Sleep Disturbances and Male Reproductive Dysfunction: Pathophysiological Mechanisms Linking Obstructive Sleep Apnea and Sleep Deprivation

BACKGROUND: Sleep disturbances, particularly obstructive sleep apnea (OSA) and sleep deprivation, are critical yet underrecognized contributors to male reproductive dysfunction. Both conditions disrupt endocrine homeostasis, reducing testosterone and luteinizing hormone levels, which are central regulators of spermatogenesis. OBJECTIVE: This review aimed to synthesize current evidence on the mechanisms linking OSA and sleep deprivation to impaired male fertility, with emphasis on endocrine, oxidative, and inflammatory pathways. METHODS: We conducted a structured, non-systematic narrative review using PubMed/MEDLINE, Scopus, and Web of Science databases, focusing on clinical and experimental studies evaluating the effects of sleep disturbances on male reproductive health. RESULTS: Disrupted sleep and OSA-related intermittent hypoxia trigger oxidative stress, systemic inflammation, and testicular dysfunction, leading to impaired sperm motility, abnormal morphology, and genomic instability. In OSA, the severity of reproductive disruption correlates with apnea-hypopnea index and nocturnal oxygen desaturation. Despite extensive evidence implicating metabolic and endocrine factors in male infertility, the role of sleep disturbances remains overlooked in clinical practice. CONCLUSIONS: Emerging evidence suggests that sleep disturbances may represent a relevant and potentially modifiable factor in male reproductive health. Interventions targeting sleep disorders and oxidative stress pathways have shown potential benefits on hormonal and physiological parameters; however, their direct impact on fertility outcomes remains to be established. Further longitudinal and interventional studies are needed to clarify causality and clinical applicability.