Background/Objectives: Erectile dysfunction (ED) is a prevalent and multifactorial condition influenced by psychological and sleep-related factors. This study aimed to evaluate the independent and combined associations of insomnia and benzodiazepine use with the risk of ED. Methods: An analytical cross-sectional study was conducted in adult men with and without ED. Logistic regression was used to estimate crude and adjusted odds ratios (ORs). Effect modification was assessed through stratified analyses. Additionally, an in silico analysis of 17 active compounds was performed using SwissADME and Molinspiration to explore physicochemical properties. Results: Insomnia (adjusted OR 2.05; 95% CI 1.13-3.74; p = 0.019) and benzodiazepine use (adjusted OR 2.14; 95% CI 1.10-4.15; p = 0.025) were each independently associated with ED. In contrast, antidepressant use was not significantly associated with ED in the sample analyzed. Participants with both insomnia and benzodiazepine use had a markedly higher risk (adjusted OR 3.96; 95% CI 1.51-10.40; p = 0.005). The joint association of insomnia and benzodiazepine use was consistent with the combined effect expected from their individual associations. The in silico analysis showed an overlapping profile, suggesting benzodiazepine properties may underline their link to ED, supporting the results of the cross-sectional study. Conclusions: Both insomnia and benzodiazepine use independently increased the odds of ED. Their co-occurrence was linked to a substantially higher likelihood of ED, highlighting the clinical importance of assessing both conditions concurrently in patients with sexual dysfunction.
Journal of clinical medicine. 2025 Oct 01*** epublish ***
Valeria Navarrete-Anaya, Iván Delgado-Enciso, Gustavo A Hernández-Fuentes, Janet Diaz-Martinez, Osiris G Delgado-Enciso, Ana Sánchez-Arizmendi, Alejandro Figueroa-Gutiérrez, José Aguilar-Cota, Jesús Venegas-Ramírez, Patricia Calvo-Soto, Karla B Carrazco-Peña, Mercedes Fuentes-Murguia, Mónica Ríos-Silva, José Guzmán-Esquivel
Departamento de Geriatría, Instituto Mexicano del Seguro Social (IMSS), Hospital de Zona No. 1, Villa de Alvarez 28984, Mexico., Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico., Department of Dietetics & Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA., Health Education Auxiliary Coordination, Mexican Institute of Social Security (IMSS), Villa de Alvarez 28984, Mexico., Department of Nephrology, Instituto Mexicano del Seguro Social (IMSS), Hospital de Zona No. 1, Villa de Alvarez 28984, Mexico., State Cancerology Institute of Colima, Health Services of the Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Colima 28085, Mexico., Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez 29883, Mexico.