Alvarenga Tathiana A, Fernandes Guilherme L, Bittencourt Lia R, Tufik Sergio, Andersen Monica Levy
Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
J Sleep Res. 2023 Feb;32(1):e13664. doi: 10.1111/jsr.13664. Epub 2022 Jun 7.
Sleep is essential for the maintenance of health and systemic homeostasis. Decreased sleep time and sleep quality have been associated with a wide range of diseases. To evaluate the effects of obstructive sleep apnea (OSA) and total or selective rapid eye movement (REM) sleep deprivation on male reproductive function, we performed a three-arm parallel study with one pre-defined OSA group and a group of healthy volunteers who were then randomised into total or REM sleep deprivation groups. Questionnaires were completed and overnight polysomnography was undertaken, and blood and sperm samples were collected at the Sleep Institute, São Paulo, Brazil. OSA was diagnosed using questionnaires and polysomnography. Male sexual function was assessed through the questionnaires, blood tests, and semen samples. Data showed an association between OSA and lower circulating levels of total and free testosterone and high-density lipoproteins, as well as a lower proportion of healthy sperm cells and decreased sperm concentration, in comparison to volunteers. Volunteers subjected to either total or REM sleep deprivation had increased circulating levels of thyroid-stimulating hormone, insulin, and higher homeostatic model assessment of insulin resistance (HOMA-IR) values. Both sleep-deprived groups also shown decreased cholesterol, and low-density lipoproteins when compared to their baseline levels, but had no alterations in their spermograms. We observed a reduction in total testosterone following total sleep deprivation, but no effect after REM sleep deprivation. OSA was associated with a hormonal imbalance, which is probably linked with impaired reproductive function and associated comorbidities, such as sleep fragmentation/loss and obesity.
睡眠对于维持健康和全身内稳态至关重要。睡眠时间和睡眠质量的下降与多种疾病有关。为了评估阻塞性睡眠呼吸暂停（OSA）以及完全或选择性快速眼动（REM）睡眠剥夺对男性生殖功能的影响，我们进行了一项三臂平行研究，其中有一个预先定义的OSA组和一组健康志愿者，然后将后者随机分为完全或REM睡眠剥夺组。在巴西圣保罗的睡眠研究所完成了问卷调查并进行了整夜多导睡眠监测，同时采集了血液和精液样本。通过问卷调查和多导睡眠监测诊断OSA。通过问卷调查、血液检测和精液样本评估男性性功能。数据显示，与志愿者相比，OSA与总睾酮和游离睾酮以及高密度脂蛋白的循环水平降低有关，同时健康精子细胞的比例较低且精子浓度降低。完全或REM睡眠剥夺的志愿者促甲状腺激素、胰岛素的循环水平升高，胰岛素抵抗的稳态模型评估（HOMA-IR）值更高。与基线水平相比，两个睡眠剥夺组的胆固醇和低密度脂蛋白也均降低，但精液检查无变化。我们观察到完全睡眠剥夺后总睾酮降低，但REM睡眠剥夺后无影响。OSA与激素失衡有关，这可能与生殖功能受损以及睡眠片段化/缺失和肥胖等相关合并症有关。
