Obstructive Sleep Apnea Is Associated with Low Testosterone Levels(ncbi.nlm.nih.gov)
ncbi.nlm.nih.gov
Obstructive Sleep Apnea Is Associated with Low Testosterone Levels
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350060/
63 comments
Read your blog - mine has a nice travel bag and I can evem go camping where there is no power.
I bought a travelling battery (lithium-ion pack) and it lasts about two nights and can re-charge from a cigarette lighter.
I bought a travelling battery (lithium-ion pack) and it lasts about two nights and can re-charge from a cigarette lighter.
I haven't had to travel yet. May I ask what battery pack you have? Also do you use a heated tube and/or humidifier? That takes a lot more power.
No heated tube but have a humidifier.
I would suggest Jackery - seen them used by lot of travel camping vloggers I follow.
Normally turn off the humidifier when I am using portable power.
https://www.jackery.com/pages/portable-power-stations
Normally turn off the humidifier when I am using portable power.
https://www.jackery.com/pages/portable-power-stations
Any tips for those of us who have very poor sleep but have done a sleep study and been determined to not have sleep apnea?
Sorry, no, but I sympathize. There's a huge amount written on this topic, "sleep hygiene" can be a useful keyword to look for. There are many different causes for sleep problems.
The funny thing about my obstructive sleep apnea is I didn't think I was having trouble sleeping. I'd sleep 8 hours and have no memory of any problems. In reality I was gasping for breath every 50 seconds, all night.
The funny thing about my obstructive sleep apnea is I didn't think I was having trouble sleeping. I'd sleep 8 hours and have no memory of any problems. In reality I was gasping for breath every 50 seconds, all night.
I had the same and it turned out to be asthma.
Note I had no symptoms during the day (even when jogging or weightlifting). In my case it's induced by dust mites and there is no good defense against this except asthma medication.
There are also people with sleeping problems due to silent reflux.
If you feel you're clearing your throat often, burp a lot or lacking air, check for those two.
Note I had no symptoms during the day (even when jogging or weightlifting). In my case it's induced by dust mites and there is no good defense against this except asthma medication.
There are also people with sleeping problems due to silent reflux.
If you feel you're clearing your throat often, burp a lot or lacking air, check for those two.
one can definitely do something about dust mites. I thought I had a cold, flu or something and could not breath comfortably because of the congestion; I tried cold medicine and allergy medicine and it did not help. I ended up searching internet at 2am and found out about dust mites. They and their poop will be in any sort of cloth material. Think matress, sheets, etc. enclose your matress in a 6 side dust mite proof matress cover. Supposedly matresses will accumulate 15 or 20 pounds of dust mites and their poop; think about how much that is. Also, your flaked off skin in food for them. You need to clean your sheets in 130 degree F water temperature to kill them. Same with all pieces of bedding; needs to be dust mite proof and properly cleaned to rid of them. Get a pillow cover that is dust mite proof. You can get dust mite proof comforter cover as well. Also, carpeting below bed could house them and their poop. I switched to hard flooring. Anyway, you can definitely do something about the dust mites. After doing this, problem went away and I slept much better.
I forgot to mention that I removed the carpeting myself and even though I used a very well rated HEPA vacuum; the crap that I found under and in the carpeting was disgusting. It was like there was a beach party or something. After see that I would remove any carpeting from a home that I owned and I would not rent a place that had carpeting.
Do you drink any caffeine at all?
I used to think (or I believe was told), that two cups and no more before noon is ok, but found my sleep was just an utter mess. I tried everything , sleep test, black out curtains, magnesium, CBD oil, melatonin, yet it never occurred to me it could be coffee as I never drank it outside of the morning.
I cut out caffeine completely. Had a horrible withdrawal; headache from hell, back ache , neck ache, everything ache, but then around day 6 or 7 I did something I had not done in years - slept all night AND had a vivid dream (showing I was in deep REM sleep).
I used to think (or I believe was told), that two cups and no more before noon is ok, but found my sleep was just an utter mess. I tried everything , sleep test, black out curtains, magnesium, CBD oil, melatonin, yet it never occurred to me it could be coffee as I never drank it outside of the morning.
I cut out caffeine completely. Had a horrible withdrawal; headache from hell, back ache , neck ache, everything ache, but then around day 6 or 7 I did something I had not done in years - slept all night AND had a vivid dream (showing I was in deep REM sleep).
