Sleep apnea and erectile dysfunction: how they're linked and what helps

Erectile dysfunction is common in men with sleep apnea, and the worse the sleep apnea, the worse erections tend to be. A 2026 meta-analysis found ED in 59% to 69% of men with obstructive sleep apnea across the studies it reviewed. CPAP can help a little, and the good news is that both conditions are treatable.

This guide covers what the research shows, why the two may be connected, what treatment does and when to see a doctor. For the wider picture, see our guide to how sleep apnea affects the body.

Is sleep apnea linked to erectile dysfunction?

Sleep apnea is clearly linked to erectile dysfunction in men. A 2026 meta-analysis in the International Journal of Impotence Research found ED in 59% to 69% of men with sleep apnea in the studies it reviewed. NHLBI lists sexual dysfunction and decreased libido among the symptoms of sleep apnea you may notice yourself.

That 2026 review went further than earlier work by measuring how closely the severity of each condition lines up. Across seven studies with 594 men, a higher apnea-hypopnea index, the number of breathing pauses and shallow breaths per hour, was moderately tied to lower scores on a standard erectile function questionnaire. Across three studies with 513 men, lower oxygen levels during sleep were tied to worse scores too.

An earlier meta-analysis, published in the Journal of Sexual Medicine in 2015, pooled nine studies with 1,275 people. It found that sleep apnea was linked to 1.82 times the risk of erectile dysfunction in men. It also found twice the risk of sexual dysfunction in women, which is a reminder that this isn't only a men's health issue.

The 2026 authors flagged two limits. Age was an important confounder, since both conditions become more common as men get older, and the studies differed a lot in how they measured erectile function.

How common is erectile dysfunction in sleep apnea?

Erectile dysfunction affects more than half of men with sleep apnea in most studies, and it's more common as sleep apnea gets more severe. In a 2016 study of 207 men in Archives of Sexual Behavior, ED was found in 60.6% of men with sleep apnea overall and 72.2% of those with severe sleep apnea.

For context, ED is common in general. NIDDK says research suggests between 30 million and 50 million men in the United States have it. About 40% of men are affected at age 40, and 70% report having ED by age 70. NIDDK also says ED is not a routine part of aging, which matters here. If you have both, it's worth asking whether something treatable like sleep apnea is contributing.

Why would sleep apnea affect erections?

Sleep apnea may affect erections through low oxygen at night, lower testosterone and its links with heart and blood vessel problems. NIDDK says diseases that affect the blood vessels, nerves or hormones can lead to ED, and lists high blood pressure, heart and blood vessel disease, obesity, diabetes and low testosterone among the most common causes.

Low oxygen is one likely piece. The 2026 meta-analysis found that men whose oxygen dropped lower during sleep tended to have worse erectile function. Erections depend on healthy blood flow, and sleep apnea often travels with high blood pressure and heart disease. Our guides to sleep apnea and high blood pressure and sleep apnea and the heart explain those links.

Hormones are another piece. A 2019 review in the World Journal of Men's Health says sleep apnea in middle-aged men is often associated with lower testosterone, together with obesity and aging. In the 2016 study, men with severe sleep apnea had lower testosterone than men who snored without sleep apnea.

Mood and tiredness probably play a part too. NIDDK says anxiety, depression and stress can cause ED or make it worse, and the NHS lists feeling very tired and mood swings among sleep apnea symptoms. Our article on sleep apnea and depression looks at that overlap.

Does CPAP help erectile dysfunction?

CPAP can modestly improve erectile function in some men, but the evidence is uncertain and it works less well than ED medicines. A 2019 meta-analysis in Sleep Medicine Reviews pulled together 26 studies and found that CPAP significantly improved erectile function scores and measures of erections during sleep.

The same review compared CPAP with PDE5 inhibitors, the class of ED medicines that includes sildenafil. The medicines did better on erectile function and intercourse satisfaction. CPAP did better on the number of erections during sleep. And CPAP combined with an ED medicine worked better than CPAP alone.

A 2021 Cochrane review took a stricter look, including only randomized trials. It found six trials with 315 men, all with some important risk of bias, and rated the evidence as very low certainty. The authors said they were uncertain whether CPAP improves ED compared with no CPAP, and that sildenafil may slightly improve erectile function at 12 weeks compared with CPAP. No serious side effects were reported with either. In one trial, 4 of 20 men using CPAP had nasal dryness, while 3 of 20 taking sildenafil had brief flushing and mild headache, and the reviewers couldn't say whether either caused more minor side effects.

The 2016 study gives a sense of scale. After three months of CPAP, men with severe sleep apnea improved their erectile scores, but the change was small and their testosterone levels didn't change. The 2026 meta-analysis found that CPAP was associated with improvements in the studies it included, though the size varied with the questionnaire used.

The practical takeaway is that CPAP is worth using well for its own sake, and any boost to sexual health is a welcome extra. If the mask is getting in the way, our guide to getting used to CPAP can help.

What about testosterone treatment?

Testosterone treatment needs care in men with sleep apnea, so talk it through with your doctor before starting. The 2019 review in the World Journal of Men's Health says treating sleep apnea doesn't reliably raise testosterone in most studies. It adds that testosterone therapy may help low testosterone and sexual function in some men.

The same review gives a clear caution. Testosterone therapy may make sleep apnea worse in some men, so doctors should ask about sleep apnea symptoms before and after starting it. The authors said it should probably be avoided in men with severe untreated sleep apnea. If you're on testosterone or thinking about it, mention any snoring or breathing pauses.

Which everyday habits help both?

Several everyday habits help both sleep apnea and erectile dysfunction, which makes them a good place to start alongside medical care. NIDDK lists not getting enough physical activity, drinking too much alcohol and smoking among the lifestyle behaviors that can contribute to ED. The NHS gives very similar advice for sleep apnea.

The NHS says sleep apnea can sometimes be treated with lifestyle changes like losing weight, giving up smoking and cutting back on alcohol. It suggests losing weight if you're overweight, exercising regularly, keeping regular sleep hours, sleeping on your side, not drinking too much alcohol shortly before bed and avoiding sleeping pills unless a doctor recommends them, since they can make sleep apnea worse.

That overlap is encouraging. Regular activity, less alcohol and not smoking appear on both lists, so one set of changes works toward both goals. They won't replace CPAP or ED treatment if you need them, but they're a sensible start while you wait for an appointment.

When should you see a doctor?

See a doctor if you have erectile dysfunction, especially alongside snoring, breathing pauses at night or heavy daytime tiredness. NIDDK says ED may be a symptom of another health problem, and the NHS says to see a GP if your breathing stops and starts while you sleep, you make gasping or choking noises, or you always feel very tired.

ED can feel awkward to bring up, but doctors ask about it routinely. NIDDK says health care professionals use your medical, sexual and mental health history, a physical exam and tests to work out what's going on. The 2026 meta-analysis authors said their findings underscore the importance of screening for sleep apnea in men who come in with ED.

If your doctor suspects sleep apnea, testing is often simple. The NHS says it can usually be done at home, and our guide to the home sleep apnea test explains the process. Our list of sleep apnea warning signs can help you describe your symptoms, and sleep apnea treatment options covers what comes next.

Treating both conditions together often makes the most sense. Sleep apnea treatment protects your heart and helps with tiredness, and ED has its own effective treatments that your doctor can talk through with you.

This article is general information, not medical advice. Talk to your doctor about your own situation.

Read next

• Sleep apnea and diabetes: the two-way link
• Sleep apnea and dementia
• How sleep apnea affects the body, system by system

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.