Guest guest Posted June 21, 2004 Report Share Posted June 21, 2004 Hi , In my case the sleep apnea started about 3 or 4 years after the TRT. I fell asleep at my PC and watching TV. Nodded off while driving making life hazardous. I wanted to sleep all the time and of course couldn't rest. When I slept, the wife jabbed me in the ribs about every 5 minutes to wake me up to stop snoring. We slept in different beds after a few weeks of that. I would even snort and gasp in the recliner waking myself up. In the sleep test I woke myself up enough I could not get REM sleep about every minute and a half. Have been using a CPAP machine every nite since and can now get the REMS. I do not sleep more than 7 hours a night now and feel rested during the day. No more falling asleep at the PC unless it is about 1/2 hour to bed time. Might be able to go to bed earlier but usually want to stretch the day out as long as possible. I have terible sinus problems and with a humidifier got rid of most of my severe or chronic sinus drainage problems from drying out the nose when my lips leak air slightly while sleeping. Mouth is dry as a bone when I wake up. ernestnolan Maybe the TRT had to do with how many hours I could > Hi folks: > > A number of months ago I first wrote of my difficulties with sleep > both before and after beginning TRT in 2000 (originally as > compounding creme, but switching over to Andriol capsules (Canada) in > 2003). I've undergone a comprehensive sleep study in the past few > months and been diagnosed with moderate sleep apnea, for which I am > now being " treated " with a new type of oral device I must use every > night to aid my breathing. On some nights, the device seems to make a > positive difference, but on other nights, the effects of TRT seem to > trigger the early wakeup that robs me of sufficient REM sleep. > > I don't want to go into great detail here, but I did want to let > anyone who was interested know that you are welcome to write to me if > you'd like more information. I've collected a number of international > studies that examine the possible links between TRT and sleep apnea. > From what I have learned, being on TRT is a mixed blessing at best-- > and how I feel confirms that. > > Regards and thanks to those of you who wrote to assist me in the past, > > > Kerlin, Ph.D. > Founder and Manager, DES Sons International Network > des-sons > E-Mail ID: skerlin2000 [@] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 On Tue, 22 Jun 2004 11:18:17 -0000, you wrote: >, > >Are you worried about an increase in sinus and sleep problems >following pellets, or have you noticed an actual increase? For >what it's worth, my sleep improves dramatically when T levels >are right. Worrying about sleep problems makes them worse. > >My understanding is it takes about 2-3 weeks for pellets to kick >in. If you had pellets implanted 6/18, is that enough time for them >to kick in? Did Dr. Gambrell say that would be long enough? My >understanding is it takes about 2-3 weeks for pellets to kick in. I >guess that might depend on where your T levels were when you >started. And if you're feeling better with the pellets, shots, what ever, get out and exercise and enjoy it. It'll help you sleep. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 Ernest, That is interesting - my mouth is held closed by the suction created from the cpap mask, or something like that. I do know that they make masks that cover the mouth and nose simultaneously for people that have problems with their mouth being open while trying to use cpap. You might want to look into those. Mark > Don't know if there is a linkage with TRT. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2004 Report Share Posted June 24, 2004 Yes, there is a link, based on discoveries from some of the literature I have identified. Here is a major study, published in 2003, which explored the type of links between TRT and sleep apnea. The Short-Term Effects of High-Dose Testosterone on Sleep, Breathing, and Function in Older Men, by Y. Liu, Brendon Yee, M. Wishart, Mark Jimenez, Dae Gun Jung, R. Grunstein and J. Handelsman Abstract Link from Journal of Clinical Endocrinology & Metabolism, 2003: http://jcem.endojournals.org/cgi/content/abstract/88/8/3605 Abstract text: The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 8 3605-3613 Copyright © 2003 by The Endocrine Society The Short-Term Effects of High-Dose Testosterone on Sleep, Breathing, and Function in Older Men Y. Liu, Brendon Yee, M. Wishart, Mark Jimenez, Dae Gun Jung, R. Grunstein and J. Handelsman Department of Andrology, ANZAC Research Institute and Concord Hospital (P.Y.L., S.M.W., M.J., D.J.H.), and Woolcock Institute of Medical Research and Royal Prince Alfred Hospital (B.Y., D.G.J., R.R.G.), University of Sydney, Sydney, 2139 Australia Address all correspondence and requests for reprints to: Prof. J. Handelsman, ANZAC Research Institute, Sydney NSW 2139 Australia. E- mail: djh@.... Androgen therapy may precipitate obstructive sleep apnea in men. Despite increasing androgen use in older men, few studies have examined sleep and breathing. Randomized, double-blind, placebo- controlled studies examining effects of testosterone simultaneously on sleep, breathing, and function in older men are not available. Seventeen community-dwelling healthy men over the age of 60 yr were randomized to receive three injections of im testosterone esters at weekly intervals (500 mg, 250 mg, and 250 mg) or matching oil-based placebo and then crossed over to the other treatment after 8 wk of washout. Polysomnography, anthropometry, and physical, mental, and metabolic function were assessed at baseline and after each treatment period. Testosterone treatment reduced total time slept (1 h), increased the duration of hypoxemia (5 min/night), and disrupted breathing during sleep (total and non-rapid eye movement respiratory disturbance indices both increased by approximately seven events per hour) (all P < 0.05). Despite expected effects on body composition (increase in total and lean mass, reduction in fat mass, P < 0.05, bioimpedance method), upper airway dimensions did not change (acoustic reflectometry). Driving ability (computer simulation), physical activity (accelerometry, Physical Activity Scale in the Elderly), quality of life (SF36, Functional Outcomes of Sleep Questionnaire), mood (Profile of Mood States Questionnaire), sleepiness (Epworth, Stanford scales), and insulin resistance (homeostasis model) also were not changed by treatment. Short-term administration of high-dose testosterone shortens sleep and worsens sleep apnea in older men but did not alter