Department of Urology, The First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei 230022, Anhui, China.
Anhui Provincial Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Shushan District, Hefei 230022, Anhui, China.
J Sex Med. 2024 Sep 28;21(10):889-896. doi: 10.1093/jsxmed/qdae106.
Poor sleep quality is now a cause of sexual dysfunction.
To investigate variations in sleep quality among patients with different types of premature ejaculation (PE) and a control group.
Patients with PE were categorized into groups according to 4 types: lifelong (LPE), acquired (APE), variable (VPE), and subjective (SPE). Basic demographic information about the participants was first collected, and then clinical data were obtained.
Outcomes included the 5-item International Index of Erectile Function, Premature Ejaculation Diagnostic Tool, 7-item Generalized Anxiety Disorder, 9-item Patient Health Questionnaire, Pittsburgh Sleep Quality Index, self-estimated intravaginal ejaculation latency time (minutes), and sleep monitoring parameters obtained from a wearable device (Fitbit Charge 2).
A total of 215 participants were enrolled in the study, of which 136 patients with PE were distributed as follows: LPE (31.62%), APE (42.65%), VPE (10.29%), and SPE (15.44%). Subjective scales showed that patients with APE were accompanied by a higher prevalence of erectile dysfunction, anxiety, and depression, as well as poorer sleep quality (assessed by the Pittsburgh Sleep Quality Index). The results of objective sleep parameters revealed that average durations of sleep onset latency (minutes) and wake after sleep onset (minutes) in patients with APE (mean ± SD; 20.03 ± 9.14, 55 ± 23.15) were significantly higher than those with LPE (15.07 ± 5.19, 45.09 ± 20.14), VPE (13.64 ± 3.73, 38.14 ± 11.53), and SPE (14.81 ± 4.33, 42.86 ± 13.14) and the control group (12.48 ± 3.45, 37.14 ± 15.01; P < .05). The average duration of rapid eye movement (REM; minutes) in patients with APE (71.34 ± 23.18) was significantly lower than that in patients with LPE (79.67 ± 21.53), VPE (85.93 ± 6.93), and SPE (80.86 ± 13.04) and the control group (86.56 ± 11.93; P < .05). Similarly, when compared with the control group, patients with LPE had significantly longer durations of sleep onset latency and wake after sleep onset and a significantly shorter duration of REM sleep.
Our study suggests that clinicians should pay attention not only to male physical assessment but also to mental health and sleep quality.
This study suggests that changes in sleep structure occur in patients with PE, which may provide some direction for future research. However, the cross-sectional study design does not allow us to conclude that sleep is a risk factor for PE.
After controlling for traditional parameters such as age, erectile dysfunction, anxiety, and depression, sleep parameters are independently associated with PE. Patients with APE and LPE show significant alterations in sleep parameters, with patients with APE having notably poorer sleep quality, whereas patients with VPE and SPE have sleep parameters similar to controls.
睡眠质量差现在是性功能障碍的一个原因。
调查不同类型早泄（PE）患者和对照组之间睡眠质量的变化。
根据 4 种类型将 PE 患者分为组：终身（LPE）、获得性（APE）、变异性（VPE）和主观性（SPE）。首先收集参与者的基本人口统计学信息，然后获得临床数据。
共有 215 名参与者入组，其中 136 名 PE 患者分布如下：LPE（31.62%）、APE（42.65%）、VPE（10.29%）和 SPE（15.44%）。主观量表显示，APE 患者伴有更高的勃起功能障碍、焦虑和抑郁患病率，以及更差的睡眠质量（通过匹兹堡睡眠质量指数评估）。客观睡眠参数的结果显示，APE 患者的入睡潜伏期（分钟）和睡眠后觉醒（分钟）的平均时长（均值±SD；20.03±9.14、55±23.15）明显高于 LPE（15.07±5.19、45.09±20.14）、VPE（13.64±3.73、38.14±11.53）和 SPE（14.81±4.33、42.86±13.14）和对照组（12.48±3.45、37.14±15.01；P<.05）。APE 患者的快速眼动（REM；分钟）的平均时长（71.34±23.18）明显低于 LPE（79.67±21.53）、VPE（85.93±6.93）和 SPE（80.86±13.04）和对照组（86.56±11.93；P<.05）。同样，与对照组相比，LPE 患者的入睡潜伏期和睡眠后觉醒的持续时间明显更长，而 REM 睡眠的持续时间明显更短。
本研究提示临床医生不仅要关注男性的身体评估，还要关注心理健康和睡眠质量。
本研究表明 PE 患者的睡眠结构发生变化，这可能为未来的研究提供一些方向。然而，横断面研究设计不允许我们得出睡眠是 PE 的危险因素的结论。
