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Cited by 302Obstructive Sleep Apnea ResearchHormonal and reproductive studiesGrowth Hormone and Insulin-like Growth Factors

Neuroendocrine Dysfunction in Sleep Apnea: Reversal by Continuous Positive Airways Pressure Therapy*

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GRUNSTEIN, RONALD R., HANDELSMAN, DAVID J., LAWRENCE, SUANNE J., BLACKWELL, CHRISTOPHER, CATERSON, IAN D., SULLIVAN, COLIN E.·1989·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem-68-2-352
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Abstract

We studied the effects of sleep apnea on neuroendocrine function in a cross-sectional study of 225 consecutive men undergoing sleep studies and in a longitudinal study of 43 men with severe obstructive sleep apnea before and after 3 months of successful treatment with nasal continuous positive airways pressure to eliminate upper airways obstruction. Blood samples were collected at 0600-0630 h on awakening for measurement of plasma insulin-like growth factor I (IGF-I), total and free testosterone, sex hormone-binding globulin (SHBG), LH, FSH, PRL, T4, T4-binding globulin, and cortisol. The plasma hormone levels were analyzed in relation to the severity of sleep apnea, as indicated by the desaturation index (the hourly rate of episodes of arterial oxygen desaturation greater than 4% of the stable baseline) and the mean minimal oxygen saturation during the desaturation episodes. In the cross-sectional study plasma IGF-I, free and total testosterone, and SHBG levels were significantly lower in relation to the severity of sleep apnea, whereas plasma LH, FSH, PRL, T4, T4-binding globulin, and cortisol were not. The decreases in plasma IGF-I and total and free testosterone were independent of the effects of aging and adiposity by covariance analysis. In the longitudinal study plasma IGF-I, total testosterone, and SHBG, but not free testosterone, significantly increased after 3 months of nasal continuous positive airways pressure treatment. We conclude that sleep apnea causes reversible neuroendocrine dysfunction in men, which is manifested by decreased plasma. IGF-I, testosterone, and SHBG levels. This neuroendocrine dysfunction is related to the severity of the sleep apnea, as indicated by the nadir levels of arterial oxygen desaturation and the rate of desaturation episodes. These hormonal measurements may provide biochemical markers for both the severity of sleep apnea and its response to therapeutic intervention. In addition, sleep apnea may be a previously unrecognized confounder of the neuroendocrine correlates of aging.

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Crossref · 10.1210/jcem-68-2-352

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  • In older men, higher degrees of hypoxemia, as a marker of more severe OSA, are associated with lower testosterone concentrations.

    “higher degrees of hypoxemia, as a marker of more severe OSA, are associated with lower testosterone concentrations [37, 104–106].”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [104]

  • Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated.

    “In fact, some derangement in TSH secretion in obesity with or without OSAS has been demonstrated [2,4].”

    From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [4]

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Authors
GRUNSTEIN, R. R., HANDELSMAN, D. J., LAWRENCE, S. J., BLACKWELL, C., CATERSON, I. D., & SULLIVAN, C. E.
Affiliations
The University of Sydney (AU)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1989-02
Volume
68
Issue
2
Pages
352-358
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem-68-2-352
OpenAlex
W2138286791
Cited by
302
References
34
Citations by year
2026: 3 · 2025: 6 · 2024: 2 · 2023: 9 · 2022: 7 · 2021: 6 · 2020: 5 · 2019: 6 · 2018: 11 · 2017: 4 · 2016: 9 · 2015: 17 · 2014: 14 · 2013: 11 · 2012: 12
FWCI
2.47
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • eCite Digital Repository (University of Tasmania) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
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 › Growth Hormone and Insulin-like Growth Factors
Keywords
obstructive sleep apnea, neuroendocrine dysfunction, continuous positive airway pressure, insulin-like growth factor I, testosterone, sex hormone-binding globulin, hypogonadism, hypoxemia, desaturation index, aging, men
MeSH terms
Adult, Age Factors, Aged, Follicle Stimulating Hormone, Humans, Insulin-Like Growth Factor I, Luteinizing Hormone, Male, Middle Aged, Positive-Pressure Respiration, Prolactin, Sex Hormone-Binding Globulin, Sleep Apnea Syndromes, Testosterone, Thyroxine

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