Can Testosterone Replacement Make OSA Worse

[Adoniscmj]

Hi everyone, Last year about this time I had gone in for a lab sleep test. It showed that I had Moderate OSA. If I remember correctly my AHI was about 37. At the time my total testosterone was at a high level 1,600. My doctor reduced my T down to about 400 now. I have read that TRT can make OSA worse. Recently I have noticed that my events that my CPAP machine report are very few, in fact almost nonexistant. Last night for example it detected one event so my AHI was about .45 for the time I was on it and the last week every day it has been AHI 0.0. I had one central apnea. I am thinking that maybe I need to have another sleep test done to see if I even have a problem. I think that because my T was so high at that time I think it made my test a bit high and not very accurate. If I really don't need a CPAP can this be harmful to use? I am also wondering has anyone else been on TRT and noticed a change in their apnea?

[0rangebear]

I have read that TRT can make OSA worse.

You can read more on this subject at the following link

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453053/

The objective of the study was to examine the association between serum testosterone levels with objectively measured sleep characteristics.

Conclusion: Low total testosterone levels are associated with less healthy sleep in older men. This association is largely explained by adiposity. Clinical trials are necessary to determine whether body weight acts directly or indirectly (via low testosterone) in the causal pathway for sleep-disordered breathing in older men.

[Adoniscmj]

I have read that TRT can make OSA worse.

You can read more on this subject at the following link

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453053/

The objective of the study was to examine the association between serum testosterone levels with objectively measured sleep characteristics.

Conclusion: Low total testosterone levels are associated with less healthy sleep in older men. This association is largely explained by adiposity. Clinical trials are necessary to determine whether body weight acts directly or indirectly (via low testosterone) in the causal pathway for sleep-disordered breathing in older men.

Thank you for the link. I just recently realized that my testosterone levels were really high when I went in for that sleep test. They are much closer to normal levels now for a man my age and I have noticed that my CPAP hardly ever scores any events. I seem to be more and more like a person who has mild to no OSA. For this reason I want to have a new sleep test done and not at a sleep lab as I don't have $1,300 dollars to pay out of pocket for it. I will insist upon a take home test instead. I feel like I was ripped off as I told them I was on TRT, granted I had no idea at the time my level was so high. Now it is more stable so I guess I have to make an appointment with the sleep doctor to discuss this issue. If I no longer have it bad enough to need CPAP I will sell my machine.

[PollCat]

Having been on a cpap machine for two years prior to receiving HRT (testosterone) in 1997, I've seen very little correlation between the two conditions/therapies. I did have one doctor who said that if you start HRT you'll probably end up needing a cpap; he didn't take kindly to my quip that since I was already on a cpap machine that maybe my need of HRT was caused by the cpap. However, since my need for HRT was caused by a genetic condition it's unlikely that one condition caused the other.

[DeepBreathing]

Have you considered that the low apnea levels you now experience are just a case of the machine doing the job it is meant to do?

[Adoniscmj]

Have you considered that the low apnea levels you now experience are just a case of the machine doing the job it is meant to do?

Yes, however the machine starts high in pressure then steadily goes down over the whole night. Usually it spikes up to fix an Apnea and that isn't happening. Breathing patterns look normal as well. I can't explain it.

[0rangebear]

There is and easy way to test this, however it will involve some risk on your part. Therefore, it would be wise to consult your doctor or have another person in the room to wake you up if you stop breathing. But it will help you avoid an unnecessary and expensive sleep test

You only need to do it for a hour or two. My doctor does this in his office with the patient under observation.

1) Set your machine in CPAP at its lowest setting Usually 4 or 5.
2) Lay flat on your back using the machine reporting software to see if the number or length of events go up.
3) If they do then you know you need you machine and the therapy is working.

My AHI runs between 0 and 1.6 at my current settings. But when my doctor ran this test in his office, with my machine,last month . I had 84 events in 1 hour. Some of that may have been sleep wake junk,. but it proved to me the therapy is working

Have you considered that the low apnea levels you now experience are just a case of the machine doing the job it is meant to do?

Yes, however the machine starts high in pressure then steadily goes down over the whole night. Usually it spikes up to fix an Apnea and that isn't happening. Breathing patterns look normal as well. I can't explain it.

[Adoniscmj]

There is and easy way to test this, however it will involve some risk on your part. Therefore, it would be wise to consult your doctor or have another person in the room to wake you up if you stop breathing. But it will help you avoid an unnecessary and expensive sleep test

You only need to do it for a hour or two. My doctor does this in his office with the patient under observation.

1) Set your machine in CPAP at its lowest setting Usually 4 or 5.
2) Lay flat on your back using the machine reporting software to see if the number or length of events go up.
3) If they do then you know you need you machine and the therapy is working.

My AHI runs between 0 and 1.6 at my current settings. But when my doctor ran this test in his office, with my machine,last month . I had 84 events in 1 hour. Some of that may have been sleep wake junk,. but it proved to me the therapy is working

Have you considered that the low apnea levels you now experience are just a case of the machine doing the job it is meant to do?

Yes, however the machine starts high in pressure then steadily goes down over the whole night. Usually it spikes up to fix an Apnea and that isn't happening. Breathing patterns look normal as well. I can't explain it.

That sounds like it will work. I have been without my machine for two months as my hose popped and I was fighting with my insurance to pay for a new one. During that time I noticed no drowsiness and one day I woke up so refreshed I could hardly believe it. Way better than with my CPAP. If not for the Testosterone then it must be due to my weight loss. I have also read that if one has a problem with the tonsils being the cause of apnea then gargling with salt water before bed will shrink them, I have been doing this as well. I still think it is my sinuses where they meet with my esophagus and it has been less restricted as well. I plan on checking this. I can't use my CPAP on the low setting as I feel like I am suffocating so I will turn it down to the lowest possible setting that I can tolerate. I am not scared of my breathing issues as I don't think I have any now. I will film it with my night vision camera and to play it safe I will set my alarm for 1.5 hours to make sure I get to sleep enough to get a solid hour in. It seems like the only events my machine reports now are a CA from time to time. I have heard that if it works too well it can cause CA's.

[captio2000]

All I know is when my urologist found out I had OSA and was on CPAP he immediately pulled me off of Testosterone patches - contraindicated he said.

[Sleeprider]

TRT can make untreated OSA worse, however many of us that use xPAP have been on TRT. If you need supplemental testosterone, then OSA is not "contraindicated", however men with mild or moderate apnea that are not treated may realize a worsening of the condition, if they are not using PAP.