Obstructive Sleep Apnea and Testosterone Therapy
Abstract
INTRODUCTION: There is persistent speculation that testosterone therapy (TTh) may induce worsening of obstructive sleep apnea (OSA). As both the incidence of OSA and the use of TTh grow more prevalent, it is important to review the current evidence that supports or refutes this relationship.
OBJECTIVES: To review the current literature regarding the relationship between TTh and OSA.
METHODS: A literature search was conducted to identify relevant studies. Search terms included "obstructive sleep apnea" and "testosterone replacement therapy." Titles and abstracts were reviewed for relevance. References from identified articles were searched and included, if appropriate.
RESULTS: The association between TTh and OSA was initially described in a 1978 case report of an individual with worsened nighttime apneas during testosterone administration, a trend seen again in subsequent small case series. In the 1990s, a large retrospective analysis and the first randomized controlled trial on the subject revealed no increased incidence of OSA in individuals on TTh. A randomized controlled trial conducted in 2012 provided a possible explanation to the previously reported discrepancies, describing a time-limited effect, wherein measures of OSA were elevated at seven weeks but were not significantly different at 18 weeks after initiation of TTh. A recent cohort study demonstrated an incidence of OSA in individuals on TTh of 16.5% compared with 12.7% in controls. TTh is thought to affect OSA…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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