The Association Between Insomnia, Insomnia Medications, and Erectile Dysfunction

• Published in: European urology focus 2024-01, Vol.10 (1), p.139-145
• Main Authors: Belladelli, Federico, Li, Shufeng, Zhang, Chiyuan A., Del Giudice, Francesco, Basran, Satvir, Muncey, Wade, Glover, Frank, Seranio, Nicolas, Fallara, Giuseppe, Montorsi, Francesco, Salonia, Andrea, Eisenberg, Michael L.
• Format: Article
• Language: English
• Subjects: Erectile dysfunction; Erectile dysfunction treatment; Insomnia; Phosphodiesterase-5 inhibitors
• ISSN: 2405-4569; 2405-4569
• DOI: 10.1016/j.euf.2023.08.005

Insomnia affects up to one-third of adults and impact male erectile function. Men only diagnosed with insomnia were found to have a higher risk of developing erectile dysfunction (ED). Moreover, men with pharmacologic insomnia treatments were more often prescribed treatments for ED. Sleep quality and duration have been investigated for their association with health. Insomnia affects up to one-third of adults and may impact male erectile function. In addition, medical treatments for insomnia (many of which are sedatives) may also affect erectile quality. To investigate the association of erectile dysfunction (ED) in patients diagnosed with and treated for insomnia. We utilized the IBM MarketScan (2007–2016) Commercial and Medicare Supplemental Databases (v 2.0). Age- and enrollment-matched controls were selected among patients without insomnia diagnosis or treatment. Cox proportional hazard models were used to estimate the risk of incident ED (ie, diagnosis alone, or diagnosis and treatment with phosphodiesterase-5 inhibitors [PDE5i], intracavernous injection (ICI)/urethral suppositories, and penile prosthesis) after the diagnosis or treatment of insomnia while adjusting for relevant comorbidities. In total, 539 109 men with an insomnia diagnosis were identified. Of these men, 356 575 were also medically treated for insomnia. The mean (±standard deviation) follow-up times for patients diagnosed with insomnia and those diagnosed with and treated for insomnia were 2.8 ± 1.6 and 3.1 ± 1.8 yr, respectively. Men with insomnia were more commonly smokers and had a higher number of office visits and comorbidities than controls (p