Advertisement

Journal of Endocrinological Investigation

, Volume 37, Issue 1, pp 9–12 | Cite as

Testosterone and estradiol are not affected in male and female patients with obstructive sleep apnea treated with continuous positive airway pressure

  • P. CelecEmail author
  • I. Mucska
  • D. Ostatníková
  • J. Hodosy
Original Article

Abstract

Background

Continuous positive airway pressure (CPAP) improves symptoms in patients with obstructive sleep apnea syndrome (OSAS). It is currently unclear, whether CPAP also alters endocrine parameters such as sex hormone levels. In a previous study, we have found no changes in sex hormones in patients with OSAS after one night with CPAP.

Aim

The aim of this study was to prove long-term effects of CPAP on sex hormone concentrations in patients with OSAS.

Methods

Twenty-two women and 67 men with severe OSAS (respiratory distress index > 30/h) were enrolled in the study. Fasting blood venous samples were taken before CPAP therapy and after 1 and 6 months of CPAP treatment. Testosterone and estradiol were measured in all samples using commercially available ELISA kits.

Results

No effects of long-term CPAP treatment were found on testosterone or estradiol levels in OSAS patients of either gender.

Conclusions

The results are in line with previous smaller studies. However, our study is larger and longer than previously published studies. In addition, this is the first study analyzing the effects of CPAP on testosterone and estradiol and in both genders. Positive effects of CPAP on sexual functions reported in other studies might, thus, be mediated by other than endocrine effects.

Keywords

Sleep apnea Testosterone Estradiol Sex hormones Non-invasive therapy 

Notes

Acknowledgments

The study was supported by the European Commission ITMS 26240120003.

Conflict of interest

The authors P. Celec, I. Mucska, D. Ostatníková, and J. Hodosy declare that they have no conflict of interest.

