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Cited by 164Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepHormonal and reproductive studies

Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea

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Meston, N., Davies, R. J. O., Mullins, R., Jenkinson, C., Wass, J. A. H., Stradling, J. R.·2003·Journal of Internal Medicine
DOI 10.1046/j.1365-2796.2003.01212.x
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Abstract

Abstract. Meston N, Davies RJO, Mullins R, Jenkinson C, Wass JAH, Stradling JR (University of Oxford, John Radcliffe Hospital; Oxford Centre for Respiratory Medicine and University of Oxford, Churchill Hospital; Health Services Research Unit; Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Infirmary; Oxford, UK). Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea. J Intern Med 2003; 254: 447–454. Objective. Obstructive sleep apnoea (OSA) is a relatively common condition producing disabling somnolence and profound physiological responses to hypoxaemic episodes during sleep, including significant oscillations in blood pressure. This study aimed to provide controlled data on the interaction between OSA and endocrine axes to establish whether overrepresentation of pathology such as hypertension and hypogonadism in OSA subjects might have an endocrine basis. Design, setting and subjects. Parallel randomized sham placebo controlled 1‐month trial of nasal continuous positive airway pressure (nCPAP) in 101 male subjects with OSA presenting to a respiratory sleep clinic. Methods. Analysis of gonadotrophins, testosterone, sex hormone binding protein (SHBG), prolactin, cortisol, thyroid stimulating hormone (TSH), free thyroxine (free T4), insulin‐like growth factor‐1 (IGF‐1), renin and aldosterone were performed at baseline and after 1 month's active or placebo nCPAP intervention. Quality of life questionnaire scoring was also recorded over the same time period. Results. Testosterone and SHBG showed significant negative correlations with baseline OSA severity. Active treatment of OSA produced SHBG elevation and TSH reduction (P ≤ 0.03). Both groups showed an increase in aldosterone (P < 0.001) and IGF‐1 (P ≤ 0.03), associated with a large improvement in subjective quality of life scoring. Conclusions. These findings demonstrate significant changes in endocrine axes not previously reported in a placebo‐controlled trial. OSA is a recognized reversible cause of testosterone reduction; SHBG suppression correlating to baseline OSA severity supports a diagnosis of secondary hypogonadism. Significant rises in aldosterone and IGF‐1 on treatment coincide with increased physical activity and an improved quality of life score.

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  • One-month nCPAP treatment compared to placebo resulted in a significant reduction in TSH without elevation in free T4 levels, consistent with the pattern of recovery from non-thyroidal illness.

    “One-month nCPAP treatment compared to placebo resulted in a significant reduction in TSH without elevation in free T4 levels, consistent with the pattern of recovery from non-thyroidal illness.”

    From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [8]

  • Meston et al. described a small significant inverse correlation between OSAS and free T4 levels but not TSH, with no apparent association between obesity and either hormone.

    “In 101 overweight and obese male patients, Meston et al. [8] have described a small significant inverse correlation between OSAS and free T4 levels but not TSH, with no apparent association between obesity and either hormone.”

    From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [8]

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Research works printed but not linked: 4

  1. Ó 2003 Blackwell Publishing Ltd Journal of Internal Medicine 254: 447-454
  2. Stewart DA, Grunstein RR, Sullivan CE, Handelsman DJ. Neuroendocrine changes in sleep apnea are not related to a pituitary defect. Sleep Res 1989; 18: 308.
  3. Rapoport D, Rothenburg SA, Hollander CS, Goldring RM. Obstructive sleep apnea (OSA) alters ultradian rhythm of ACTH secretion. Am Rev Respir Dis 1989; 139: A80.
  4. Melmed S. Acromegaly [see comments]. NEJM 1990; 322: 966-77.

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Authors
Meston, N., Davies, R. J. O., Mullins, R., Jenkinson, C., Wass, J. A. H., & Stradling, J. R.
Affiliations
  • John Radcliffe Hospital (GB)
  • Churchill Hospital (GB)
  • University of Oxford (GB)
Corresponding author
Meston, N.
ORCID
Venue
Journal of Internal Medicine
Publisher
Wiley
Published
2003-10-09
Volume
254
Issue
5
Pages
447-454
ISSN
  • 0954-6820 (ISSN-L)
  • 1365-2796
DOI
10.1046/j.1365-2796.2003.01212.x
OpenAlex
W2002557448
Cited by
163
References
40
Citations by year
2026: 4 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 3 · 2019: 9 · 2018: 8 · 2017: 5 · 2016: 11 · 2015: 8 · 2014: 19 · 2013: 12 · 2012: 6
FWCI
2.77
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
obstructive sleep apnea, nasal continuous positive airway pressure, endocrine effects, secondary hypogonadism, testosterone, sex hormone-binding globulin, aldosterone, insulin-like growth factor I, thyroid-stimulating hormone, prolactin, cortisol, quality of life, male patients
MeSH terms
Aldosterone, Hormones, Humans, Insulin-Like Growth Factor I, Male, Positive-Pressure Respiration, Quality of Life, Sex Hormone-Binding Globulin, Testosterone, Thyrotropin, Sleep Apnea, Obstructive

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