I would suggest getting checked for vitamin/nutritional deficiencies If you haven’t already done so. Exercise regularly if you don’t already.
Poor sleep can also be caused by stress/anxiety/depression, or just poor sleep hygiene.
Poor sleep can also be caused by stress/anxiety/depression, or just poor sleep hygiene.
> The study included 104 severely obese (Body Mass Index (BMI) ≥ 35 kg/m2) men
Wouldn't obesity more a factor than a sleep apnea for testosterone levels?
Wouldn't obesity more a factor than a sleep apnea for testosterone levels?
Obstructive Sleep Apnea correlates to obesity and obesity correlates to testosterone levels. Obesity is probably the root cause of both because of the behaviors of adipose tissue (taking up room and trashing your endocrine system, respectively), but I'm not an expert.
I've been studying this for a few years and the consensus seems to be that the causation is bidirectional.
It's definitely true that getting fat constricts your airways. When you lose weight, your tongue actually gets smaller, letting through more air. This is basically the same idea as losing weight in your feet and your shoes fitting differently -- weight gain or loss happens all over.
But the converse is also a problem: when you can't breathe at night, your body is under stress, and that can lead to overeating during the day.
There is some connection between the hormones lectin and ghrelin and lack of sleep. Not sure what the best reference is but I googled and found a few articles:
https://medsleep.com/sleep-deficits-may-lead-weight-gain/
It's definitely true that getting fat constricts your airways. When you lose weight, your tongue actually gets smaller, letting through more air. This is basically the same idea as losing weight in your feet and your shoes fitting differently -- weight gain or loss happens all over.
But the converse is also a problem: when you can't breathe at night, your body is under stress, and that can lead to overeating during the day.
There is some connection between the hormones lectin and ghrelin and lack of sleep. Not sure what the best reference is but I googled and found a few articles:
https://medsleep.com/sleep-deficits-may-lead-weight-gain/
Would losing the weight increase your testosterone? If you were obese
One thing that I haven't seen mentioned here is that adipose tissue (fat) contains aromatase, an enzyme that converts testosterone to estrogen. Thus it seems likely that weight loss would increase testosterone levels, or at the least lower estrogen levels which counteract much of the effects of testosterone.
Working out would raise your testosterone levels. Losing weight would happen in the kitchen though. Weight is a bad metric though, since muscles is heavier than fat.
1 kg of muscles is not heavier than 1 kg of fat.
By the way, professional body builders who go to the gym a couple times per week, increase their diet, optimize their diet, etc. are happy to gain 2,5kg of muscle a year.
So no, muscle gain has nothing to do with weight gain/loss. Successful diets are a lot faster, and most exercise based programs fail in studies.
By the way, professional body builders who go to the gym a couple times per week, increase their diet, optimize their diet, etc. are happy to gain 2,5kg of muscle a year.
So no, muscle gain has nothing to do with weight gain/loss. Successful diets are a lot faster, and most exercise based programs fail in studies.
An untrained individual who starts training with weights will gain much more than 2.5kg of muscle per year. As the individual accumulates muscle mass the rate of muscle gain will decrease gradually.
Any concrete numbers or sources? I pretty much doubt that it is much more. Or even any more at all.
No matter if you are trained or untrained, the number of muscle cells doesn't change. Only the amount of muscle fibers inside the cells changes.
No matter if you are trained or untrained, the number of muscle cells doesn't change. Only the amount of muscle fibers inside the cells changes.
Check this out: "The rate of strength increase differs considerably between untrained and trained individuals (148), as trained individuals have shown much slower rates of improvement (83,107,111,221). A review of the literature reveals that muscular strength increases approximately 40% in “untrained,” 20% in “moderately trained,” 16% in “trained,” 10% in “advanced,” and 2% in “elite” over periods ranging from 4 wk to 2 yr. [...] The difficulty in continuing gains in strength appears to occur even after several months of training. It is well documented that changes in muscular strength are most prevalent early in training (92,185). (Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34(2):364-380.)
That only talks about strength, not muscle mass.
Also there is a difference in what kinds of muscle fibers are added, and which are removed or replaced by others. Some are better for endurance, others more for peak strength.
My main point is that it is impossible to gain muscle mass faster than you can loose body fat with a proper diet. A proper weight loss in my opinion starts at one kg a week. Extremely obese people should, with medical consultation, aim much higher, though. There is no way you can gain 52kg of muscle mass in a year. Also for shorter periods it doesn't add up.
