Effects of testosterone therapy on sleep and breathing in obese men with severe obstructive sleep apnoea: a randomized placebo‐controlled trial
Abstract
Summary: Study objectives: High doses of short‐term testosterone have been shown to acutely worsen sleep‐disordered breathing in men with obstructive sleep apnoea (OSA). The effects of lower, near‐conventional doses of testosterone in obese men with OSA may differ over the longer term but have not been systematically studied. We assessed sleep and breathing effects of near‐conventional testosterone treatment as an adjunct to weight loss in obese men with severe OSA. Design: An 18‐week randomized, double‐blind, placebo‐controlled, parallel group trial in 67 men. Interventions: All subjects were placed on a hypocaloric diet and then received intramuscular injections of 1000 mg testosterone undecanoate or placebo at 0, 6 and 12 weeks. Measurements and Results: Sleep and breathing were measured by nocturnal polysomnography at 0, 7 and 18 weeks. Testosterone, compared to placebo, worsened the oxygen desaturation index (ODI) by 10·3 events/h (95%CI, 0·8–19·8 events/h; P = 0·03) and nocturnal hypoxaemia (sleep time with oxygen saturation <90%, SpO 2 T90%) by 6·1% (95%CI, 1·5–10·6; P = 0·01) at 7 weeks. Testosterone therapy did not alter ODI (4·5, −5·4 to 14·4 events/h; P = 0·36) or SpO 2 T90% at 18 weeks (2·9, −1·9–7·7%; P = 0·23) compared to placebo. The testosterone treatment effects on ODI and SpO 2 T90% were not influenced by baseline testosterone concentrations (testosterone by treatment interactions, all P > 0·35). Blood testosterone concentrations did not correlate with ODI or SpO 2 T90% (all P > 0·19). Conclusions: Testosterone therapy in obese men with severe OSA mildly worsens sleep‐disordered breathing in a time‐limited manner, irrespective of initial testosterone concentrations. This time‐dependency was not related to testosterone concentrations. Trial Registration: www.anzctr.org.au Identifier: ACTRN1260‐6000404527.
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A recent, preliminary RCT failed to find additive effects of dietary restriction and testosterone therapy on weight loss.
“a recent, preliminary RCT failed to find additive effects of dietary restriction and testosterone therapy on weight loss.112”
From Lowered testosterone in male obesity: Mechanisms, morbidity and management (2014) · cites this paper as [112]
In men with moderate-severe OSA, testosterone treatment significantly increased sleep-disordered breathing by a moderate amount (10 events/hour) at week 7 but not at week 18.
“Testosterone treatment significantly increased sleep-disordered breathing by a moderate amount (10 events/hour) at week 7 (one week after the second injection of testosterone undecanoate), but not at week 18.”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [129]
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BackgroundHoyos, C., Killick, R., Keenan, D. M., Baxter, R. C., Veldhuis, J., & Liu, P. Y. (2014) · Sleep · doi:10.5665/sleep.3580
Self-citationAhmad, F., Said, S. A. T., & Vejayan, J. (2025) · AIP Conference Proceedings · doi:10.1063/5.0248782
Neurocognitive and Neuropsychological Effects of OSA
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Testosterone and Disordered Sleep
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Self-citationPellechi, A. N., & Sedky, K. (2020) · Sleep Medicine and Mental Health · doi:10.1007/978-3-030-44447-1_14
Low Testosterone: Determine and Treat the Underlying Disorder
Tompkins, K., & Rothman, M. (2019) · Management of Patients with Pseudo-Endocrine Disorders · doi:10.1007/978-3-030-22720-3_17
Hypogonadism and Testosterone Therapy in Elderly Men
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Vascular outcomes and developmental programming in a mouse model of sleep apnea
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TESTOSTERONE REPLACEMENT THERAPY AND CARDIOVASCULAR RISK
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“В 2012 году были опубликованы результаты рандомизированного двойного слепого исследования, целью которого было изучения влияния ТЗТ на функцию внешнего дыхания у мужчин с ожирением и тяжелым синдромом обструктивного апноэ сна [25].”
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Sleep, Sexual Function, and Testosterone
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- Authors
- Hoyos, C. M., Killick, R., Yee, B. J., Grunstein, R. R., & Liu, P. Y.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Liu, Peter Y.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2012-09-11
- Volume
- 77
- Issue
- 4
- Pages
- 599-607
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2027870056
- Cited by
- 118
- References
- 36
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 11 · 2018: 10 · 2017: 6 · 2016: 11 · 2015: 15 · 2014: 12 · 2013: 7 · 2012: 3
- FWCI
- 7.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- testosterone replacement therapy, testosterone undecanoate, obstructive sleep apnea, obesity, sleep-disordered breathing, nocturnal hypoxemia, oxygen desaturation index, hypocaloric diet, weight loss, men, testosterone levels, time-dependent effects, nocturnal polysomnography
- MeSH terms
- Double-Blind Method, Humans, Male, Middle Aged, Obesity, Respiration, Sleep, Testosterone, Sleep Apnea, Obstructive
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