Dear Men, Fixing Your Sleep Apnea May Improve Sperm Quality

With November as Men’s Health Month, it’s a good time to examine the factors that affect men’s health, including sperm quality. Previous research has noted that average sperm counts and sperm concentration have declined globally over the past several decades. While there are a few factors behind this decline, a recent study suggested that sleep apnea may be one of these factors.

Sleep Apnea and Men’s Health

Sleep apnea is a sleep disorder where breathing repeatedly stops and starts throughout the night. Obstructive sleep apnea (OSA) remains the most common type, affecting around 1 billion people worldwide. Since OSA has been associated with systemic inflammation and male reproductive dysfunction, researchers sought to examine the relationship between OSA and semen quality.

To investigate, the study enrolled 72 reproductive-aged men with OSA and 22 non-OSA men for the control group. The researchers assessed erectile function (IIEF-5), semen quality, and serum/seminal cytokines.

According to the findings published in Sleep Medicine, the participants with OSA were more likely to have significantly lower semen volume,

“Our findings suggest that OSA is associated with lower semen parameters, particularly reduced sperm motility and semen volume.”

The researchers further pointed out that these are key determinants of male reproductive potential. That said, the study also noted that when 25 of the participants with OSA were treated with a CPAP machine (Continuous Positive Airway Pressure), they began to show improvements in progressive sperm motility as early as a month later, with the percentage of progressively motile sperm increasing from nearly 40% to 45%.

“CPAP therapy is accompanied by longitudinal improvements in sperm motility suggesting that evaluation for sleep-disordered breathing may be considered an exploratory assessment in men presenting with unexplained semen abnormalities,” the authors wrote.

Improving sperm quality

While the researchers hoped to use follow-up studies to confirm their findings, they experienced a large dropout rate. This may be due to CPAP machines being uncomfortable and sleep apnea patients struggling to use them in the long run. As a result, it’s hard to determine long-term success.

Also, the researchers acknowledge that large studies need to better confirm the findings.

In the meantime, there are ways in which men can do their part to improve their sperm quality, beyond managing sleep apnea, and these include;

• Maintaining a healthy weight: Obese men are more likely to have a lower total sperm count or low sperm concentration, and excess weight makes it harder for sperm to swim towards an egg.
• Eating a healthy diet: Ultra-processed, sugary, and fatty foods can trigger biological changes that damage sperm DNA and reduce movement. Also, a 2020 study found that men who follow a typical Western-style diet have lower sperm counts and concentrations compared to men who eat a balanced diet. As such, a Mediterranean-style diet that emphasizes fresh fruits, vegetables, whole grains, legumes, extra virgin olive oil, nuts, and fish has been linked to higher sperm counts and better motility (movement).
• Engaging in safe and protective sex: Unprotected sex can expose you to STIs that may later damage sperm production and quality.
• Managing stress: Chronic stress can lower testosterone levels and trigger oxidative stress, both of which are not good for sperm quality. Journaling, speaking about your emotions, and yoga are great ways to manage stress.
• Exercising: Sedentary living can lead to weight gain and increased oxidative stress, both of which are not good for sperm quality.
• Quitting smoking: Unsurprisingly, smokers have been found to typically have a lower sperm count and reduced semen volume compared to non-smokers. Nicotine replacement therapy, group therapy, exercising, and a strong support system can help you quit smoking.
• Reducing alcohol consumption: Heavy or chronic drinking can lower testosterone production and thus overall sperm production.

What about sleep apnea?

Unfortunately, sleep apnea cannot be fixed with a single treatment. Thankfully, it can be controlled and treated with certain medical devices and even a few lifestyle changes.

In addition to machines like Continuous Positive Airway Pressure (CPAP), BiPAP, or APAP, lifestyle habits can also help. These include losing weight, adjusting your sleep position, not smoking, clearing nasal passages, and avoiding alcohol or sedatives.

Want to know more?

Plastic is everywhere. In fact, high volumes of plastic waste break down into microplastics and make their way inside of us. Yes, I mean that literally, as microplastics found in semen may be causing a declining sperm count.

References

Ji, Y., Wang, H., Lv, M., Tan, A., et al. (2026). Obstructive sleep apnoea is associated with reduced semen quality and compartmentalized seminal inflammation: A prospective cohort with non-randomized CPAP follow-up. Sleep Medicine, 149, 109333. https://doi.org/10.1016/j.sleep.2026.109333

Nassan, F. L., Jensen, T. K., Priskorn, L., Halldorsson, T. I., Chavarro, J. E., & Jørgensen, N. (2020). Association of Dietary Patterns With Testicular Function in Young Danish Men. JAMA network open, 3(2), e1921610. https://doi.org/10.1001/jamanetworkopen.2019.21610

Slowik JM, Sankari A, Collen JF. Obstructive Sleep Apnea. (2025) StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459252/