Also there is a difference in what kinds of muscle fibers are added, and which are removed or replaced by others. Some are better for endurance, others more for peak strength.
My main point is that it is impossible to gain muscle mass faster than you can loose body fat with a proper diet. A proper weight loss in my opinion starts at one kg a week. Extremely obese people should, with medical consultation, aim much higher, though. There is no way you can gain 52kg of muscle mass in a year. Also for shorter periods it doesn't add up.
I don't think this is a fair comparison. Body builders are at the very limit of how much muscle they can gain, someone who's out of shape can gain muscle a lot faster. That's not to say that you're going to gain muscle as fast as you lose fat, but the 2.5kg number is misleading.
>> professional body builders who go to the gym a couple times per week
I've never heard of a professional body builder, or any other athlete, who only went to the gym a couple times every week. The handful of semi-pro body builders I have known are more likely to be at the gym a couple times per day.
I've never heard of a professional body builder, or any other athlete, who only went to the gym a couple times every week. The handful of semi-pro body builders I have known are more likely to be at the gym a couple times per day.
And juicing most likely, so the 2.5kg figure doesn't really apply
Absolutely, changing your body composition definitely will.
With consistency and the right approach you really can feel a sort of compounding effect on your body's hormonal output. It's important to have some intuition around nutrition, human physiology, and the necessity of rest also. The more muscle mass you have the easier it is to get lean quickly because your body just has more capacity to expend energy.
Do not listen to the lies on this website that movement and exercise are not an important part of the equation, but keep in mind that getting injured will derail you the most and should be avoided at all cost. Nutrition is easy if you consume a variety of natural foods (nothing out of a package or can) and get enough protein, which is possible also for vegetarians and vegans and I'd suggest it.
If you are fairly obese I would suggest by starting with regular short walks, as many as you can manage in a day, while eating as much as you need, as long as the ratio of calories from protein compared to those from carbs and fat is reasonable.
With consistency and the right approach you really can feel a sort of compounding effect on your body's hormonal output. It's important to have some intuition around nutrition, human physiology, and the necessity of rest also. The more muscle mass you have the easier it is to get lean quickly because your body just has more capacity to expend energy.
Do not listen to the lies on this website that movement and exercise are not an important part of the equation, but keep in mind that getting injured will derail you the most and should be avoided at all cost. Nutrition is easy if you consume a variety of natural foods (nothing out of a package or can) and get enough protein, which is possible also for vegetarians and vegans and I'd suggest it.
If you are fairly obese I would suggest by starting with regular short walks, as many as you can manage in a day, while eating as much as you need, as long as the ratio of calories from protein compared to those from carbs and fat is reasonable.
>> Obesity is probably the root cause of both
Equally, lower testosterone levels often result in diminished activity and less muscle mass, leading to weight gain.
But the primary cause of reduced testosterone is age. The trick to avoiding all of these problems is to not be old. Stay at 18 and you are less likely to suffer any of these things.
Equally, lower testosterone levels often result in diminished activity and less muscle mass, leading to weight gain.
But the primary cause of reduced testosterone is age. The trick to avoiding all of these problems is to not be old. Stay at 18 and you are less likely to suffer any of these things.
That correlation is somewhat tenuous. Plenty of people with a healthy weight have OSA, but being fat does greatly increase the odds.
Anything that increases neck girth and puts weight on your chest
I'll add this from experience. Prescription drugs, and alcohol, can cause Sleep Apnea too.
The fact that they don't have a control group of normal BMI OSA patients makes me very skeptical regarding any outcomes.
The researchers would say that they adjusted the statistics to eliminate that variable but these statistical tricks work only in physics yet somehow they find it acceptable to use for such small N.
Small N point might be true, but “these statistical tricks work only in physics” is false on numerous spots. Things like statistical methods for controlling for certain associations aren’t “tricks” (they use GLM here) and they do not “only” work in physics. Without bringing up the whole replication crisis, there’s a lot of good science in other fields being done with these methods.
But what if the relationship with obesity has nonlinearities, how good is this control?
There are studies with millions of participants and by controlling for smoking, obesity, they still find increased risk and associations that are still very probably noise.fitting.
