Sleep quality, sleep duration and sexual health among older people: Findings from the English Longitudinal Study of Ageing

Abstract

Highlights Subjective sleep quality was associated with self-reported poorer sexual health and sexual satisfaction.  Self-reported sleep duration was largely unrelated to sexual activities, functioning and satisfaction.  Robust associations between poorer sleep quality and vaginal pain and vaginal dryness were observed in women. 2 Abstract Context: How sleep quality and sexual health are associated among community-dwelling individuals remains largely unknown. Objective: We examined the association of sleep disturbance and sleep duration with a range of measures assessing sexual activities, functioning and concerns in a representative sample of older people. Methods: Participants were community-dwelling adults aged 50-90+ years from wave 6 (2012/2013) of the English Longitudinal Study of Ageing (ELSA) who reported any sexual activity in the last year. Sleep disturbance, sleep duration and sexual health were measured by self-report at wave 6. Retrospective reports of restless sleep (waves 1-6 [2002-2013]) were also examined. The association between sleep measures and sexual health was assessed using logistic regressions stratified by gender and adjusted for demographic, health and lifestyle factors with results expressed as odds ratios (OR) and 95% confidence intervals (CI).Results: Among both men and women disturbed sleep was associated with reported declines in sexual activity and function over the last year, and increased concern about their sexual desire, frequency of sexual activity and sexual functioning. Robust associations between high sleep disturbance and vaginal pain (OR=1.67, 95% CI=1.21, 2.31) and vaginal dryness (OR=1.69, 95% CI=1.24, 2.30) were also observed among women. Retrospective reports of restless sleep showed a dose-response relationship with reported declines in sexual health over the last year, and increased concerns about sexual expression and functioning.Conclusions: Self-reported sleep disturbance and retrospective restless sleep were mainly associated with subjective assessments of recent declines in sexual activity and functioning, and higher levels of sexual concerns.

Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference

“…Cigarette smoking was recorded as never, former, and current. Alcohol drinking was categorized as rarely, regularly, and frequently according to the frequency of alcohol consumption in the last 12 months [25]. Physical activity was classed as low, moderate, or high based on the frequency of participation in mild, moderate, and vigorous physical activities [26].…”

The Health Benefits of Sexual Expression

“…Studies have found links between good sex and good sleep, but the causal direction is unclear. For example, individuals with disturbed sleep report a decline in sexual activity and function (Lee & Tetley, 2019), yet it is not clear which phenomenon (disrupted sleep or disrupted sexual activity) is primary. Certainly, the physiological after-effects of sexual activity may promote highquality sleep (physical activity followed by muscle relaxation; elevated oxytocin level and consequent stress-reduction; elevated prolactin level after orgasm; lowered cortisol after orgasm).…”

Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment

“…Related to mental health, many women, particularly those in midlife, experience compromised sleep quality, contributing to many symptoms including decreased sexual desire. 41 Addressing sleep problems through sleep hygiene or medication may positively affect sexual function. 4 If the biopsychosocial assessment reveals significant relational issues, one should consider referral to couples therapy to address underlying relationship challenges and improve communication, particularly around intimacy.…”

“…If the patient screens positive, a brief assessment of behavioral health concerns may be performed and referral to specialized care with a behavioral health specialist may be appropriate. Related to mental health, many women, particularly those in midlife, experience compromised sleep quality, contributing to many symptoms including decreased sexual desire 41 . Addressing sleep problems through sleep hygiene or medication may positively affect sexual function 4 .…”