Contribuições para o entendimento do papel do sono sobre a função sexual masculina

• Ano de defesa: 2013
• Autor(a) principal: Andersen, Monica Levy [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Sono; Ereção Peniana; Comportamento Sexual; Testosterona; Progesterona; Disfunção Erétil; Apneia do Sono Tipo Obstrutiva
• Link de acesso: https://repositorio.unifesp.br/handle/11600/58401

Penile erection is essential for successful reproduction, and depends on the integration of various mechanisms, including psychological, vascular, endocrine, neurological, and myogenic processes triggered by reflex response or psychogenic stimulus from central origin. During sleep, erections can occur through the descending pathway that passes through the spinal cord and signals able to activate the penile reflex system in all healthy males from birth to aging, regardless of the content of the dream. The cumulative duration of tumescence during the night is approximately 90 minutes or 20% of total sleep time. Since its discovery in the 1940s, the function of penile erection during sleep remains a puzzling enigma. It is important to note that elucidation of erectile mechanisms related to sleep and wakefulness is essential to the eventual diagnosis and treatment of impotence. Study of the interaction between the underlying neurobiological and neuroendocrine bases for sleep and sexual behavior in rats will illuminate the influence of hormonal factors in expression of mating behavior and its relationship with sleep. Although sleep is essential for good health, sleep loss is increasingly prevalent in the contemporary world. Sleep debt causes numerous changes to overall welfare. In fact, most of sleep deprivation in modern life occurs during paradoxical/ REM sleep in the second half of the night. However, the consequences of paradoxical sleep deprivation (PSD) on sexual function have been little studied. Thus, this thesis presents the main studies of the research on the role of sleep in sexual response. During the past 13 years, our work has revealed a marked participation of sleep, and especially its deprivation in male sexual function. To broaden the understanding of the complex interactions underlying the regulation of sexual behavior, we used two approaches: a) male rats submitted to PSD and then behavioral observation and hormonal analysis; or b) clinical studies including men with complaints of sexual dysfunction. The results have consistently shown that PSD has facilitates the occurrence of spontaneous genital reflexes in young, adult, and old rats. However, PSD promotes impairment of sexual performance in the presence of females. Herein, increased progesterone and decreased testosterone levels were documented in sleep deprived rats. The importance of this study to the scientific field is reflected by 112 citations of this original article. In the next experiments, we developed several protocols in order to identify hormonal factors modulated by PSD relevant to promoting good sexual response in male rats. We observed that administration of progesterone after PSD in castrated rats induced an increase in number of erections compared to rats administered testosterone, whereas pre-treatment with the progesterone receptor antagonist significantly reduced the number of erections after sleep deprivation. These results add more evidence to the participation of progesterone in core reproductive events, such as the erection. Regarding clinical findings derived from an epidemiological study, we observed an association between some polymorphisms related to erectile dysfunction complaints and sleep disorders. The line of research initiated in the PhD dissertation of the candidate provided ample evidence for a strong association between reduced sleep and changes in sexual function in male rats and men. Collectively, this thesis presents the main contributions of the candidate to the international literature on the topic of the role of sleep in male sexual function under a translational approach. Thus, it is possible to raise different perspectives to be used for pre-clinical and population studies: a) animal models incorporating different sophisticated methodologies to record penile erection during sleep deprivation; and b) conducting epidemiological studies with polysomnography to identify correlates of complaints of sexual dysfunction related to sleep disturbances. The impact of these studies together with the level of productivity in the scientific field enable us to maintain the excellence of our research group in the topic of "sleep and sexual behavior".