .068).

CONCLUSIONS:
There is a positive linear and a possible inverse U-shaped relationship between sleep duration and testis volume. Longitudinal or interventional studies manipulating sleep are required to better define causality, and ultimately to establish how much sleep is needed to maximize male reproductive potential.
 

Nelson Vergel

Founder, ExcelMale.com
 

Nelson Vergel

Founder, ExcelMale.com
 

rlm55

New Member
Do we know the physiological reason for getting erections while we sleep? I've read that its important to have to keep the penile tissue healthy - sort of like lifting weights for the rest or your muscles. Is it during REM or only upon waking?
 

Nelson Vergel

Founder, ExcelMale.com
The cause of nocturnal penile tumescence is not known with certainty. Bancroft (2005) hypothesizes that the noradrenergic neurons of the locus ceruleus are inhibitory to penile erection, and that the cessation of their discharge that occurs during rapid eye movement sleep may allow testosterone-related excitatory actions to manifest as nocturnal penile tumescence.[5] Suh et al. (2003) recognizes that in particular the spinal regulation of the cervical cord is critical for nocturnal erectile activity.[6]

Evidence supporting the possibility that a full bladder can stimulate an erection has existed for some time and is characterized as a 'reflex erection'.[7] The nerves that control a man’s ability to have a reflex erection are located in the sacral nerves (S2-S4) of the spinal cord.[8] A full bladder is known to mildly stimulate nerves in the same region.

The possibility of a full bladder causing an erection, especially during sleep, is perhaps further supported by the beneficial physiological effect of an erection inhibiting urination, thereby helping to avoid nocturnal enuresis[citation needed]. However, given females have a similar phenomenon called nocturnal clitoral tumescence, prevention of nocturnal enuresis (bed-wetting) is not likely a sole supporting cause.[9]
 

Nelson Vergel

Founder, ExcelMale.com
The effects of testosterone replacement on nocturnal penile tumescence and rigidity and erectile response to visual erotic stimuli in hypogonadal men
C Carani 1, A R Granata, J Bancroft, P Marrama

Abstract​

Nocturnal penile tumescence (NPT) and erectile response to visual erotic stimuli (VES) were measured, by means of a Rigiscan device, in nine hypogonadal men, and repeated after 3 months of androgen replacement. The same assessments were carried out once in 12 eugonadal controls. The number of satisfactory NPT responses, in terms of both circumference increase and rigidity, were less in the hypogonadal men than the controls and were significantly increased by androgen replacement, confirming the results of earlier studies. In terms of circumference increase, erectile response to VES did not differ between the hypogonadal men and the controls, and did not increase with androgen replacement. In terms of rigidity, the erectile response to VES did not differ between hypogonadal men and controls. However, in terms of both duration and maximum level of rigidity, there was a significant increase following androgen replacement in the hypogonadal men. These new findings, in relation to rigidity, require a modification of the earlier formulation, which saw NPT as androgen dependent and erectile response to VES as androgen independent. NPT, and possibly spontaneous erections at other times, clearly involve an androgen sensitive system. Erectile response to VES predominantly involves an androgen independent system but may also be influenced by androgen sensitive mechanisms.


 

Nelson Vergel

Founder, ExcelMale.com
 

Nelson Vergel

Founder, ExcelMale.com
 

MIP1950

Active Member
I have treatment resistant bipolar illness and my ability for normal sleep was blown apart when I relapsed in 2004. I was 54. Not coincidentally, my erectile function began to decline several months later. And for sleep, the psychiatrist I was seeing prescribed clonazepam(Klonopin). Been addicted for 17 years. Kills erections. I was going to an endocrinologist at Kaiser Mid-Atlantic(psychiatrist was with Kaiser, too). I asked him to check my total and free testosterone; 325, total/45, free. At Kaiser, I found out that a man has to have a total of 240 before they'll treat. Between bipolar and its related sleep problems, trauma from no longer being able to work, marital discord, long term clonazepam use and low T, erectile function became infrequent.
 

BigTex

Well-Known Member
I never understood the importance of sleep and especially circadian cycle until later in my life. The first 21 years of my life, I ran night clubs and was generally up all night and train with weights in the afternoon before going in to work. I trained with a guy who was a multi-world record holder. He told me that I had a lot of potential as a powerlifter but would never make it to the top until I got a job during day light hours. Years later I put myself in that position after going back and getting my master's degree. When I hit my 40's I was quickly rising to the top of my game, It wasn't maybe 5 years after working day jobs that I was rated #1 and #2 in the world in two different weight classes in the same year. No doubt my sleep cycle was so screwed up I was not able to take that next step. Since then I have done quite a bit of research on the circadian cycle and how it effects your athletic potential. Good stuff! Thanks for posting this information Nelson.

I actually have been tracking my sleep for a few years now. These new FitBit watches monitor things like SP02, HR variability, temperature variations, resting HR, light sleep phases, Deep sleep, REM and awake time. They are pretty accurate.
 
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MIP1950

Active Member
My sleep has been wrecked for 18 years from untreatable bipolar illness. I don't doubt it's impact on my ED, though there were longstanding marital issue, too. Some sleep problems are self-created. I congratulate you on getting your sleep back on track.
 
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