There are studies with millions of participants and by controlling for smoking, obesity, they still find increased risk and associations that are still very probably noise.fitting.
I’m not disagreeing with you that proper statistical research especially in a clinical setting is hard. It was the “tricks” and hint of non-physics : no-science I was responding to. I do think we should give doctors the benefit of the doubt. Just imagine the work involved in research with 100 real patients, let alone larger numbers. Then the next point is: where to get your research subjects. If you want to study non-linearities you’d want both patients and healthy subjects (and ideally people who switch categories). That’s several orders of magnitude more complex to get going. Not every subject gets funding for that scale.
Do you mean that the GLM wouldn't properly account for obesity's relationship with testosterone if the two have a nonlinear relationship? Is this something that could be accounted for by splines? I'm still trying to learn this stuff.
Isn't low testosterone correlated with other, more "general" health conditions anyway? It's certainly an interesting correlation, but I definitely would not try to infer any causality here.
I don't know but I suspect sleep apnea messes up REM sleep. And testosterone is released during REM sleep. Might be a little of both though.
Probably. People would rather be chained to a machine at night than lose weight.
That would be a stupid way to design a study, right?
That's why they compared obese patients who have sleep apnoe to obese patients who don't.
No, not everybody who is obese has sleep apnoe.
That's why they compared obese patients who have sleep apnoe to obese patients who don't.
No, not everybody who is obese has sleep apnoe.
But then conclude it's the testosterone levels, not the obestiy 'itself' or something more closely related to body fat? I think that's the point.
(But maybe testosterone levels are way more tightly correlated than I realise, IANA anything relevant!)
(But maybe testosterone levels are way more tightly correlated than I realise, IANA anything relevant!)
No such conclusion. The study finds a correlation between sleep apnoe and testosterone levels.
I can only recommend anybody to get checked out for sleep apnoe. Maybe not if you're under 25, slim and super-healthy. But otherwise...
You don't really notice it but it can mess up a lot of your health and it's not obvious...
You don't really notice it but it can mess up a lot of your health and it's not obvious...
I suffered from sleep apnea even as a swimmer on a division 1 college team. If you snore or find yourself constantly sleepy, regardless of your fitness levels, you should get it checked out.
You kinda do - it's one of the most common causes of sleepyness during the day. Obstruction of airways during sleep (apnea -> transient oxygen deprivation -> stress -> short interruptions of sleep and arousal). And it's common too: >40% has some kind of sleep apnea. 20% stress, 10% restless legs, and 10% because of obstructive sleep apnea (OSAS, obesity). I bet OSAS is a lot more common than that in the US.
My point is that it is hard to make the connection between snoring and sleepiness (and a few other things) and sleep apnoe. Unless you know there is one.
Has anyone tested to see if testosterone replacement can improve sleep? It increases lean muscle mass, which would in theory be correlated with lower body fat which is heavily correlated with osa. It seems a lot if science has been devoted to one direction — sleep problems causing say metabolic syndrome, but oddly not much science looking at the other direction — low testosterone causing increased body fat leading to poor sleep. It’s always assumed body fat is “lifestyle” choices. Doctors like to blame fat people for their medical issues it seems to me.
No, that seems logical but as is usually the case, such logic is simplistic and likely to cause more complications. It is more important to identify the cause of low testosterone and address that. Then you get to return testosterone to normal or improved levels and have the knock on benefits, etc. that you mention.
Worsening sleep apnea is listed as one of side effects of testosterone replacement therapy.
https://www.mayoclinic.org/healthy-lifestyle/sexual-health/i...
https://www.mayoclinic.org/healthy-lifestyle/sexual-health/i...
Apnea is extremely common among weightlifters. Even a slight increase in the volume of muscle in the neck can trigger major changes in breathing.
Looking on scholar, this Meta-Analysis of RCTs suggests no difference in sleep apnea between the treatment and control groups and I'll take that over mayoclinic.
[0] https://academic.oup.com/biomedgerontology/article/60/11/145...
[0] https://academic.oup.com/biomedgerontology/article/60/11/145...
Well is the TRT causing the sleep apnea or are people with low T getting sleep apnea and then getting replacement therapy? Or could it be associated with being larger (i.e more muscle - more T, or fat - low T, can obstruct breathing).
Two years now using CPAP using a nasal mask.
My boss woke me up at my desk as I was snoring away after lunch.
