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Sleep Disorders

Nocturnal Erections Disrupting Sleep

02/25/2009

Question:

I am a 63 years old. When I experience an erection I wake up. I`ve read that the nocturnal erections occur in deep sleep and are unnoticed normally. My experience is that I wake up EVERY TIME. I seem rested enough in the day but it`s a terrible nuisance. Is this some sort of phase or could it be drug related? I am bipolar and take various meds for that condition? No one seems too concerned except me. For 60 years I wasn`t concerned, either. I haven`t had a full night`s sleep for three years.

Answer:

This is an interesting question about what is normal during sleep with regards to the body’s physiology. Erections are considered a normal part of sleep physiology in men. As a matter of fact, the absence of erections during sleep in a man with impotence can suggest an underlying physical problem (and not emotional problem) as the cause of their impotence.

Erections typically occur during dream sleep, also known as rapid eye movement (REM) sleep. REM sleep usually occurs at the end of each sleep cycle throughout the night. These cycles are roughly 90-120 minutes in duration and, with each successive cycle, the amount of REM sleep gets longer. Thus, we experience most of our dream sleep late in the night with the longest block of REM sleep occurring right before we awaken in the morning. This explains why we often remember our dreams when we wake up.

It is quite normal to awaken at the end of each sleep cycle, as we are coming out of dream sleep. And since erections typically occur during dream sleep, it is a normal and common phenomena for men to awaken from sleep with an erection.

In the context of the above background, it is unlikely your erections are waking you up at night. What is much more likely is that you are frequently awakening from dream sleep with an erection and happen to notice this. This would be considered normal and nothing to worry about.

You could ask why you are awakening so frequently at night, especially since you feel you haven’t had a good nights sleep in at least 3 years. This brings up the possibility of other factors interfering with your sleep. Aside from primary sleep disorders, such as obstructive sleep apnea or periodic limb movements, numerous other factors may influence the quality of your sleep. These can range from the environment you sleep in (i.e. too warm, too loud) to other medical problems (i.e. heartburn or breathing problems) to medications you may taking.

To determine if there is sleep-related cause for your frequent awakenings and nonrestful sleep, a thorough history and physical examination are needed. A referral to a Sleep Specialist by your primary care physician should be considered to help sort out whether further testing is needed. Once a history and physical examination have been performed, the Sleep Specialist will decide if further evaluation is necessary.

To learn more about sleep and sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you.

Good luck and here's to better sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University