Jump to content
RemedySpot.com

Re: TRT and Sleep -

Rate this topic


Guest guest

Recommended Posts

Guest guest

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 [@]

Link to comment
Share on other sites

Guest guest

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.

Link to comment
Share on other sites

Guest guest

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.

>

Link to comment
Share on other sites

Guest guest

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

> >

Link to comment
Share on other sites

Guest guest

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

> > >

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...