Effects of Sleep Disorders and Circadian Rhythm Changes on Male Reproductive Health: A Systematic Review and Meta-analysis

Abstract

Objectives: The purpose of this study was to elucidate the relationship between sleep disorders and male reproductive health, and to explore the underlying mechanisms via a systematic review and meta-analysis.Methods: PubMed, Embase, The Cochrane library, Web of Science, Scopus databases were searched to collect clinical research on the effects of sleep disorders on male semen parameters from inception to February 24, 2022. RevMan 5.4 was used for meta-statistical analysis. Stata16 software was used to detect publication bias.Results: The results of meta-analysis showed that sleep disorders were associated with reduced total sperm count (mean difference (MD) = −27.91, 95% CI = (−37.82, −18.01), p < 0.001), reduced sperm concentration (MD = −5.16, 95% CI = (−9.67, −0.65), p = 0.02), reduced progressive motility (MD = −2.94, 95% CI = (−5.28, −0.59), p = 0.01), and reduced normal morphology (MD = −0.52, 95% CI = (−0.80, −0.24), p < 0.001). However, there is no significant association between sleep disorders and semen volume/reproductive hormones. Further bioinformatics mining revealed that related clock genes (PER1, PER2, CRY2, NR1D1 and NPAS2) were down-regulated in non-obstructive azoospermia patients.Conclusion: In conclusion, current evidence suggests that sleep disorders have a negative impact on male reproductive health, and its underlying mechanism may be related to circadian rhythm disorders. However, the relationship between sleep disorders and reproductive hormone levels has not been found. Due to the limited number and quality of included studies, the above findings need to be validated by more high-quality studies.

Sleep duration and biomarkers of fecundity in young men: a cross‐sectional study from a population‐based cohort

“…18 Other biomarkers of male fecundity, such as testes volume or reproductive hormone levels, have been rarely studied in relation to sleep duration. 4,5 One cross-sectional study from the United States found no association between self-reported sleep duration and testes volume, however, when measuring sleep duration using actigraphy, the authors found a linear association between sleep duration and testes size. 12 In another study from the United States, the shorter sleep duration was associated with lower testosterone levels in men aged 16−80 years old, 19 whereas in a Danish cross-sectional study, the longer sleep duration was associated with lower levels of testosterone in middle-aged men.…”

“…1,2 Sleep disturbances such as late bedtime, shift work, and low quality sleep may pose such risk factors. [3][4][5][6][7][8] Moreover, epidemiological findings suggest that short and long sleep duration might be associated with biomarkers of poor male fecundity too; however, results are inconsistent (for an overview of the epidemiological literature, please see Table S1). [3][4][5][9][10][11][12][13][14][15][16][17] Some studies of young Chinese men report an inverse u-shaped association between sleep duration and semen characteristics.…”

“…[3][4][5][6][7][8] Moreover, epidemiological findings suggest that short and long sleep duration might be associated with biomarkers of poor male fecundity too; however, results are inconsistent (for an overview of the epidemiological literature, please see Table S1). [3][4][5][9][10][11][12][13][14][15][16][17] Some studies of young Chinese men report an inverse u-shaped association between sleep duration and semen characteristics. [9][10][11]15 In addition, one case-control study based in China found that men sleeping less than 8 h/night had an increased risk of asthenozoospermia compared with men sleeping 8−9 h/night.…”

“…Up to one‐fourth of young men in Western countries may have low semen quality, which is a major public health concern, since this might be associated with longer time to pregnancy and a higher risk of medically assisted reproduction 1,2 . Sleep disturbances such as late bedtime, shift work, and low quality sleep may pose such risk factors 3–8 . Moreover, epidemiological findings suggest that short and long sleep duration might be associated with biomarkers of poor male fecundity too; however, results are inconsistent (for an overview of the epidemiological literature, please see Table S1).…”

“…Moreover, epidemiological findings suggest that short and long sleep duration might be associated with biomarkers of poor male fecundity too; however, results are inconsistent (for an overview of the epidemiological literature, please see Table S1). 3–5,9–17 …”