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AHI went from <5 to around 10, Testosterone replacement therapy
#1
AHI went from <5 to around 10, Testosterone replacement therapy
Hi, 

I started on testosterone replacement therapy in January. This is known to worsen OSA, so I did expect my numbers to change at least somewhat. Here is my Oskar screenshots, let me know if there's anything else you need...

I'm wondering if bumping up the pressures a little may help. Stomach sleeper, cpap hourglass shaped pillow, conscious effort to not tuck my neck.


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#2
RE: AHI went from <5 to around 10, Testosterone replacement therapy
Your obstructive events are clustered implying a chin tucking. I do suggest a cervical collar.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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#3
RE: AHI went from <5 to around 10, Testosterone replacement therapy
I also have TRT and have not experienced any increases in AHI. The pattern of obstructive events suggests chin tucking. Your machine is near the limits of its pressure range, so if a soft cervical collar does not resolve this, and I think it will, the next step may be a bilevel machine which is capable of higher pressure and more comfortable pressure support. I frankly think stomach sleeping is quite a challenge for the airway as it requires turning your head at an angle that that is likely to increase airway.

Watch your weight on TRT, also be sure to pay attention to blood tests to ensure you are not over-treating. It's fine to be a mere mortal at 400 to 600 rather than 1000+ ng/dL
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: AHI went from <5 to around 10, Testosterone replacement therapy
(04-07-2020, 12:23 PM)Sleeprider Wrote: I also have TRT and have not experienced any increases in AHI. The pattern of obstructive events suggests chin tucking. Your machine is near the limits of its pressure range, so if a soft cervical collar does not resolve this, and I think it will, the next step may be a bilevel machine which is capable of higher pressure and more comfortable pressure support.  I frankly think stomach sleeping is quite a challenge for the airway as it requires turning your head at an angle that that is likely to increase airway.

Watch your weight on TRT, also be sure to pay attention to blood tests to ensure you are not over-treating.  It's fine to be a mere mortal at 400 to 600 rather than 1000+ ng/dL

As far as TRT goes, I'm at 100mg/wk and not overly worried about going any higher since 125mg/wk already had my resting heart rate rising and I didn't feel any better. Minimum effective dose has always been my outlook.

I agree with both of you that I may still have tucking problems. You can't really will that out (as much as I'd like to think I can). I will look into different collar options and see if I can implement one. Any advice based on experience for choosing a collar?  I wish I could learn to sleep on my back or my side, but I seem not succeed anytime I try to train myself to do it.
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#5
RE: AHI went from <5 to around 10, Testosterone replacement therapy
Read the link in my signature on Soft Cervical Collar. It does talk about collars and alternatives.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: AHI went from <5 to around 10, Testosterone replacement therapy
I envy you, I got low testo. too, 3 in a scale of 7-21 but they dont want to prescribe me any gels, im 31.
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#7
RE: AHI went from <5 to around 10, Testosterone replacement therapy
*update*

Purchased a soft cervical collar about 4 weeks ago and have been wearing it every night since. It has 100% resolved neck and shoulder pain, it feels like it's helping but my numbers still aren't great. I'm wondering if there are any other obvious things i'm missing here, i'm getting days with like 1-3 AHI, then 10-13 AHI. Here are a few charts:
           
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#8
RE: AHI went from <5 to around 10, Testosterone replacement therapy
Make sure the collar prevents chin tucking. With results and pressure like this a Resmed Aircurve 10 Vauto is medically necessary. If you have good insurance ask your doctor.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: AHI went from <5 to around 10, Testosterone replacement therapy
With the collar on, see whether your chin can tuck down between the collar and your neck. If it can, that might be the problem. A somewhat different style of collar: the Eliminator, which is a half collar that is firmer. I find that when I adjust it just right, it will support the end of my chin but barely touch the rest of my lower jaw.

Looking at your charts, I do also wonder whether you sometimes sleep on your side or back and have a better or worse time of it in one sleep position rather than another. Any idea whether that might be the case?

Finally, people can train themselves to sleep in new positions. I wonder whether a half-way measure for you would be to get one of those long body pillows and lean on it to sleep half-way between stomach and side.
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