Testosterone therapy and CPAP

[BlizzardUK]

Does anyone here take (or know someone who does) testosterone therapy and is also on CPAP ? I just had a blood test and shows I have low testosterone, probably due to my obesity. I am seeing my doctor soon about the results and to ask if they can put me on testosterone replacement therapy. Supposedly it is not suggested for patients who suffer sleep apnea, but just wondered if anyone takes it here ? I will obviously do as my doctor instructs, and I can't get the treatment without them anyway, just curious in the meantime.

Below are copied and pasted from a medical journal, it doesn't seem to mention if this is with CPAP or not, I use Auto PAP so not sure if it matters...........

More research needs to be done, but from what we do know, testosterone may make sleep apnea worse, or even cause people to develop the sleep disorder if they don’t already have it.

One study gave three high-dose testosterone injections to healthy men over 60. The results showed an increased duration of hypoxemia — or low blood oxygen levels — and more disrupted breathing during sleep. The researchers stated that more research needs to be done into long-term lower-dose testosterone therapy on breathing during sleep, however.

Another study measured the disordered-breathing events in hypogonadal men (men with low testosterone) on and off testosterone replacement therapy. When taking testosterone, the number of disordered-breathing events rose from about six per hour to about 15.

There’s also some evidence that suggests testosterone therapy may cause sleep apnea symptoms, but the symptoms may stop when therapy is discontinued. And a 2018 study suggested testosterone replacement therapy increased the risk of developing sleep apnea.

[rick blaine]

The only well-established connection I know between sleep apnea and testosterone is that untreated OSA can lead to a decrease in the serum level of the hormone. It is thought that the interruptions in deep, restorative sleep interfere with the synthesis of testosterone, and that the benefit of successful sleep apnea treatment is that the serum level returns to something like its previous value.

[Miss Emerita]

Unlike Rick Blaine, I don't have information that might answer your question. But I do want to point out that if you are still using your PAP machine, you'll be the first to know if you have an increase in your AHI after starting testosterone supplementation. Thus you can easily identify and flag any problems to your doctor.

[Really]

I just had a blood test and shows I have low testosterone,

Testosterone can feed prostate cancer in men.

So approach with Caution, Really.

[Miss Emerita]

I just had a blood test and shows I have low testosterone,

Testosterone can feed prostate cancer in men.

So approach with Caution, Really.

Here’s some research about that:

https://newsroom.uw.edu/news-releases/s ... e%20cancer.

But a person’s own doctor would be the best advisor about risks and benefits.

[Sheriff Buford]

You always hear that men today have lower testosterone. Ever wondered why? I looked it up, and the answer is that fewer men are smoking today. So..... lets all start smoking! Hah!

On the serous side, I have taken weekly injections for years, and have not seen any change in my apnea numbers. Just recently, I've had some apnea issues, but I attribute it to other health issues. I have had issues falling asleep, so I take CBD about an hour before bedtime. Works great, but it can be expensive.

Gotta go! I need to get a pack of cigarettes!

Sheriff

[SleepGeek]

Here’s some research about that:

https://newsroom.uw.edu/news-releases/s ... e%20cancer

My Dr told me "Nothing in Medicine is 100%"

[Curious_Steve]

Does anyone here take (or know someone who does) testosterone therapy and is also on CPAP ? I just had a blood test and shows I have low testosterone, probably due to my obesity. I am seeing my doctor soon about the results and to ask if they can put me on testosterone replacement therapy. Supposedly it is not suggested for patients who suffer sleep apnea, but just wondered if anyone takes it here ? I will obviously do as my doctor instructs, and I can't get the treatment without them anyway, just curious in the meantime.

Below are copied and pasted from a medical journal, it doesn't seem to mention if this is with CPAP or not, I use Auto PAP so not sure if it matters...........

More research needs to be done, but from what we do know, testosterone may make sleep apnea worse, or even cause people to develop the sleep disorder if they don’t already have it.

One study gave three high-dose testosterone injections to healthy men over 60. The results showed an increased duration of hypoxemia — or low blood oxygen levels — and more disrupted breathing during sleep. The researchers stated that more research needs to be done into long-term lower-dose testosterone therapy on breathing during sleep, however.

Another study measured the disordered-breathing events in hypogonadal men (men with low testosterone) on and off testosterone replacement therapy. When taking testosterone, the number of disordered-breathing events rose from about six per hour to about 15.

There’s also some evidence that suggests testosterone therapy may cause sleep apnea symptoms, but the symptoms may stop when therapy is discontinued. And a 2018 study suggested testosterone replacement therapy increased the risk of developing sleep apnea.

I've been on Test replacement therapy and CPAP therapy for approximately 15 years. I don't feel like it has any effect on my sleep quality.

If you can, find a practice that focuses on bioidentical hormones and is willing to check your adrenals, thyroid, a1c, etc. and looks at your body as a system vs a low t clinic that is only concerned with jabbing you weekly.

[KungFuCow]

I do the bioidentical hormone pellets and I dont see any change in my sleep or sleep apnea.

[ElusiveSleep]

Personal experience with testosterone (T) replacement. Ten years ago, after I started taking T by injections, my snoring became pretty intense, such that while on vacation it was so bad my daughter told my wife that she was tempted to put a pillow over my face during a hotel stay. This prompted me to get sleep test and was I positive for sleep apnea. I ended up stopping T since it made me very aggressive (such that I was yelling at people in work meetings) and also caused excessively high libido.

A group of university urologists wanted to find out possible short term medical benefits from T replacement, so they did several controlled trials in old men (age 70), and found some slight benefits but also some concerns ("increased the coronary artery noncalcified plaque"). Lessons From the Testosterone Trials: https://pubmed.ncbi.nlm.nih.gov/29522088/

The statement below is from this article: https://pubmed.ncbi.nlm.nih.gov/29774669/
"because TRT may exacerbate OSA in some patients, patients should be asked about OSA symptoms before and after starting TRT. Furthermore, TRT should probably be avoided in patients with severe untreated OSA."

Carefully consider whether or not to do T replacement.

[SirGaspAlot]

I don’t use CPAP myself, but a friend of mine faced a similar situation. He did go on a military muscle testosterone therapy while using CPAP and monitored closely by his doctor to manage potential complications.

[prodigyplace]

Here’s some research about that:

https://newsroom.uw.edu/news-releases/s ... e%20cancer

My Dr told me "Nothing in Medicine is 100%"

Perhaps that is why it is called a practice. They do not have the real certainty?

[prodigyplace]

I just had a blood test and shows I have low testosterone,

Testosterone can feed prostate cancer in men.

So approach with Caution, Really.

Take this seriously, especially if there is some prostate cancer in your family history.

When they tested & found mine, I ended up electing for surgery. The biopsy afterwards found the cancer more aggressive & widespread than they expected. I have been cancer-free for many years now.

[MyIdaho]

I have self administered replacement T by injection (1x every 2 weeks) for over 35 years. My body does not produce GnRH hormone which means I would not naturally produce T and must administer an exogenous source. I was diagnosed with severe OSA 15 years ago (AHI = 65). XPAP therapy successfully treats my OSA. My AHI is routinely less 1 and I sleep like a happy baby!

I have routinely been checked for prostate issues with annual palpation plus blood test since age 40. No issues and incredibly low PSA results. I highly recommend XPAP therapy and T replacement if your Dr agrees it is necessary. If you add T therapy, strongly agree to discuss prostate health and monitoring with your family Dr. An endocrinologist would be even better choice.