Technische Universität München

The Entrepreneurial University

Some studies associate androgen administration with a higher risk of occurrence or exacerbation of the sleep apnea syndrome. In general, sleep apnea is a phenomenon of recurrent cessation or decrease of airflow to the lungs during sleep. Sleep apnea is classified as either central, due to cessation of respiratory movements, or obstructive due to narrowing of the upper respiratory airways. The repetitive episodes of obstruction are associated with severe intermittent hypoxia and sleep fragmentation. The symptoms include morning headaches, fatigue and in more advanced cases – clinical picture of respiratory failure. Sleep apnea is a common cause of snoring, daytime sleepiness, impaired cognitive performance and road traffic accidents.
Androgen administration may induce or exacerbate obstructive sleep apnea in some men, women and children. Consistent with these observations are recent results demonstrating a reduction in total sleep time, longer hypoxic episodes and increases in the respiratory disturbance index (the number of apneas and hypopneas per hour) in healthy older men exposed to high doses of testosterone esters. Increased endogenous testosterone production as a result of testosterone-producing tumor also may induce obstructive sleep apnea in women. The possible mechanisms of this effect of androgens are associated with an increase in the upper airway collapsibility and influence on the neuromuscular control of upper airway patency during sleep, as well as to a reduction in upper airway dimension following the anabolic effect on the structural configurations of the oropharynx, especially in women.