Obstructive Sleep Apnea Syndrome and Age-Related Hypogonadism
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Objectives. To assess the combined use of CPAP treatment (constant positive airway pressure) and testosterone replacement therapy (transdermal formulation – Androgel) on measures of polysomnographic monitoring with simultaneous investigation of erectile dysfunction and total testosterone levels. Materials and methods. The study included 26 men with diagnoses of combined moderately severe obstructive sleep apnea and age-related androgen deficit (mean age 46.1 ± 8.4 years, body mass index 35.2 ± 4.6 kg/m2). Subjects were divided into two groups depending on treatment type. Patients of group 1 (n = 14) received CPAP monotherapy, while patients of group 2 (n = 12) received combined therapy using CPAP and Androgel (50 mg once daily). CPAP was selected and delivered using automated Prisma 20 A (Weinemann, Germany) and iSleep (Breas, Sweden) devices. Treatment duration was two months. Results. After two-month treatment courses using these schemes, patients receiving combined treatment (CPAP + Androgel) showed a two-fold increase in the testosterone level (p < 0.05) and a statistically significant improvement in the altered measures of nocturnal penile episodes as compared with the analogous parameters in patients of the background of CPAP monotherapy. There were significant improvements in objective status, though no changes in polysomnographic characteristics were seen in either group. Conclusions. The study results demonstrated that combined treatment (CPAP + Androgel) was more effective in patients with obstructive sleep apnea syndrome and age-related androgen deficiency.
Keywordsobstructive sleep apnea syndrome polysomnography age-related hypogonadism testosterone CPAP therapy testosterone replacement therapy
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- 3.J. Catesby, and M. Hirshkovitz, “Monitoring penile erection during sleep,” in: Sleep Medicine, T. Lee-Choiong (ed.), No. 673–681 (2002).Google Scholar
- 4.I. M. Madaeva, L. I. Kolesnikova, O. N. Berdina, N. V. Semenova, V. V. Dolgikh, and V. V. Madaev, “Studies of erectile function during nocturnal sleep in men with obstructive sleep apnea syndrome: advances in contemporary sleep medicine,” Urologiya, 3, 32–36 (2014).Google Scholar
- 5.I. M. Madaeva, V. A. Petrova, L. I. Kolesnikova, and O. N. Shevyrtalova, “Obstructive sleep apnea/hypopnea syndrome and lipid peroxidation,” Pulmonologiya, 2, 65–69 (2009).Google Scholar
- 8.A. V. Zilov, I. M. Sheilor, and A. A. Gusova, “Age-related hypogonadism: diagnosis, clinical features, and treatment,” Farmateka, 11, 1–7 (2007).Google Scholar
- 9.G. G. Sharvadze, E. A. Poddubskaya, and M. N. Mamedov, “An interdisciplinary approach to the diagnosis and treatment of age-related hypogonadism associated with cardiovascular diseases,” Arkh. Vnutr. Med., 1, No. 15, 59–65 (2014).Google Scholar
- 14.A. A. Belkin, M. A. Frank, A. I. Gomzhin, and E. V. Alekseeva, “Features of the diagnosis of erectile dysfunction in patients with obstructive sleep apnea syndrome,” Ural. Med. Zh., 8, 51–52 (2006).Google Scholar
- 15.M. G. Poluektov, E. A. Aristakesyan, R. V. Buzunov, et al., Somnology and Sleep Medicine, M. G. Poluektov (ed.), Moscow (2016), pp. 264–296.Google Scholar
- 16.S. A. Bahammam, M. M. Sharif, A. A. Jammah, and A. S. Bahammam, “Prevalence of thyroid disease in patients with obstructive sleep apnea,” Respir. Med., 105, 1755–1760 (2011), https://doi.org/10.1016/j. rmed.2011.07.007.Google Scholar
- 21.Yu. A. Karpov, “Erectile dysfunction as a cardiovascular disease,” Klin. Farmakol. Ter., 11, No. 4, 84–87 (2002).Google Scholar
- 23.International Classification of Sleep Disorders. Diagnostic and Coding Manual, American Academy of Sleep Medicine, Darien, IL (2014), 2nd ed.Google Scholar
- 24.B. Lunenfeld, G. Mskhalaya, M. Zitzmann, C. Arver, S. Kalinchenko, Y. Tishova, and A. Morgentaler, “Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men,” Aging Male, 18, No. 1, 5–15 (2015), https://doi.org/10.3109/13685538.201 5.1004049.Google Scholar