Sleep Disorders are Associated with Testosterone Deficiency and Erectile Dysfunction- A U.S. Claims Database Analysis

Abstract The relationship between male genitourinary conditions and sleep disorders has only been reported in small sample sizes. Our objective was to assess the association of erectile dysfunction (ED) and testosterone deficiency with various sleep disorders using a large claims database. The TriNetX Diamond database, a research network of over 220 million patients, was queried in June 2022. In men aged 40–70 years, insomnia (ICD-10 G47.0), sleep apnea (G47.33), and circadian rhythm sleep disorder (G47.2) were each independently assessed to determine the association with ED (N52) and testicular hypofunction (E29.1). A propensity-score-matched control cohort was generated with an absence of sleep disorders (G47 & F51), sleep deprivation (Z72.820), or morbid obesity with alveolar hypoventilation (E66.2). Propensity score matching was performed for age, hypertension (I10-16), hyperlipidemia (E78), diabetes mellitus (E08-13), ischemic heart disease (I20-25), tobacco usage (Z72.0), and obesity (E66). Sensitivity analyses were conducted via a negative polysomnography testing (CPT 1013314) cohort. Men diagnosed with a sleep disorder had significantly higher odds of testosterone deficiency and ED compared to propensity-score matched controls. Our results emphasize the negative impact of poor sleep on diseases of the male genitourinary system by identifying these relationships in the largest cohort in the U.S. reported to date.