The wife complained I snored and also that I stopped breathing at night - driving home from work I nearly hit the road dividers a couple of times.
Went to a pulmonologist and got a home sleep study - it was eye opener.
The first night was horrific - felt like I was struggling to breath but the machine needed some calibration to up the start pressure.
The first month I used sleep tablets and wore the mask 30 minutes with the machine on before I went to actual sleep just to get used to it.
Biggest issue is mask comfort - tried different brands (the fittings are universal) and eventually settled on a F&P Eson 2.
Life changer for me.
My boss woke me up at my desk as I was snoring away after lunch.
The wife complained I snored and also that I stopped breathing at night - driving home from work I nearly hit the road dividers a couple of times.
Went to a pulmonologist and got a home sleep study - it was eye opener.
The first night was horrific - felt like I was struggling to breath but the machine needed some calibration to up the start pressure.
The first month I used sleep tablets and wore the mask 30 minutes with the machine on before I went to actual sleep just to get used to it.
Biggest issue is mask comfort - tried different brands (the fittings are universal) and eventually settled on a F&P Eson 2.
Life changer for me.
I wonder if there might be some amount of reverse causation here. I believe lower testosterone levels are also associated with obesity which is a known risk factor for sleep apnea.
I suspect a lot of things we associate with obesity are more bidirectional than we realize.
Interesting there was no mention of slow wave sleep (sws) in the study.
People with apnea have reduced SWS, which is responsible for the release of growth hormone, which is tied to testosterone.
People with apnea have reduced SWS, which is responsible for the release of growth hormone, which is tied to testosterone.
It's probably worth mentioning that the average of men's testosterone has been falling in the US for quite some time.
https://www.urologytimes.com/view/testosterone-levels-show-s...
https://www.urologytimes.com/view/testosterone-levels-show-s...
Interesting. I wonder if the lower testosterone levels in society is a knock on effect of the massive obesity epidemic (Apnea is one symptom of obesity).
Does anyone have any experience with treating this outside of CPAP? Not overweight btw.
Before CPAP, there was surgery, to remove part of the esophagus, and mouth guards, which moved the jaw forward, to increase airflow and reduce obstruction of the airway.
I had mild to medium sleep apnea where for a couple years I was probably only sleeping 4-6 hours a night. One day I separated my shoulder playing football and the only way I could sleep was on my back, but this made the sleep apnea much worse and I was probably getting 3-5 hours for several months. I caved and went through the tedious process of getting insurance to cover a CPAP machine. It was awful though and I slept worse while using it.
Meanwhile, the orthopedist I had seen for my shoulder suggested I try to correct the hunch I've developed from sitting at desks so that my shoulder doesn't heal in an awkward position. I had been doing that and noticed that every once in a while, I would sleep perfectly fine and wake up fully rested. This made me suspect this was a fixable problem and not some permanent feature of my anatomy.
After ~6 months of exercising and stretching to fix my shoulder hunch, I could finally sleep through a night and today I get better sleep than I can remember having in many years, without the CPAP. If you think you have sleep apnea, I'd recommend checking out r/posture on Reddit to see if you might have poor posture first. It can be really difficult and uncomfortable to fix if it's been developing for ~10-15 years like mine, but it's so worth it and there are a lot of other nice health benefits that come with it.
Meanwhile, the orthopedist I had seen for my shoulder suggested I try to correct the hunch I've developed from sitting at desks so that my shoulder doesn't heal in an awkward position. I had been doing that and noticed that every once in a while, I would sleep perfectly fine and wake up fully rested. This made me suspect this was a fixable problem and not some permanent feature of my anatomy.
After ~6 months of exercising and stretching to fix my shoulder hunch, I could finally sleep through a night and today I get better sleep than I can remember having in many years, without the CPAP. If you think you have sleep apnea, I'd recommend checking out r/posture on Reddit to see if you might have poor posture first. It can be really difficult and uncomfortable to fix if it's been developing for ~10-15 years like mine, but it's so worth it and there are a lot of other nice health benefits that come with it.
I guess if the body is short of oxygen all sorts of processes won't happen.
If you think you are having trouble breathing at night or are sleepy all the time please consider looking into whether you have sleep apnea. It's very common, has many serious systemic health consequences, and can be easily treatable. I wrote a blog post about my experience with diagnosis and treatment here: http://www.somebits.com/weblog/life/cpap-obstructive-sleep-a...