Nocturnal penile tumescence

Nocturnal penile tumescence (NPT) is the spontaneous occurrence of a penile erection during sleep. All men without erectile dysfunction experience this phenomenon, usually several times a night. It typically happens during REM sleep and it is not uncommon for an erection to be present when a man wakes up — such an erection is colloquially referred to as ' in North America, and as ' in the United Kingdom (though in some areas of the U.K. the adjective '''' is often used instead).

The existence and predictability of nocturnal tumescence is used by sexual health practitioners to ascertain whether a given case of erectile dysfunction (E.D.) is psychological or physiological in origin. A patient presenting with E.D. is fitted with an elastic device to wear around his penis during sleep; the device detects changes in girth and relays the information to a computer for later analysis. If nocturnal tumescence is detected, then the E.D. is presumed to be due to a psychosomatic illness such as sexual anxiety; if not, then it is presumed to be due to a physiological cause.

The cause of NPT is not known certainly. Bancroft (2005) hypothesizes that the noradrenergic neurons of the locus ceruleus are inhibitory to penile erection, and that the cessation of their discharge that occurs during REM sleep may allow testosterone-related excitatory actions to manifest as NPT.

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