physical, mental, or metabolic function. These changes did not appear to be due to upper airway narrowing. Further study of longer-term lower-dose androgen therapy on sleep and breathing is needed to evaluate its safety in older men. This work was supported by National Health and Medical Research Council of Australia Grants 142613 and 262025. There are no financial disclosures by any of the authors. This study was presented in part during the Clinical Trials Symposium of the 84th Annual Meeting of The Endocrine Society, San Francisco, California, June 20–23, 2002. Abbreviations: BMI, Body mass index; FOSQ, Functional Outcomes of Sleep Questionnaire; IPSS, International Prostate Symptom Score; NREM, non-rapid eye movement; OSA, obstructive sleep apnea; PASE, Physical Activity Scale in the Elderly; POMS, Profile of Mood States Questionnaire; PSA, prostate-specific antigen; RDI, respiratory disturbance index; REM, rapid eye movement. Excerpts from text conclusions: " This is the first randomized placebo-controlled study to show that high-dose testosterone therapy can disrupt sleep and breathing, increase sleep-related hypoxemia, and potentially precipitate obstructive sleep apnea... Furthermore, this is the first study to show that high-dose testosterone therapy can shorten time slept, although inconsistent effects on sleep architecture have been previously described [in other published studies]. Sleep loss of the magnitude described in this study can impair cognitive and physical performance in younger individuals, and the combination of reduction in sleep time and obstructive sleep apnea is particularly harmful because sleep deprivation can worsen disordered breathing. In addition, the absolute and relative (to the proportion of total time slept) duration of hypoxemia increased, although there was no reduction in nadir oxygen saturation. This study, therefore, underlines the safety concerns of testosterone treatment in older men... Testosterone may worsen breathing by a number of mechanisms because upper airway patency is determined by many structural and neuromuscular factors that control pharyngeal airway size and collapsibility... Testosterone may worsen breathing by neuromuscular mechanisms. Testosterone treatment increases upper airway collapsibility, ventilation, and hypoxic and hypercapnic ventilatory responses, leading to reduced apneic threshold. These effects on breathing may occur particularly during NREM sleep, which is consistent with our findings. Although androgen deficiency, particularly in older men, is associated with insomnia and other sleep disturbances, a marked reduction in time slept with testosterone administration was actually observed [in the current study]. It may be that high and low circulating testosterone concentrations are both associated with sleep disturbances. Testosterone may directly alter sleep through central nervous system effects including altered serotingergic neurotransmission. Testosterone increases nocturnal metabolic rate, potentially impairing sleep quality. " Kerlin DES Sons International Network: des-sons Hi , > > > > In my case the sleep apnea started about 3 or 4 years after the TRT. > > > > I fell asleep at my PC and watching TV. Nodded off while driving > > making life hazardous. I wanted to sleep all the time and of course > > couldn't rest. > > > > When I slept, the wife jabbed me in the ribs about every 5 minutes to > > wake me up to stop snoring. We slept in different beds after a few > > weeks of that. I would even snort and gasp in the recliner waking > > myself up. > > > > In the sleep test I woke myself up enough I could not get REM sleep > > about every minute and a half. Have been using a CPAP machine every > > nite since and can now get the REMS. I do not sleep more than 7 hours > > a night now and feel rested during the day. No more falling asleep at > > the PC unless it is about 1/2 hour to bed time. Might be able to go to > > bed earlier but usually want to stretch the day out as long as > possible. > > > > I have terible sinus problems and with a humidifier got rid of most of > > my severe or chronic sinus drainage problems from drying out the nose > > when my lips leak air slightly while sleeping. Mouth is dry as a bone > > when I wake up. > > > > ernestnolan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2004 Report Share Posted June 24, 2004 Hi , You probably have an understanding of statistics also so won't bother trying to explain the confidence of accuracy in this study considering the quantity of men involved in the study. First, I am not surprised TRT increases the water content of the throat making snoring more noticeable. I had 45 interuptions of breathing per hour compared to the few they noticed in the study. In any studies the variables between people is very tough to evaluate the impact of TRT when it comes to such additional things as drinking habits, other medications being taken, heredity, physical condition obese or skinny, smoking habits, daily exercise, diabetes, heart or other health problems, family and employment stress and many more that may take a toll of their own. Probably there is a link but the severity of the impact on sleep apnea should not be a deterent to TRT IMHO. ernestnolan Hi , > > > > > > In my case the sleep apnea started about 3 or 4 years after the > TRT. > > > > > > I fell asleep at my PC and watching TV. Nodded off while driving > > > making life hazardous. I wanted to sleep all the time and of > course > > > couldn't rest. > > > > > > When I slept, the wife jabbed me in the ribs about every 5 > minutes to > > > wake me up to stop snoring. We slept in different beds after a few > > > weeks of that. I would even snort and gasp in the recliner waking > > > myself up. > > > > > > In the sleep test I woke myself up enough I could not get REM > sleep > > > about every minute and a half. Have been using a CPAP machine > every > > > nite since and can now get the REMS. I do not sleep more than 7 > hours > > > a night now and feel rested during the day. No more falling > asleep at > > > the PC unless it is about 1/2 hour to bed time. Might be able to > go to > > > bed earlier but usually want to stretch the day out as long as > > possible. > > > > > > I have terible sinus problems and with a humidifier got rid of > most of > > > my severe or chronic sinus drainage problems from drying out the > nose > > > when my lips leak air slightly while sleeping. Mouth is dry as a > bone > > > when I wake up. > > > > > > ernestnolan > > > Quote Link to comment Share on other sites More sharing options...
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