Sleep-Related Painful Erections: Latest Facts, Diagnosis, Causes and Treatments

There are many reasons why a person may not be able to get quality sleep. One of those, for men, is sleep-related painful erection (SRPE). What causes this disorder and how do you deal with it if you have it? Continue reading to learn more.

Man Sleeping

Man Sleeping

What is Sleep-Related Painful Erection?

SRPE is just what its name suggests: a painful erection that occurs while you sleep. It is a rare sleep disorder that is deemed a parasomnia.

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A person having this condition usually doesn’t experience pain when having erections during the day or when involved in sexual activity. The pain only comes while they sleep, especially during REM sleep, and results in nighttime awakenings.

Apart from pain, other symptoms that SRPE can present include:

  • Drowsiness during daytime
  • Irritability
  • Anxiety
  • Tension

Many urologists and sexologists knew little or almost nothing about the disorder many years ago. But there has been an increased awareness in more recent years.

Who Does it Affect?

SRPE is obviously a problem for men. Evidence suggests that it typically begins when a man is in his 40s. A 2012 study in the peer-reviewed journal Archives of Sexual Behavior reported that the average age of diagnosis was 45 years.

Researchers found that the average onset age for the disorder was around 40 years. However, there is usually a span of five years, on average, from onset to diagnosis. This is mainly because many experts do not have adequate knowledge of it.

Causes of SRPE

The exact causes of this rare sleep disorder are not known. This is primarily because urologists and other experts do not yet know enough about it.

Researchers that conducted the 2012 study mentioned above noted only about 30 cases in the literature.

Read Also: Deep Sleep Reduces Anxiety Levels Considerably During The Day, UC Berkeley Study Shows

However, a 2005 study in Nature Clinical Practice Urology showed that nervous system disruptions could lead to it. These are capable of releasing adrenaline (epinephrine) and other beta-adrenergic compounds. The disturbances can also result in hyperactivity.

The same study suggested that stimulation or damage to the hypothalamus may cause SRPE. Neurotransmitter disorders can bring about the problem as well.

Another group of researchers reported in a 2017 study in Sexual Medicine that issues with the pelvic floor muscles may be a cause of the disorder.

SRPE Treatment

There is no universal treatment for nighttime painful erections. Again, this is clearly because the condition isn’t well understood yet.

However, below some of the options that could help to an extent.

Ice pack

It was shown in one study that applying an ice pack to a painful, erected penis brings relief. A problem with that, though, is that it might not resolve your sleep issue. You might find it hard going back to bed with the sensation of ice down under.


Several drugs could help deal with SRPE symptoms.

In a 2008 review in the Journal of Sexual Medicine, researchers found the drugs baclofen, clonazepam, and clozapine most effective for long-term treatment. They reported that most medications for patients didn’t work and a few others only worked for some time.

Researchers have also found that a gabapentin-clonazepam combo can help when used about an hour prior to bedtime. The treatment reduced nightly erection frequency and symptom severity while also increasing sleep duration.

Clomipramine and the selective serotonin reuptake inhibitor paroxetine are also reported to be helpful for SRPE patients.

Read Also: The relationship between Sleep and HGH


Research shows that exercises – specifically, pelvic floor physiotherapy – may help reduce SRPE symptoms. These can help to deal with the tightness of the pelvic floor muscles when sleeping. Kegel exercise is a popular form of this physiotherapy.

In addition to the above, you may get relief from a painful erection by urinating and applying a cold towel to your penis.

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It is important to talk to your doctor if you are experiencing SRPE that is affecting your sleep quality. Among other things, this can help you find out whether you also have obstructive sleep apnea, which has a link to painful nighttime erections.


Sleep-related Painful Erections Associated With Obstructive Sleep Apnea Syndrome – PubMed (

The treatment of sleep-related painful erections | Read by QxMD (

Sleep-Related Painful Erections: Causes and Solutions (

What are Sleep-Related Painful Erections (




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