Sleep quality, duration and associated sexual function at older age: findings from the English longitudinal Study of Ageing

Background: This study aimed to explore associations between sleep quality, duration and sexual problems (erectile dysfunction, difficulty becoming aroused, difficulty reaching orgasm) in a large, representative sample of older adults. Method: Data were from 2,568 men and 1,376 women (age ≥50y) participating in Wave 6 of the English Longitudinal Study of Ageing (2012/13). Sleep quality, duration and problems with erectile function, sexual arousal and orgasmic experience were self-reported, and associations examined using logistic regression models. Covariates included age, ethnicity, partner status, wealth, limiting long-standing illness, smoking, alcohol consumption, physical activity and depressive symptoms. Results: In women, moderate (OR=1.53, 95% CI 1.09-2.13, p=0.013) and low sleep quality (OR=1.70, 95% CI 1.24-2.32, p=0.001) were associated with increased odds of arousal problems relative to high sleep quality. In men, moderate sleep quality was associated with increased odds of erectile difficulties (OR=1.47, 95% CI 1.16-1.85, p=0.001), the difference between low and high sleep quality did not reach statistical significance (OR=1.24, 95% CI 0.97-1.58, p=0.091). Sleep quality was not associated with difficulty achieving an orgasm in men, but in women low sleep quality was associated with increased odds of orgasmic difficulty (OR=1.63, 95% CI 1.18-2.25, p=0.003). No associations between sleep duration and problems with sexual function were observed in women, but in men, long sleep was associated with higher odds of difficulty achieving orgasm (OR=1.75, 95% CI 1.04-2.95, p=0.036) relative to optimal sleep duration. Clinical Implications: Older adults presenting sleep problems should be screened for sexual dysfunction and vice versa. Strengths and Limitations: Strengths of this study include the large representative sample of older English adults, the assessment of several aspects of sexual dysfunction and sleep, and the inclusion of potentially important confounding variables into statistical models. However, the study was cross-sectional, meaning we were unable to ascertain the direction of the observed associations. Conclusion: Sleep problems are associated with sexual dysfunction in older English adults, although some variation is noted between men and women.