The Low Testosterone and Sleep Apnea Connection
According to the National Sleep Foundation, more than 18 million American adults across all age groups and both sexes have sleep apnea, including 11.3 percent of men between 45 and 64—the age group that’s also highly susceptible to chronic low testosterone.
What Is Sleep Apnea?
Obstructive sleep apnea (OSA) is a sleep disorder in which a person’s breathing repeatedly suffers brief interruptions during sleep. These interruptions occur when the muscles in the back of the throat fail to maintain an open airway, which inhibits a person’s efforts to breathe.
These pauses often last ten seconds or more, resulting in fragmented sleep and poor blood oxygen levels, which may complicate a person’s daily life or lower their effectiveness on the job by causing:
- Insomnia
- Sleep deprivation
- Excessive daytime sleepiness
Over time, these harmful conditions may contribute to more serious health problems that include:
- Hypertension
- Heart disease
- Mood swings
- Memory problems
The Sleep Apnea and Low Testosterone Connection
During sleep, the testosterone (and other hormones) that was used by your body throughout the day is naturally replenished. This replenishment is most effective during REM sleep.
When your sleep is constantly interrupted by a sleep disorder like sleep apnea, the amount of REM sleep you get at night is reduced, which hinders the replenishment cycle. The possible result is insufficient production of testosterone, leading to chronically low levels and some or all of the accompanying symptoms of hypogonadism (the medical term for Low T).
Research Supports the Connection
In one study, researchers from Fujian Medical University separated subjects into four groups based on the severity of their sleep apnea and measured their testosterone levels. Results showed that men suffering from severe OSA had much lower testosterone levels and a higher rate of erectile dysfunction compared to the groups suffering from simple snoring or mild OSA.
A second study showed that men suffering from clinically diagnosed low testosterone:
- Got less REM sleep
- Experienced increased nighttime awakenings
- Suffered from reduced sleep efficiency
- Exhibited a higher number of complications and symptoms associated with sleep apnea
This study also associated both sleep apnea and low testosterone with obesity, which would indicate the possibility of a cycle of poor health—each of these conditions perpetuating and exacerbating the others, with researchers suggesting continued research into any cause-and-effect relationships.
TRT—Breaking the Cycle
For health to be restored, a vicious cycle must be broken.
Assuming these 3 conditions (low testosterone, sleep apnea, and obesity) all play a role in overall poor health with the potential to cause serious medical consequences, determining which condition to medically treat first could be challenging.
When obesity is a prominent factor, significant weight loss through lifestyle intervention is often assumed to be the best course of action. However, weight loss of an amount sufficient to improve testosterone levels and disrupt the harmful relationship between these conditions often involves extreme changes to lifestyle that are exhausting to achieve and difficult to maintain.
Instead, consider that Testosterone Replacement Therapy (TRT) uses supplementary testosterone to restore testosterone levels to normal, in balance with estrogen and other hormones.
Healthy hormone balance in turn promotes lean muscle production and reduces adipose tissue (body fat) production.
Therefore, it would make good sense that TRT could attack 2 links of the chain simultaneously, contributing to the relief of obstructive sleep apnea symptoms.
That said, some studies have suggested that Testosterone Replacement Therapy (TRT) may exacerbate the severity of pre-existing Sleep Apnea. Talk to your healthcare professional to determine if you consider a sleep study prior to initiating TRT.
Learn More About TRT and Your Health
Our comprehensive guide provides more information on our methods and the associated health benefits of TRT. We have included facts and answers to the most common questions regarding the treatment of Low Testosterone.
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