Who experiences Apnea/Polycythemia w/TRT and what are you doing about it?

[howard-sd]

Originally Posted by Numb&Dumber

pcgizzmo,
If you already have sleep apnea I'd say that TRT will most definately make it worse. I believe that sleep apnea is made worse from edema developing in the lungs and other soft tissues in the throat and nasal passages.

Sorry to differ on two of the above points:

1 - I have sleep apnea, have been on CPAP since 1997, on TRT since 2001. I monitor my apnea level through the measuring algorithms built into my machine, and have seen no increase in apneic events after I started TRT. (Yes, from time to time, I do a measurement of my AHI [apnea & hypopnea index] without CPAP.)

2 - Apnea can be induced from physical restrictions in a number of places, including a loose soft palate or position of the jaw at rest occluding the throat, or any combination.

Treating low testosterone with TRT will increase a person's energy level, making it easier to control or lose weight, one of the proven methods to reduce AHI.

To say that TRT will definately make sleep apnea worse is pure conjecture, and probably not supportable by controlled studies.

[pmgamer18]

Originally Posted by howard-sd

Sorry to differ on two of the above points:

1 - I have sleep apnea, have been on CPAP since 1997, on TRT since 2001. I monitor my apnea level through the measuring algorithms built into my machine, and have seen no increase in apneic events after I started TRT. (Yes, from time to time, I do a measurement of my AHI [apnea & hypopnea index] without CPAP.)

2 - Apnea can be induced from physical restrictions in a number of places, including a loose soft palate or position of the jaw at rest occluding the throat, or any combination.

Treating low testosterone with TRT will increase a person's energy level, making it easier to control or lose weight, one of the proven methods to reduce AHI.

To say that TRT will definately make sleep apnea worse is pure conjecture, and probably not supportable by controlled studies.

I agree with you my wife got tested and had apnea but could not use the machine it drove you nuts she would put on the mask then her mouth would open so they gave her a strap to keep her mouth shut man she looked like she just landed from mars. She checked on this.
http://www.restoremedical.com/pillar.asp
And the Dr. told her before she does this to try to lose weight she lost 40 lbs and the apnea is now gone.

[stat1951]

Originally Posted by howard-sd

Sorry to differ on two of the above points:

1 - I have sleep apnea, have been on CPAP since 1997, on TRT since 2001. I monitor my apnea level through the measuring algorithms built into my machine, and have seen no increase in apneic events after I started TRT. (Yes, from time to time, I do a measurement of my AHI [apnea & hypopnea index] without CPAP.)

2 - Apnea can be induced from physical restrictions in a number of places, including a loose soft palate or position of the jaw at rest occluding the throat, or any combination.

Treating low testosterone with TRT will increase a person's energy level, making it easier to control or lose weight, one of the proven methods to reduce AHI.

To say that TRT will definately make sleep apnea worse is pure conjecture, and probably not supportable by controlled studies.

I personally - as relates to my apnea - would agree with this post. My grandfather had sleep apnea very bad (but of course they had no definitive treatments back then - I don't even know if he ever saw a local doctor who even knew what it was)... and I am sure that it led to his early death from cardio problems (his family was otherwise very long lived - most going well into heir 90s while he died in early 70s). He did not smoke nor drink nor was he overweight. He was somewhat short and thinner and but very wiry and muscular. He had severe snoring and sleep apnea as early as his late 20s.

I developed severe snoring and my late 20s and started getting actual apnea events in my early to mid 30s. The condition seemed to worsen almost monthly. At that time I had bulked up quite a bit (from my early 20s to my early 30s) from having been bitten by the weight training bug - power oriented training for primarily strength and secondarily size. The severer snoring and sleep apneas started when I was probably around 200 - 210 and I maxed out (back then) in the 240 - 250 range but mainly muscular.

After putting up with it for 10 - 12 years my wife contacted a specialist and had a sleep test arranged.

Possibly a genetic connection?

According to the doctor, I indeed had the combination of Apnea as "induced from physical restrictions in a number of places, including a loose soft palate or position of the jaw at rest occluding the throat", etc. Surgery was discussed, but he felt that my condition was so severe that I would probably have to stay on a CPAP anyway, just at a lower air pressure setting. Since I had no problems with using the CPA machine I opted to forego the surgery at that time (though I do check on new options periodically in case a procedure is developed that will insure a 100% cure - for my particulars). If an advanced surgical procedure comes along that will do the trick and allow me to discontinue use of CPAP then I would jump on it. Not that I have a problem with wearing / using the CPA, it's just a pain when travelling, etc.

I have also discussed this with my wife and she has said that on the occasion where I drift off watching TV or reading that she has noticed that my snoring is not quite as severe and my apnea events are much less frequent that prior to being on TRT.

Personally I believe that TRT-induced sleep apnea is like most other side effects of any medication, hormone, etc. It is a very minor risk for a small segment (very small IMHO) of TRT patients, either to cause sleep apnea to develop or worsen existing sleep apnea.

Larry

[pcgizzmo]

Numb&Dumber,

Thanks for the reply. I work out on a pretty consistent basis. I am 5'10 and weigh about 228. I have a fairly large build. I would be called stocky by most people. That being said, I am not fat but certainly do not have a six pack either. My last T test showed 168. I have had Testosterone tests off and on for the last three years. The highest being 420 when I was on Clomid EOD to see if that would raise my T levels. I have tried the patch but that made my apnea worse on the first night of trying it. I was not on a CPAP at this time. I have injectable T Cyp. sitting at home and am afraid to take it because of what might happen w/my apnea. I am also concerned about the Polycythemia thing. Even though my blood levels are OK right now. HGB 15.5 and HCT 45. I am afraid the shot will push me over the limit there as well. I am just confused as to what to do. I really appreciate all the great responses and this board in general. It is good to be able to talk w/people w/some of the same problems.

