Association between sleep quality, depression, and sexual dysfunction in men seeking treatment for sexual dysfunction: a multicenter prospective analysis

Abstract

Background: Sleep quality, depression, and sexual dysfunction are interrelated yet under-investigated areas, particularly in clinical urology practice. Given the high prevalence of these conditions and their impact on men’s health, our study aimed to explore the associations between these factors in men seeking treatment for sexual dysfunction. Methods: This prospective multicenter study included 121 men aged 18–65 years with sexual dysfunction, recruited from eight urology clinics. Patients were assessed using the Pittsburgh Sleep Quality Index (PSQI), the International Index of Erectile Function (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), and the Beck Depression Inventory (BDI). Hormonal parameters were also evaluated. Participants were classified according to sleep quality and depression severity. Comparative and logistic regression analyses were performed. Results: Poor sleep quality was found in 72.7% of patients. These individuals had lower sexual desire and overall satisfaction scores, and higher PEDT scores (p < 0.05). Moderate to severe erectile dysfunction and premature ejaculation were more prevalent in this group. Depression severity was also significantly higher among those with poor sleep (p = 0.03). Logistic regression analysis showed independent associations between poor sleep quality, older age, erectile dysfunction severity, lower sexual desire, and the presence of premature ejaculation. Conclusions: Poor sleep quality is associated with increased sexual dysfunction and depressive symptoms. Evaluation of sleep and mood should be integrated into the clinical assessment of male patients presenting with sexual complaints.