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the essentials in brief
➜ Healthy men have an erection 3-5 times a night – the last of these erections is the “morning wood”
➜ Nocturnal erections usually occur during REM sleep and are used to “train” and “test” the penis
➜ The absence of nocturnal and morning erections can indicate erectile dysfunction
What is a nocturnal erection?
getting healthy men a stiff penis about 3 to 5 times a night. These are known as nocturnal erections. nocturnal penile tumescences (NPTs)which occur unconsciously during sleep. The last of these nocturnal erections, the so-called morning wood, shows up regularly when you wake up.
The repeated swelling of the penis during bedtime is a completely natural, physiological process that is not triggered by sexual stimulation. It occurs in men of all ages – from infants to the elderly.
Why do erections occur at night?
Contrary to the misconception that nocturnal erections are triggered by erotic dreams, these are usually caused by physiological processes in the body.
The physiological function of nocturnal erections has not yet been scientifically clarified. The hypothesis that the nocturnal erection is a “training” of the erectile tissue of the penis and a “test” of the body’s ability to function seems plausible. In addition, the nocturnal erections should train the coordination between the neuronal, vascular and hormonal systems in the body. This coordination is responsible, among other things, for the development and maintenance of an erection¹.
Why are nocturnal erections so important?
During the nocturnal erections, the erectile tissue and vessels of the penis are supplied with blood. Even the smallest vessels are supplied with oxygen and nutrients. This process prevents tissue damage to the penis and counteracts the aging process of the penis. True to the motto “use it or lose it”, the infrastructure of virility is trained and erectile dysfunction is prevented.
What happens in a man’s body during a nocturnal erection?
The body goes through 4 different sleep phases every night: the falling asleep phase, the light sleep phase, the deep sleep phase and the REM phase. This cycle repeats itself several times a night with healthy sleep.
In principle, nocturnal erections can occur in all of these sleep phases. In the REM phase, which is defined by rapid eye movements and intense dreaming, nocturnal erections occur particularly frequently. The reason: During the REM phase, not only does eye movement increase, but also heart rate and breathing. Blood circulation and the supply of oxygen to the body also increase. At the same time, the muscles relax. All of these processes are involved in creating and maintaining an erection.
In addition, individual nerves are randomly activated during the REM phase, which can also cause an erection, among other things.
What does the morning wood have to do with the nocturnal erection?
In the morning hours, the proportion of the REM sleep phase increases significantly. Accordingly, during a typical sleep cycle, most nocturnal erections occur between 4am and 7am. This also explains why many men regularly wake up with a morning wood. Because the spontaneous awakening usually occurs in the morning after the end of the REM phase – i.e. with a magnificent erection.
Of course there are exceptions: If you are woken up by external stimuli or change your sleep cycle, the waking phase and REM phase may no longer coincide and you may not even notice your last nocturnal erection.
However, if the morning wood disappears in the long term, one should start to worry and consult a doctor.
How many nocturnal erections does a man have?
How many erections you have during the night depends on a number of factors – especially your sleeping habits. On average, the healthy man has between 3 and 5 erections each night, with an erection lasting an average of 25-35 minutes².
Absence or weakening nocturnal and morning erections
The fact that the frequency and duration of nocturnal erections decreases with age is completely normal and part of the natural aging process. However, healthy men can still get nocturnal erections well into old age and wake up with a morning wood.
If the nocturnal and morning erections fail completely, this is an indication of a erectile dysfunction. Certain diseases, such as cardiovascular diseases, diabetes or depression are often associated with a decrease in nocturnal erections. The same applies to taking certain medications (e.g. antidepressants) and an irregular or disturbed sleep cycle.
How is the absence of nocturnal erections diagnosed?
A major challenge in the medical evaluation of nocturnal erections is to first find out whether and if so, how many erections occur during the night. Nocturnal erections occur during sleep and are not even registered by the person concerned. Only the morning wood is an indication that the nocturnal erections are still working.
Therefore, to diagnose the absence of nocturnal erections, the doctor uses various measures with which the erection of the man can be evaluated:
The morning wood ✔
The morning wood is the last of the nocturnal erections and indicates whether the penis can still get hard during the night. Accordingly, asking about morning erections is part of the routine medical history of patients with erectile dysfunction³.
❌ It is questionable whether this question is a reliable means of assessing nocturnal erections. Because the presence of a morning latte depends on various factors. This includes, for example, the sleep cycle, i.e. how long and regularly you sleep or how you wake up. A lack of morning wood does not have to mean that no erections took place during the night.
The stamp check ✔
For the stamp check, tape a series of connected stamps around your flaccid penis before bed. A tight pair of boxer shorts can help keep the stamps from falling off. If the connection between the markers is broken the next morning, you had a nocturnal erection.
❌ With this method, no information can be given about the frequency and duration of nocturnal erections and – as with the morning latte – you can only rule out the complete absence of erections⁴.
NPT test: The measurement of erections in the sleep laboratory ✔
The NPT test is usually performed on an outpatient basis or in a sleep laboratory. Cables are attached to the penis and glans. These “erectometers” can measure and record the number, length, degree of hardness and intensity of each night’s erection the following night.
The results of this measurement can help to precisely adjust sexual enhancers and drugs for the nightly cavernous body training. In addition, the results can provide clues to the causes of erectile dysfunction. The NPT test is carried out in particular on patients in whom a purely “psychogenic” erectile dysfunction is suspected⁵.
How can nocturnal erection be treated?
In order to boost the nocturnal function of your best piece, you should primarily work on your lifestyle and sleep rhythm. What counts in particular here is regular and sufficient sleep, appropriate sleep hygiene, a healthy diet, not taking addictive substances such as nicotine and alcohol, and getting enough exercise during the day. You should also have any existing illnesses treated by a doctor.
If there are no nocturnal erections despite these measures, sexual enhancers such as Viagra can help. These can be taken for a limited time before bedtime. Taking it before bed can improve the frequency and duration of nocturnal erections⁸ – even in men with organic impotence⁹. This “training” in turn has a positive effect on the blood flow and oxygen supply to the penis, which can improve potency in the long term.
The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.
Isabel D White
Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.
