Introduction: Neuroendocrine secretion is regulated by sleep. OSA can impair hormone secretion with a decrease in pituitary function and morning serum testosterone levels. This can affect negatively libido and fertility. There is a paucity of studies evaluating this.
Methods: Ambulatory males (20 to 50 years-old) were consecutively recruited from a Sleep Disorder Clinic, between August and December 2012. All underwent a clinical and anthropometric evaluation, a Epworth Sleepiness Scale (ESS), and polysomnography (PSG). We selected subjects with OSA defined as an apnea-hypopnea index (AHI) ≥5/h. Subjects with diabetes; hypothyroidism; pituitary tumors; morbid obesity and on chronic steroid treatment were excluded. We included 31 subjects of which 8 (25.8%) completed the study. Six were treated with CPAP and two with oral appliances. Sex hormone binding globulin (SHBG) protein, total and free testosterone levels were measured at baseline and at three months of OSA treatment.
Results: We studied 8 subjects of mean age 43. Mean BMI 31.3. Mean AHI 47.3, events/h. Hormone levels at baseline and follow up were: Total testosterone 228.1 ng/ml and 259.1 ng/ml (p = 0.012); free testosterone 7.4 pg/ml and 9.2 pg/ml (p = 0.012); SHBG 15.3 nmol/lt and 17.4 nmol/lt (p = 0.05). Baseline ESS was 15.2. On follow up ESS was 3.2 (p = 0.018). BMI did not change significantly (p = 0.553).
Conclusion: A significant increase in SHBG protein, total and free testosterone levels was observed after 3 months of treatment of OSA. This suggests that the improvement on libido reported on subjects treated with CPAP could be related to the increase in serum hormone levels and decrease in subjective daytime somnolence.
© 2015 Published by Elsevier Inc.