ArticleSexual medicine2026
Cognitive-emotional associations between non-restorative sleep and erectile dysfunction: the role of rumination profiles and resilience.
Article in Sexual medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Erectile dysfunction (ED) is a prevalent male health condition that substantially correlates with impaired sexual function and reduced overall quality of life. Non-restorative sleep (NRS), a prevalent subjective sleep disturbance, has recently been identified as an under-recognized factor linked to ED. Nonetheless, the psychological factors involved in the association between NRS and ED remain poorly clarified. Rumination and psychological resilience are two promising psychological variables that may participate in this correlational pathway yet have not been empirically examined in the NRS-ED context. The present study aimed to explore the potential indirect correlational link between NRS and ED through rumination, and further evaluate whether resilience moderates this associative pathway. Methods: Between February 2024 October 2025, we conducted a cross-sectional study of 880 men with ED recruited from the Andrology Clinic of the First Affiliated Hospital of Anhui Medical University. Participants completed the NRS Scale (lower scores indicate more severe NRS), Ruminative Responses Scale, 10-item Connor-Davidson Resilience Scale, and the 5-item International Index of Erectile Function (IIEF-5). Pearson correlations, bootstrapped mediation, and moderated mediation models with covariate adjustment, and latent profile analysis (LPA) in Mplus were performed to identify rumination subgroups and compare erectile function across profiles. Results: Non-restorative sleep severity was significantly associated with worse ED and elevated rumination (all Conclusion: Our findings demonstrate that NRS is linked to ED via a ruminative associational pattern, and this association varies across levels of resilience. These findings suggest that integrated therapeutic strategies targeting these cognitive-emotional factors could facilitate more personalized clinical management for patients.
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