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Cited by 275Hormonal and reproductive studiesObstructive Sleep Apnea ResearchMenopause: Health Impacts and Treatments

The Short-Term Effects of High-Dose Testosterone on Sleep, Breathing, and Function in Older Men

Liu, Peter Y., Yee, Brendon, Wishart, Susan M., Jimenez, Mark, Jung, Dae Gun, Grunstein, Ronald R., Handelsman, David J.·2003·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2003-030236
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Abstract

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 ( approximately 1 h), increased the duration of hypoxemia ( approximately 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.

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  • Two randomized controlled trials show that testosterone therapy can acutely (within 2-3 weeks) induce sleep-disordered breathing.

    “two randomized controlled trials show that testosterone therapy can acutely (within 2–3 weeks) induce sleep-disordered breathing [126, 127].”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [127]

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Authors
Liu, P. Y., Yee, B., Wishart, S. M., Jimenez, M., Jung, D. G., Grunstein, R. R., & Handelsman, D. J.
Affiliations
  • The University of Sydney (AU)
  • Concord Repatriation General Hospital (AU)
Corresponding author
Handelsman, David J.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2003-08
Volume
88
Issue
8
Pages
3605-3613
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2003-030236
OpenAlex
W2011113929
Cited by
275
References
66
Citations by year
2026: 7 · 2025: 6 · 2024: 9 · 2023: 12 · 2022: 5 · 2021: 9 · 2020: 14 · 2019: 12 · 2018: 12 · 2017: 8 · 2016: 10 · 2015: 12 · 2014: 17 · 2013: 12 · 2012: 13
FWCI
8.43
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Health and Medical Research Council
  • National Medical Research Council
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
testosterone replacement therapy, androgen therapy, obstructive sleep apnea, older men, sleep duration, hypoxemia, sleep-disordered breathing, upper airway dimensions, body composition, driving ability, physical activity, mood, sleepiness, insulin resistance, quality of life
MeSH terms
Aged, Automobile Driving, Body Weight, Double-Blind Method, Hormones, Humans, Insulin Resistance, Male, Mental Processes, Middle Aged, Motor Activity, Psychomotor Performance, Quality of Life, Respiration, Respiratory System, Sleep, Testosterone, Polysomnography, Cross-Over Studies

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