[Numb&Dumber]

I don't think you need to be on TRT. I've read recently while googling that apnea can cause low testosterone and that once you treat the apnea the testosterone will come back up. With apnea you will stop breathing at night and this keeps your from getting the deeper sleep where your body does all the repairing and rejuvinating, and if your not getting the deep sleep then you'll have low T and feel tired during the day. Try sleeping on your side and put a pillow behind you so that you don't roll over on your back. Go on a diet. Lose some weight. You also need to exercise 30 minutes a day and get an hour of sunlight a day. This will raise your T and also melatonin so that you can get a better quality of sleep.

Also, if I were you, I'd throw that T-cyp out. If you can't breath on the Androgel then the cyp will be worse. You'll be getting a higher dose of T with cyp so the side effects will be worse, and unlike the androgel, if you have a problem breathing you can't just wash it off. With the androgel you can wash it off and most of the T will be out of your system within 24 hours, but with cyp it's in there for 2 weeks.

I just read your post where you say that the CPAP made your symptoms worse. If you can't use that then all I can tell you is to sleep on your side, keep it cool in your bedroom and maybe use a fan to circulate the air.

[LiquidGib]

Why do you suggest sleeping on your side?

[Numb&Dumber]

Obstructive sleep apnea is caused by repetitive upper airway obstruction during sleep as a result of narrowing of the respiratory passages. Patients with the disorder are most often overweight, with associated peripharyngeal infiltration of fat and/or increased size of the soft palate and tongue. Some patients have airway obstruction because of a diminutive or receding jaw that results in insufficient room for the tongue. These anatomic abnormalities decrease the cross-sectional area of the upper airway. Decreased airway muscle tone during sleep and the pull of gravity in the supine position further decrease airway size, thereby impeding air flow during respiration.

Initially, partial obstruction may occur and lead to snoring. As tissues collapse further or the patient rolls over on his or her back, the airway may become completely obstructed. Whether the obstruction is incomplete (hypopnea) or total (apnea), the patient struggles to breathe and is aroused from sleep. Often, arousals are only partial and are unrecognized by the patient, even if they occur hundreds of times a night. The obstructive episodes are often associated with a reduction in oxyhemoglobin saturation.

With each arousal event, the muscle tone of the tongue and airway tissues increases. This increase in tone alleviates the obstruction and terminates the apneic episode. Soon after the patient falls back to sleep, the tongue and soft tissues again relax, with consequent complete or partial obstruction and loud snoring.

Cycles of sleep, snoring, obstruction, arousal and sleep occur throughout the night. Some patients with severe apnea may have episodes of upper airway obstruction a hundred or more times in one hour. Multiple arousals with sleep fragmentation are the likely cause of excessive daytime sleepiness in patients with obstructive sleep apnea. Patients often complain of unrestful sleep and sometimes lament that they are sleepier in the morning than when they go to bed at night.

http://www.aafp.org/afp/991115ap/2279.html

[Numb&Dumber]

Decreased Testosterone Levels Linked To Sleep Disorder

The current study, reported in the July issue of The Journal of Clinical Endocrinology & Metabolism, found that nearly half the subjects who suffered from severe sleep apnea also secreted abnormally low levels of testosterone throughout the night.

"Should follow-up studies confirm these findings, then therapeutic intervention of sleep apnea could become a recommended remedy for certain forms of male sexual dysfunction," said Prof. Rephael Luboshitzky, an endocrinologist on the research team. "It is our hope that in the future, by correcting nighttime breathing patterns we will be able to stimulate hormone production and thereby raise libidos."


http://www.ats.org/news.php?id=45

[pmgamer18]

Originally Posted by Numb&Dumber

Decreased Testosterone Levels Linked To Sleep Disorder

The current study, reported in the July issue of The Journal of Clinical Endocrinology & Metabolism, found that nearly half the subjects who suffered from severe sleep apnea also secreted abnormally low levels of testosterone throughout the night.

"Should follow-up studies confirm these findings, then therapeutic intervention of sleep apnea could become a recommended remedy for certain forms of male sexual dysfunction," said Prof. Rephael Luboshitzky, an endocrinologist on the research team. "It is our hope that in the future, by correcting nighttime breathing patterns we will be able to stimulate hormone production and thereby raise libidos."


http://www.ats.org/news.php?id=45

That is old a lot of good Dr.'s will test men with low T to see if they have apnea. Fixing the apnea problems with a machine has and does bring T levels back up with out the man going on TRT.

[LiquidGib]

I find myself wanting to sleep on my tummy too. I force myself to sleep on my back but sometimes wake up the other way lol. I'll try sleeping on my side.

I don't think I have sleep apnea or anything like that, but sometimes one side of my nostril is partially clogged.

[pmgamer18]

Originally Posted by LiquidGib

I find myself wanting to sleep on my tummy too. I force myself to sleep on my back but sometimes wake up the other way lol. I'll try sleeping on my side.

I don't think I have sleep apnea or anything like that, but sometimes one side of my nostril is partially clogged.

One guy I know sowed a tennis ball in the back of his T-shirt so he would not sleep on his back this helps with apnes sleeping on ones side.