The association between shift work, shift work sleep disorders and premature ejaculation in male workers

Abstract

Objective: Shift work and Shift Work Sleep Disorder (SWSD) are known to affect the secretion of several neurotransmitters and hormones associated with premature ejaculation (PE). However, their specific influence on the regulation of male ejaculation remains unclear. This study explores the relationship between shift work, SWSD, and PE.

Methods: From April to October 2023, a cross-sectional survey was conducted across five regions of China to explore the work schedules, sleep quality, and sexual function of male workers. Participants' sleep quality was evaluated using a validated SWSD questionnaire, and their erectile function and ejaculatory control were assessed with the International Inventory of Erectile Function (IIEF-5) scores and Premature Ejaculation Diagnostic Tool (PEDT) scores, respectively. Univariate and multivariate linear regression analyses were employed to identify risk factors associated with PE. Confounders were controlled using multiple regression models, and clinical prediction models were developed to predict PE onset and assess the contribution of risk factors.

Results: The study included 1239 eligible participants, comprising 840 non-shift workers and 399 shift workers (148 with SWSD and 251 without SWSD). Compared to non-shift working males, those involved in shift work (β 1.58, 95% CI 0.75 - 2.42, p < 0.001) and those suffering from SWSD (β 2.86, 95% CI 1.86 - 3.85, p < 0.001) they had significantly higher PEDT scores. Additionally, we identified daily sleep of less than six hours, depression, anxiety, diabetes, hyperlipidemia, frequent alcohol consumption (more than twice a week), and erectile dysfunction as risk factors for PE. The predictive model for PE demonstrated commendable efficacy.

Conclusion: Both shift work and SWSD significantly increase the risk of premature ejaculation, with the risk magnifying in tandem with the duration of shift work. This study reveals the potential impact of shift work and SWSD on PE and provides new theoretical foundations for the risk assessment and prevention of this condition.

Keywords: Predictive model; Premature ejaculation; Risk factors; Shift work; Shift work sleep disorder.

Fig. 1

Flow chart of enrollment for this cross-sectional study

Fig. 2

Nomogram construction and validation for predicting the risk of premature ejaculation. a A nomogram was developed to predict the risk of premature ejaculation onset. b, c Receiver Operating Characteristic (ROC) curves illustrate good sensitivity and specificity of the predictive model with an area under the curve (AUC) of 0.855 for the training set and 0.783 for the validation set. d, e Calibration plots demonstrate high predictive accuracy, with close alignment between the actual and predicted probabilities of premature ejaculation. f, g Decision curve analysis indicates the substantial clinical utility of the nomogram by evaluating the net benefits at different threshold probabilities