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Is There A Link Between Sleep Apnea And Male Fertility?

When the plan is a baby, but you’re having a hard time conceiving, it’s normal to start wondering why. While there can be a number of issues in play, one tends to be overlooked: sleep quality. Specifically, men who have the sleep disorder sleep apnea could be at greater risk of fertility issues. Now, new research is drawing a more definitive link between sleep apnea and male fertility. Let’s review.

Key Takeaways

  • Sleep apnea is a common sleep disorder with well-known side effects like daytime fatigue and loud snoring. It can lead to a number of health risks, and new research is linking it to fertility issues as well.
  • Studies show that men with sleep apnea are more likely to experience erectile dysfunction, reduced testosterone levels and a drop in semen quality.
  • Sleep apnea can be managed, and the same lifestyle recommendations that help improve symptoms of this sleep disorder can also have a positive impact on male fertility.

What is Sleep Apnea?

Sleep apnea is a common sleep disorder that involves interrupted breathing during sleep. Well-known symptoms are snoring and fatigue during the daytime, but because it affects overall sleep quality, it takes a tremendous toll on overall health. There are a few types of sleep apnea, but the most common is obstructive sleep apnea (OSA). Essentially, the muscles in the throat relax so much when a man falls asleep that they completely block the airway. This means he’s without oxygen until he startles awake before falling back asleep and repeating the cycle. It’s a rough way to spend the night, and associated health risks include cardiovascular disease, metabolic syndrome and neurocognitive dysfunction. But what about fertility issues?

Sleep Apnea and Male Fertility

In the past few years, research has looked at the potential relationship between sleep apnea and male fertility and a handful of studies have drawn a significant association between the two. Turns out, sleep apnea can be detrimental to a man’s fertility in more ways than one. According to one 2022 study, men with OSA were more likely to experience significantly impaired erectile function, reduced testosterone levels and lowered semen quality in the form of a decline in sperm motility (1). The good news? Sexual function improved after a year of CPAP therapy.

Other research points to the impact sleep apnea has on the endocrine system and resulting deviations in reproductive hormone profiles including testosterone and prolactin (2). Testosterone is a key hormone for healthy male reproductive function. It plays an essential role in sex drive and sperm production. Since testosterone naturally begins to decline when a man reaches his 30s, adding sleep apnea to the mix can be problematic for a healthy conception.

While more research is warranted to determine exactly how sleep apnea affects so many facets of male fertility is something called testicular hypoxia. Essentially, the interrupted breathing cycle all night low means an insufficient supply of oxygen to the testes. That affects spermatogenesis, or the sperm maturation process, which results in poor quality sperm.

When we talk about healthy sperm, there are a few parameters to consider:

  • Sperm count: An important aspect of semen quality is the number or concentration of sperm cells in a given amount of semen. Normal semen contains 40 million to 300 million sperm per milliliter. A low sperm count – ie oligospermia –  is anything between 10 and 20 million sperm per milliliter (20 million sperm per milliliter could be enough for pregnancy if the sperm are healthy).
  • Sperm morphology: Normal sperm have egg-shaped heads and long tails, which they use to “swim” to the egg. The more normal-shaped sperm you have, the easier it is for them to reach your partner’s egg.
  • Sperm motility: An essential function of healthy sperm cells is their ability to swim. Sperm motility is measured as the percentage of moving sperm cells in a sample of semen. Healthy sperm motility is defined as sperm with forward progressions of at least 25 micrometers per second.
  • Testosterone levels and hormonal balance: The precise balance of hormones in a man’s body determines the success of the male reproductive system. This includes producing enough testosterone or gonadotropins, which includes follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

It’s a delicate process, and it’s clear that insufficient oxygen—not to mention the cascading health effects of poor sleep quality night after night—throws a wrench in the works.

How Is Sleep Apnea Treated?

Baby plans or not, sleep apnea is a serious sleep disorder that should be treated. That means early detection is key. Men experiencing symptoms of sleep apnea (loud snoring, daytime fatigue and a partner who swears up and down that he stops breathing when he’s sleeping) should speak to their doctor right away. There are treatments for sleep apnea, and managing this condition can help improve related fertility issues. 

Keep in mind that in addition to something like CPAP therapy, there are other recommendations for improving sleep apnea. As researchers from the 2022 study mentioned above put it, “higher severity of OSA is associated with other comorbidities such as physical activity, smoking habits, alcohol consumption, diet, family history, and body mass index that are also contributing factors to male infertility.” In other words, by dealing with sleep apnea, you can also improve other lifestyle habits that aren’t great for fertility. 

Research shows that the health of both biological parents in the three to six months before a baby is conceived (aka the preconception window) plays a huge role in the health of the conception, pregnancy and baby (3). Anything you can do to support your health as a whole has a trickle-down effect on reproductive health, which is why experts recommend embracing healthy habits. That includes regular exercise, managing stress, high-quality sleep and a balanced diet. Pro tip: both partners benefit from the targeted nutrition of specialized prenatal vitamins formulated to support their respective reproductive processes. Beli for Men is made with nutrients that promote healthy sperm production, support optimal motility and morphology and counteract DNA damage, along with helping to balance hormones.

The Bottom Line

Understanding what’s standing between you and fatherhood is empowering. While not all fertility issues are easily identified, research has pinpointed sleep apnea as problematic. If this is something you have or suspect you may have, make sure you’re discussing its implications on your fertility and taking steps to support your reproductive function in every way possible.


Article Resources

  1. Kyrkou, K et al. (2022). Impaired Human Sexual and Erectile Function Affecting Semen Quality, in Obstructive Sleep Apnea: A Pilot Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225560/
  1. Lin, P et al. (2022). Risk of Infertility in Males with Obstructive Sleep Apnea: A Nationwide, Population-Based, Nested Case-Control Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224853/
  1. Preconception health. (2018). https://www.thelancet.com/series/preconception-health

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