Documented sleep deprivation-type disorders and coded male reproductive and endocrine outcomes: a multicenter propensity-matched study

Andrew Edgington; Siddharth Ramanathan; Tarak Davuluri; Grant Nelson; Paul Gabriel; Brayden Seliger; Vivek Aslot; Aidin Abedi; Puneet Sindhwani

doi:10.32604/cju.2026.083395

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Documented sleep deprivation-type disorders and coded male reproductive and endocrine outcomes: a multicenter propensity-matched study

Andrew Michael Edgington^#, Siddharth Ramanathan^#, Tarak Sai Davuluri, Grant Bradley Nelson, Paul Michael Gabriel, Brayden Jeffery Seliger, Vivek Rahul Aslot, Aidin Abedi, Puneet Sindhwani^*
Department of Urology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
* Corresponding Author: Puneet Sindhwani. Email: email
# These authors contributed equally to this work

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.083395

Received 03 April 2026; Accepted 03 September 2026; Published online 24 September 2026

Abstract

Background: Sleep deprivation-type disorders may impair male reproductive health, but electronic health record [EHR] studies remain limited. We aimed to examine associations between sleep deprivation-type disorders and male reproductive and endocrine outcomes in a multicenter healthcare network. Methods: In this retrospective TriNetX cohort study, men aged 18–50 years with and without documented sleep deprivation-type disorders from 2005–2020 were propensity score matched 1:1 across more than 60 covariates. Outcomes included male infertility, testicular hypofunction/dysfunction, fertility-associated encounters, pharmacologic infertility treatment, and a composite endpoint. Risk ratios [RRs] with 95% confidence intervals [CIs] were calculated at 1, 2, 3, 5, and 10 years. Results: The matched cohort included 117,154 men (58,577 per group). Sleep deprivation-type disorders were associated with higher composite-outcome rates across all intervals (1-year RR 1.40, 95% CI 1.26–1.56; 10-year RR 1.35, 95% CI 1.27–1.43). Testicular hypofunction/dysfunction emerged earliest and remained consistent (RR 1.55–1.66), and pharmacologic infertility treatment was elevated (1-year RR 1.89, 95% CI 1.27–2.82; 10-year RR 1.65, 95% CI 1.39–1.97). Male infertility showed a weaker association that reached significance at 10 years. Associated observations were more consistent among men aged 26–50 years, while sleep apnea demonstrated stronger and earlier associations than insomnia. Conclusions: Sleep deprivation-type disorders were associated with increased rates of male reproductive and endocrine outcomes. These findings should be interpreted as EHR-based associations rather than proof of biologically confirmed infertility or causality. Prospective studies incorporating semen parameters, reproductive intent, hormone data, sleep disorder severity, and treatment adherence are needed.