In Built To Survive brief mention was made that testosterone administration could be involved with obstructive sleep apnea (OSA) in the chapter, Testosterone and Anabolic Steroids: Adverse Effects, Rumors and Reality.
More and more reports have appeared that HIV(+) men are being diagnosed as having OSA concurrent with continuing use of testosterone.
One study stated that OSA can be caused by enlarged tonsils caused by HIV itself. (1)
Testosterone Can Cause Sleep Apnea
A look at published studies show that testosterone administration is associated with the occurrence of sleep apnea.
To clarify, while a study may show an association between two things but not show that one thing causes another to occur, studies do show that testosterone administration can cause sleep apnea.
Testosterone administration has been shown to be associated with an increase in upper airway collapsibility during sleep, and that this condition reverses when testosterone administration is stopped.
One study concluded that “testosterone administration may induce or exacerbate sleep apnea through an influence on neuromuscular control of upper airway patency [openness] during sleep.”
Additionally, testosterone has also been shown to reduce respiratory drive, which also can contribute to OSA.
Another study stated that men experience apnea more than women (because men have more testosterone) and that injectable testosterone administration increased the incidence of both sleep apneas and hypopneas, breathing that is shallower or slower than normal.
It also noted that upper airway dimensions were not affected by testosterone, suggesting that “testosterone contributes to sleep-disordered breathing through mechanisms independent of anatomical changes in the upper airway.” This points at testosterone administration as having effects on the brain and the nervous system that control breathing.
Again, it is suggested that when OSA is diagnosed, careful evaluation be conducted to determine whether unusual tissue is obstructing breathing or there is inadequate stimulation of the airway muscles.
Yet another study of five hypogonadal men (whose bodies do not produce adequate testosterone) that looked at the mechanisms involved in breathing showed that testosterone enanthate administered at 200 mg every two weeks caused sleep apnea in one man and worsened pre-existing sleep apnea in a second of the five men (40 percent). Both men experienced uneven heartbeats (dysrhythmias) during sleep and large increases in hematocrit with decreased oxygen saturation (less oxygen in the bloodstream.)
Another study showed that elevated testosterone was associated with sleep apnea in a 70-year old woman, and that correction of the problem that caused elevated testosterone resulted in the apnea stopping.