What is a Sleep-Related Painful Erection (SRPE)?

A sleep-related painful erection is a painful erection that appears during REM sleep. It is not produced by sexual activity and there are no lesions or physical damage from this condition. It only occurs during sleep.

These erections are painful enough to rouse you from sleep, causing severe sleep deprivation. These erections should subside soon after waking.

This sleep disorder is considered parasomnia, which is a collection of sleep disorders that involve some type of movement during sleep.

Who is Affected by SRPE?

A 2012 study found that men who were 45 years of age were the average age of those diagnosed. However, because SRPE is not well understood, there is a delay between of about 5 years from actual onset to diagnosis.

Studies have also found that some men’s SRPE was linked to sleep apnea and that their SRPE went away after treatment with CPAP therapy.

What Causes Sleep-Related Painful Erections?

SRPE has unknown causes. Getting an erection during REM sleep is completely normal, and will be experienced by most men anywhere from three to five times per night. However, these erections should not be painful.

Some insights were suggested in a 2005 study published as to the causes of SRPE being: 

• Disturbances in the nervous system that lead to hyperactivity and the release of beta-adrenergic substances such as adrenaline
• Neurotransmission disturbances
• Damage or stimulation to the hypothalamus

A 2017 study suggested that abnormal tightening of the pelvic floor muscles during REM sleep was a potential cause. 

The causes are varied and still under investigation, however, those who suffer from SRPE will be happy to know that there are treatments for their condition. 

How to Treat SRPE?

SRPE has no primary treatment. Some essential points for SRPE treatment are:

• Urinating and a cold towel/water will make the erection subside quickly, though this doesn’t prevent the erection from initially happening
• One study found that applying an ice pack to the penis during sleep prevented the painful erection, but also made it difficult to sleep
• Another study found that the drug clomipramine prevented erectile pain at night
• Pelvic floor physiotherapy may treat the symptoms of SRPE, such as Kegeling and other exercises

If you are experiencing SRPE that is negatively impacting your sleep, please take this free online sleep test to get in contact with our sleep health professionals and begin exploring your options.