Sleep Apnea vs Testosterone therapy

by Ben

I have been on Testosterone therapy for almost 20 years and about 7 years ago diagnostic tests revealed I had severe Sleep Apnea >127 episodes per hour.

I just found out that there may be a relationship between the Testosterone therapy and my sleep apnea.

I would rather have a good nights sleep than gather what are supposed to be the benefits of T therapy.

Is it possible to reverse the apnea? What effects will I suffer from stopping the Testosterone therapy?

I have had the surgery to extend the lower jaw by 10mm to try and reduce the obstructive apnea, Helped ? My deviated septum was corrected.

During the 5th sleep study it was discovered that I additionally have central apnea. I use an Auto Bi-Pap SV and at time the levels get so high that it seems the mask wants to levitate on my face and wakes me up.

My Testosterone therapy is an injection of 0.5ml Testosterone Enanthate I.M. every nine days which I am truly tired of.

Would it be best to slowly reduce the amount I'm taking?

I am 60 years old now and as active as I can be.

Back surgeries have left me with an implanted pain pump to try and control the pain that is constant.

I realize this is a lot but would really appreciate your assistance.


There is no doubt that testosterone therapy can have the potential to make sleep apnea worse.

Actually, patients with obstructive apnea are primarily affected by testosterone therapy, whether you use pills, gel, or injections.

Obese men with OSA (obstructive sleep apnea) have an bigger disadvantage. Clinical studies demonstrated that increased weight in patients with testosterone therapy can worsen sleep apnea. Read about this study here.

So if you are overweight, but it's necessary to continue the testosterone therapy, losing weight by 10% to 20% can help you improve your sleep.

In my personal opinion, I think it's unusual not to include in contraindications and warnings of your medicine (Testosterone Enanthate) the side effects of testosterone therapy for patients with sleep apnea.

It's true, many dangerous side effects are included, such as:

  • hypercalcemia,

  • bony metastasis,

  • development of peliosis hepatis (which is a life-threatening or fatal complication),

  • development of hepatic neoplasms including hepatocellular carcinoma,

  • development of prostatic hypertrophy and prostatic carcinoma,

  • Gynecomastia,

  • older patients treated with testosterone are the most affected by these side effects.
My source of information is this article.

However, I will include the increased risk of worsening obstructive sleep apnea, mainly in older people.

Possible Solution to Improve Your Sleep Quality

Because I'm not an expert in testosterone therapy, I searched for clinical studies online that can demonstrate an improvement of sleep apnea after the cessation of hormone administration.

And guess what! I found something interesting for you.

In a clinical study the researchers (P A Cistulli, R R Grunstein and C E Sullivan) induced or exacerbated obstructive sleep apnea in a 13 year old male.

However, sleep apnea improved after cessation of testosterone administration. Here is the link to this study.

I can't give you information about the side effects from stopping the testosterone therapy, because I'm not expert in this subject.

Your doctor has the answer for this, and I strongly advise you to speak with him before taking the decision to stop the testosterone therapy.

In case you stop the therapy safely, I really hope your severe sleep apnea will be improved. In this way, you will need to decrease the Bi-PAP pressure to a new level. Which is good, considering your high pressure in this moment.

I hope it helps. Don't be afraid to comment back.

Remy Thierry
Founder of Sleep Apnea Guide

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