Apnea and Testosterone
What does apnea have to do with testosterone? Everything! As you hopefully know from my link on Sleep, your precious shuteye is responsible
for a host of all-important physiological functions, including rebuilding your
testosterone and neurotransmitters, optimizing stress hormones and mapping
memory. Any condition, such as apnea, that lowers quality or quantity of sleep is a physical
and hormonal train wreck waiting to happen.
Apnea is one of the nastiest sleep disorders, because it is so disruptive.
After all, what could interfere with sleep more than having your airways and
oxygen blocked off? One study after another has rolled out showing how
hard apnea is on the body and hormones are no exception.
One early study looked at just how severe the damage can be and found that apnea
suffers went from a low average testosterone of 391 to a much closter-to-normal
487 after corrective surgery. [1] That's a jump of 25% in testosterone after their apnea was
corrected! However, a later study of guys in their 40's, showed an
astonishing 68% difference between controls and males with apnea. [2]
Regardless of the exact number, you get the idea: apnea is devastating to
your most precious hormone, testosterone.
However, there is actually a logical explanation for the difference in the two
numbers above: the first number comes from a comparison after apnea
correction and the second before. Researchers have found that guys who
have had apnea for a significant amount of time are often overweight, even
obese. [3] Fat cells pump out more aromatase, which means more estrogen,
and estrogen inhibits testosterone. In other words, if you've built up a
big spare tire during your sufferings with apnea, CPAP or other therapy cannot
get you back to where you were before, because your own body is fighting against
itself.
The researchers found that apnea subjects appeared more like aged subjects where
LH (Leutinizing Hormone) cycles at night were increased, yet without a
corresponding increase in testosterone as is experienced by younger males.
Young guys get a pulse of leutinizing hormone followed by one of testosterone
and so on. This cycle is dampened increasingly in males as they age and
apnea appears to accelerate this process.
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In other words, once you get your apnea corrected, you must take care to also
lose any excess weight in order re-optimize your testosterone as much as
possible. The good news is that just getting treated for apnea will give
you a nice jump in testosterone and then as you lose weight and control cortisol, you should increase
it even further. Studies have even verified this in obese men with a BMI
of 32, which isn't what I would even call obese by the way. When they lost
the weight, they regained their testosterone. [4]
Similarly, apnea also leads to elevated cortisol levels. One study found
that subjects had 50% percent higher cortisol before CPAP when compared to
after. [6] This is truly nasty: cortisol is not something you want
elevated by even the smallest amount. Higher elevations, especially in the
middle age and beyond years, can lead to memory damage, lowered testosterone and
a host of other ills.
NOTE: It is critical to get your apnea treated. One study looked at
380 participants with moderate or severe sleep apnea over a 14 year period and
found that one third of the patients died! [7] That's in comparison to 8
percent without apnea.
Apnea and Testosterone: Solutions
Furthermore, research shows that mild apnea can often be significantly helped or
even cured simply by losing those pounds in the first place. One recent
study found that almost two thirds of study participants who dropped 23 pounds
through diet and exercise were actually completely cured of their apnea. [5]
Therefore, assuming your apnea isn't too severe, you may want to try simple
weight loss first as a solution and, as a side benefit, you may have your
testosterone significantly restored as well. In other words, dropping those
pounds has the potential to boost your testosteorne and cure your apnea at the
same time.
If your apnea is severe, however, simple weight loss will not do the trick and
you will likely end up with a CPAP (Continuous Positive Airway Pressure)
machine. These masks can be a testosterone and life and saver, literally.
There are also dental mouthpieces and surgery of the throat as options as well,
but these are considered less effective in most cases.
By the way, I should mention one other procedure that has the potential to
restore your testosterone: the Pillar procedure. This is performed
by a dentist and involves tiny polyester implants in the soft palate of an apnea
(or snoring) sufferer. It is actually the vibration of the soft palate
that can lead to snoring and often apnea and so this can be an easy fix in some
cases, since it is done with minimal anesthetics.
1)
Clin Endocrinol (Oxf), 1988 May ,28(5):461-70, "Reversible reproductive
dysfunction in men with obstructive sleep apnoea"
2) The Journal of Clinical Endocrinology & Metabolism, 2002, 87(7):3394-3398,
"Decreased Pituitary-Gonadal Secretion in Men with Obstructive Sleep Apnea"
3) Neuroendocrinology Letters No. 6, Dec 2003, 24:463-467 ,
"Pituitary-gonadal function in men with obstructive sleep apnea"
4) Intl J of Obesity, Nov 2000, 24(11)1433-1437, "Decreased androgen levels in
massively obese men may be associated with impaired function of the gonadostat"
5) Consumer Reports on Health, Jul 2009, p. 10.
6) The Journal of Clinical Endocrinology & Metabolism, 2009, 94(11):4234-4242,
"Hypothalamic-Pituitary-Adrenal Axis Activation in Obstructive Sleep Apnea: The
Effect of Continuous Positive Airway Pressure Therapy
7) Sleep, 2008 Aug , ;31(8):1079-85, "Sleep apnea as an independent risk factor
for all-cause mortality: the Busselton Health Study"
