Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings from the English Longitudinal Study of Ageing

Abstract

Introduction: One factor that may plausibly be associated with sexual dysfunction is sleep disturbance. Like sexual problems, complaints of sleep disturbance increase with age and are commonly reported by older adults.

Aims: To examine associations between sleep quality, duration, and a range of sexual problems in a large, representative sample of older adults.

Methods: Data were from 2,568 men and 1,376 women (age ≥50 years) participating in Wave 6 of the English Longitudinal Study of Ageing (2012-2013). Sleep quality, duration, and problems with erectile function, sexual arousal, and orgasmic experience were self-reported; associations were examined using logistic regression models. Covariates included age, ethnicity, partner status, wealth, limiting long-standing illness, smoking, alcohol consumption, physical activity, and depressive symptoms.

Main outcome measure: Participants self-reported problems with erectile function, sexual arousal, and orgasmic experience.

Results: In women, moderate (odds ratio [OR] = 1.53, 95% CI 1.09-2.13, P = .013) and low sleep quality (OR = 1.70, 95% CI 1.24-2.32, P = .001) were associated with increased odds of arousal problems relative to high sleep quality. In men, moderate sleep quality was associated with increased odds of erectile difficulties (OR = 1.47, 95% CI 1.16-1.85, P = .001), the difference between low and high sleep quality did not reach statistical significance (OR = 1.24, 95% CI 0.97-1.58, P = .091). Sleep quality was not associated with difficulty achieving an orgasm in men, but in women low sleep quality was associated with increased odds of orgasmic difficulty (OR = 1.63, 95% CI 1.18-2.25, P = .003). No associations between sleep duration and problems with sexual function were observed in women, but, in men, long sleep was associated with higher odds of difficulty achieving orgasm (OR = 1.75, 95% CI 1.04-2.95, P = 0.036) relative to optimal sleep duration.

Clinical implications: Older adults presenting sleep problems should be screened for sexual dysfunction and vice versa.

Strength & limitations: Strengths of this study include the large representative sample of older English adults, the assessment of several aspects of sexual dysfunction and sleep, and the inclusion of potentially important confounding variables into statistical models. However, the study was cross-sectional, meaning we were unable to ascertain the direction of the observed associations.

Conclusion: Sleep problems are associated with sexual dysfunction in older English adults, although some variation is noted between men and women. Smith L, Grabovac I, Veronese N, et al. Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings From the English Longitudinal Study of Ageing. J Sex Med 2019;16:427-433.

Keywords: Erectile Dysfunction; Sexual Activity; Sexual Dysfunction; Sleep Duration; Sleep Problems.