References

  1. 1.
    Andersen ML, Santos-Silva R, Bittencourt LR, Tufik S (2010) Prevalence of erectile dysfunction complaints associated with sleep disturbances in Sao Paulo, Brazil: a population-based survey. Sleep Med 11:1019–1024PubMedCrossRefGoogle Scholar
  2. 2.
    Barrett-Connor E, Dam TT, Stone K, Harrison SL, Redline S, Orwoll E (2008) The association of testosterone levels with overall sleep quality, sleep architecture, and sleep-disordered breathing. J Clin Endocrinol Metab 93:2602–2609PubMedCrossRefGoogle Scholar
  3. 3.
    Bratel T, Wennlund A, Carlstrom K (1999) Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoea. Effects of continuous positive airway pressure treatment (CPAP). Respir Med 93:1–7PubMedCrossRefGoogle Scholar
  4. 4.
    Cistulli PA, Grunstein RR, Sullivan CE (1994) Effect of testosterone administration on upper airway collapsibility during sleep. Am J Respir Crit Care Med 149:530–532PubMedCrossRefGoogle Scholar
  5. 5.
    Gambineri A, Pelusi C, Pasquali R (2003) Testosterone levels in obese male patients with obstructive sleep apnea syndrome: relation to oxygen desaturation, body weight, fat distribution and the metabolic parameters. J Endocrinol Invest 26:493–498PubMedGoogle Scholar
  6. 6.
    Grunstein RR, Handelsman DJ, Lawrence SJ, Blackwell C, Caterson ID, Sullivan CE (1989) Neuroendocrine dysfunction in sleep apnea: reversal by continuous positive airways pressure therapy. J Clin Endocrinol Metab 68:352–358PubMedCrossRefGoogle Scholar
  7. 7.
    Hammoud AO, Walker JM, Gibson M, Cloward TV, Hunt SC, Kolotkin RL, Adams TD, Meikle AW (2011) Sleep apnea, reproductive hormones and quality of sexual life in severely obese men. Obesity (Silver Spring) 19:1118–1123CrossRefGoogle Scholar
  8. 8.
    Hoekema A, Stel AL, Stegenga B, van der Hoeven JH, Wijkstra PJ, van Driel MF, de Bont LG (2007) Sexual function and obstructive sleep apnea-hypopnea: a randomized clinical trial evaluating the effects of oral-appliance and continuous positive airway pressure therapy. J Sex Med 4:1153–1162PubMedCrossRefGoogle Scholar
  9. 9.
    Hoyos CM, Killick R, Yee BJ, Grunstein RR, Liu PY (2012) Effects of testosterone therapy on sleep and breathing in obese men with severe obstructive sleep apnoea: a randomized placebo-controlled trial. Clin Endocrinol (Oxf) 77:599–607CrossRefGoogle Scholar
  10. 10.
    Hoyos CM, Yee BJ, Phillips CL, Machan EA, Grunstein RR, Liu PY (2012) Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial. Eur J Endocrinol 167:531–541PubMedCrossRefGoogle Scholar
  11. 11.
    Killick R, Wang D, Hoyos CM, Yee BJ, Grunstein RR, Liu PY (2013) The effects of testosterone on ventilatory responses in men with obstructive sleep apnoea: a randomised, placebo-controlled trial. J Sleep Res 22:331–336Google Scholar
  12. 12.
    Koseoglu N, Koseoglu H, Itil O, Oztura B, Baklan B, Ikiz AO, Esen AA (2007) Sexual function status in women with obstructive sleep apnea syndrome. J Sex Med 4:1352–1357PubMedCrossRefGoogle Scholar
  13. 13.
    Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ (2003) The short-term effects of high-dose testosterone on sleep, breathing, and function in older men. J Clin Endocrinol Metab 88:3605–3613PubMedCrossRefGoogle Scholar
  14. 14.
    Luboshitzky R, Aviv A, Hefetz A, Herer P, Shen-Orr Z, Lavie L, Lavie P (2002) Decreased pituitary-gonadal secretion in men with obstructive sleep apnea. J Clin Endocrinol Metab 87:3394–3398PubMedGoogle Scholar
  15. 15.
    Luboshitzky R, Lavie L, Shen-Orr Z, Herer P (2005) Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea. Obes Res 13:780–786PubMedCrossRefGoogle Scholar
  16. 16.
    Luboshitzky R, Lavie L, Shen-Orr Z, Lavie P (2003) Pituitary-gonadal function in men with obstructive sleep apnea. The effect of continuous positive airways pressure treatment. Neuro Endocrinol Lett 24:463–467PubMedGoogle Scholar
  17. 17.
    Macrea MM, Martin TJ, Zagrean L (2010) Infertility and obstructive sleep apnea: the effect of continuous positive airway pressure therapy on serum prolactin levels. Sleep Breath 14:253–257PubMedCrossRefGoogle Scholar
  18. 18.
    Matsumoto AM, Sandblom RE, Schoene RB, Lee KA, Giblin EC, Pierson DJ, Bremner WJ (1985) Testosterone replacement in hypogonadal men: effects on obstructive sleep apnoea, respiratory drives, and sleep. Clin Endocrinol (Oxf) 22:713–721CrossRefGoogle Scholar
  19. 19.
    Meston N, Davies RJ, Mullins R, Jenkinson C, Wass JA, Stradling JR (2003) Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea. J Intern Med 254:447–454PubMedCrossRefGoogle Scholar
  20. 20.
    Onem K, Erol B, Sanli O, Kadioglu P, Yalin AS, Canik U, Cuhadaroglu C, Kadioglu A (2008) Is sexual dysfunction in women with obstructive sleep apnea-hypopnea syndrome associated with the severity of the disease? A pilot study. J Sex Med 5:2600–2609PubMedCrossRefGoogle Scholar
  21. 21.
    Santamaria JD, Prior JC, Fleetham JA (1988) Reversible reproductive dysfunction in men with obstructive sleep apnoea. Clin Endocrinol (Oxf) 28:461–470CrossRefGoogle Scholar
  22. 22.
    Schiavi RC, White D, Mandeli J (1992) Pituitary-gonadal function during sleep in healthy aging men. Psychoneuroendocrinology 17:599–609PubMedCrossRefGoogle Scholar
  23. 23.
    Schneider BK, Pickett CK, Zwillich CW, Weil JV, McDermott MT, Santen RJ, Varano LA, White DP (1986) Influence of testosterone on breathing during sleep. J Appl Physiol 61:618–623PubMedGoogle Scholar
  24. 24.
    Soukhova-O’Hare GK, Shah ZA, Lei Z, Nozdrachev AD, Rao CV, Gozal D (2008) Erectile dysfunction in a murine model of sleep apnea. Am J Respir Crit Care Med 178:644–650PubMedCrossRefGoogle Scholar
  25. 25.
    Stavaras C, Pastaka C, Papala M, Gravas S, Tzortzis V, Melekos M, Seitanidis G, Gourgoulianis KI (2012) Sexual function in pre- and post-menopausal women with obstructive sleep apnea syndrome. Int J Impot Res 24:228–233PubMedCrossRefGoogle Scholar
  26. 26.
    Stewart DA, Grunstein RR, Berthon-Jones M, Handelsman DJ, Sullivan CE (1992) Androgen blockade does not affect sleep-disordered breathing or chemosensitivity in men with obstructive sleep apnea. Am Rev Respir Dis 146:1389–1393PubMedCrossRefGoogle Scholar
  27. 27.
    Vlková B, Mucska I, Hodosy J, Celec P (2013) Short-term effects of continuous positive airway pressure on sex hormones in men and women with sleep apnoea syndrome. Andrologia. doi: 10.1111/and.12092
  28. 28.
    Zhuravlev VN, Frank MA, Gomzhin AI (2009) Sexual functions of men with obstructive sleep apnoea syndrome and hypogonadism may improve upon testosterone administration: a pilot study. Andrologia 41:193–195PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2013

Authors and Affiliations

  • P. Celec
    • 1
    • 2
    • 3
    • 4
    Email author
  • I. Mucska
    • 5
  • D. Ostatníková
    • 6
  • J. Hodosy
    • 1
    • 6
  1. 1.Institute of Molecular BiomedicineComenius UniversityBratislavaSlovakia
  2. 2.Institute of PathophysiologyComenius UniversityBratislavaSlovakia
  3. 3.Department of Molecular BiologyComenius UniversityBratislavaSlovakia
  4. 4.Center for Molecular MedicineSlovak Academy of SciencesBratislavaSlovakia
  5. 5.Sleep laboratoryUniversity HospitalBratislavaSlovakia
  6. 6.Institute of PhysiologyComenius UniversityBratislavaSlovakia

Personalised recommendations