Shift work sleep disorder (SWSD) and shift work have previously been shown to affect the secretion of several hormones and neurotransmitters associated with premature ejaculation (PE). However, there remains a lack of research on the specific influence of SWSD and shift work on PE.
A recent BMC Public Health study explores the relationship between SWSD, shift work, and PE.
Study: The association between shift work, shift work sleep disorders and premature ejaculation in male workers. Image Credit: KANGWANS / Shutterstock.com
Shift work and male reproductive health
To increase productivity, an increasing number of factories have adopted a 24-hour shift work system. Certain occupations, such as police officers and nurses, also require 24-hour staffing.
Individual circadian rhythms can be disrupted if individuals alternate between day and night shifts, with these workers more likely to suffer from SWSD. SWSD is characterized by insomnia, sleepiness, or both and has various adverse effects on the affected individual's physical and mental health.
The adverse effect of SWSD in males includes lower testosterone levels and an increased risk of hypogonadism, which has been associated with PE and negatively affects both reproductive capacity and erectile function. To date, there remains a lack of research on the impact of sleep disturbances and shift work on PE and male ejaculatory regulation.
About the study
The current study's researchers hypothesized that sleep disturbances and shift work indirectly influence the onset of PE through the secretion of central neurotransmitters and increase the risk of other diseases. The current study builds upon previous studies reporting that PE is influenced by various hormones and neurotransmitters, including dopamine and serotonin, which are, in turn, affected by the duration and rhythm of sleep.
A representative sample of 1,239 individuals from multiple regions in China were recruited to participate in the study between April and October 2023. The sample comprised 399 shift workers, 148 reported having SWSD, and 840 non-shift workers.
A SWSD questionnaire was used to assess participants' sleep quality. Premature Ejaculation Diagnostic Tool (PEDT) and the International Inventory of Erectile Function (IIEF-5) scores were also used to evaluate ejaculatory control and erectile function, respectively. Linear regression models were used to estimate and account for confounding factors to identify specific risk factors associated with PE.
Study findings
Higher PEDT scores confirmed the hypothesis that men working in shifts, particularly those suffering from SWSD, were more likely to report PE issues as compared to non-shift workers. Shift work of less than one year did not significantly impact PE, whereas shift work of more than one year significantly increased the risk of PE, with this effect much stronger after three years of shift work.
Young men were more likely to be involved in shift work as compared to older or middle-aged men. This observation increases concerns about the reproductive health of young men engaged in shift work and suffering from SWSD.
Several risk factors were identified for PE, including less than six hours of sleep each day, anxiety, depression, frequent alcohol use, diabetes, hyperlipidemia, and erectile dysfunction. PE was also more likely to occur in overweight men and those older than 45 years.
A multifactorial regression analysis was used to integrate all risk factors with clinical realities to accurately quantify each risk factor's impact on PE. Variables such as the aforementioned PE risk factors were included to construct a nomogram to forecast PE incidents. In the future, clinicians could use this highly specific and sensitive model to assign risk scores to patients.
Mechanisms involved in SWSD and PE
Metabolic changes may lead to psychological and mental disorders, which influence central neurotransmitter secretion. Neurotransmitter secretion and circadian rhythms may also be affected by SWSD and shift work.
SWSD and shift work negatively impact insulin and glucagon secretion, which interrupts metabolic homeostasis and increases the risk of cardiovascular diseases, many of which were also risk factors for PE. SWSD and shift work may also impact steroid hormone changes in the body, increase the risk of hypogonadism, and potentially impair erectile function, all of which are biological changes that can directly or indirectly affect the development of PE.
Nevertheless, additional research is needed to elucidate the mechanisms by which sleep disorders affect PE.
Conclusions
The study findings confirm the negative impact of SWSD and shift work on PE, with the risks of PE increasing as the duration of shift work rises.
One limitation of the current study is the use of the SWSD questionnaire to assess participants' sleep quality, which may be less accurate than objective polysomnographic monitoring results. The researchers also did not consider the effect of various physical and chemical factors individuals are exposed to during shift work.
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