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Can Testosterone Replacement Make OSA Worse
#11
(05-01-2016, 09:03 AM)Sleeprider Wrote: TRT can make untreated OSA worse, however many of us that use xPAP have been on TRT. If you need supplemental testosterone, then OSA is not "contraindicated", however men with mild or moderate apnea that are not treated may realize a worsening of the condition, if they are not using PAP.

That is what I am getting at. Will Apnea get worse in those who are on TRT. My T was super high when I went in for my test. My AHI was 37, not super bad but not that good either. Now my T is much lower and I hardly ever see the machine intervene with my breathing. My AHI is at 0.00 every night even at low pressure. I have my CPAP set at a max of 9.5 and it spends most of the night at the lower setting of 8.00. I fell asleep last night without the mask on and I feel fine. I just think that I am a mild case and CPAP may not be needed.
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#12
(05-01-2016, 10:48 AM)Adoniscmj Wrote:
(05-01-2016, 09:03 AM)Sleeprider Wrote: TRT can make untreated OSA worse, however many of us that use xPAP have been on TRT. If you need supplemental testosterone, then OSA is not "contraindicated", however men with mild or moderate apnea that are not treated may realize a worsening of the condition, if they are not using PAP.

That is what I am getting at. Will Apnea get worse in those who are on TRT. My T was super high when I went in for my test. My AHI was 37, not super bad but not that good either. Now my T is much lower and I hardly ever see the machine intervene with my breathing. My AHI is at 0.00 every night even at low pressure. I have my CPAP set at a max of 9.5 and it spends most of the night at the lower setting of 8.00. I fell asleep last night without the mask on and I feel fine. I just think that I am a mild case and CPAP may not be needed.

I have been using PAP therapy since 2008, and I assume my testosterone levels were normal then. I was prescribed TRT in 2014 when levels were found be be well under 200 ng/dL. So for me, OSA was already present and being treated a long time before TRT. We used blood tests to ensure levels of testosterone were <800 and >400 ng/dL, which is appropriate for a guy my age.

If you had a mild case of obstructive apnea that was not being treated prior to starting TRT, then it's possible that a sleep test taken after starting TRT would find moderate or even severe apnea. That OSA might be reversed or reduced if the TRT is cut back or eliminated. So, it is very plausible that your reduction in TRT resulted in enough improvement in OSA that you do not need PAP therapy, or pressures as high as when you were overdosed to 1600 ng/dL. That artificially high level of T in an older man is certainly enough to cause a host of problems, including OSA. Correcting that therapy level may have resolved your OSA enough that you don't need PAP.
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#13
(05-01-2016, 11:11 AM)Sleeprider Wrote:
(05-01-2016, 10:48 AM)Adoniscmj Wrote:
(05-01-2016, 09:03 AM)Sleeprider Wrote: TRT can make untreated OSA worse, however many of us that use xPAP have been on TRT. If you need supplemental testosterone, then OSA is not "contraindicated", however men with mild or moderate apnea that are not treated may realize a worsening of the condition, if they are not using PAP.

That is what I am getting at. Will Apnea get worse in those who are on TRT. My T was super high when I went in for my test. My AHI was 37, not super bad but not that good either. Now my T is much lower and I hardly ever see the machine intervene with my breathing. My AHI is at 0.00 every night even at low pressure. I have my CPAP set at a max of 9.5 and it spends most of the night at the lower setting of 8.00. I fell asleep last night without the mask on and I feel fine. I just think that I am a mild case and CPAP may not be needed.

I have been using PAP therapy since 2008, and I assume my testosterone levels were normal then. I was prescribed TRT in 2014 when levels were found be be well under 200 ng/dL. So for me, OSA was already present and being treated a long time before TRT. We used blood tests to ensure levels of testosterone were <800 and >400 ng/dL, which is appropriate for a guy my age.

If you had a mild case of obstructive apnea that was not being treated prior to starting TRT, then it's possible that a sleep test taken after starting TRT would find moderate or even severe apnea. That OSA might be reversed or reduced if the TRT is cut back or eliminated. So, it is very plausible that your reduction in TRT resulted in enough improvement in OSA that you do not need PAP therapy, or pressures as high as when you were overdosed to 1600 ng/dL. That artificially high level of T in an older man is certainly enough to cause a host of problems, including OSA. Correcting that therapy level may have resolved your OSA enough that you don't need PAP.
Yea, that is kinda my point of this whole thing. I don't think at this point I need CPAP in order to sleep well. It seems to be the opposite, I use CPAP and I get tired because I can't sleep with the machine very well and I have noticed that I get CA's when I use the machine. I had no Central Apnea's during my lab test. I think being on the machine may be giving me CA's. How to convince my sleep doctor?
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#14
(04-25-2016, 10:19 AM)Adoniscmj Wrote: If I really don't need a CPAP can this be harmful to use? I am also wondering has anyone else been on TRT and noticed a change in their apnea?

My suggestion is to lower your overall range and see if the events change. You don't need a sleep study for that. You can make the adjustments yourself. For instance, if you breathe comfortably at a pressure of 6, for ONE NIGHT, set your pressure at a straight 6 and then look at your events. If no events, go another week before determining that your OSA is gone. For some posters, they don't see an increase in events for the first couple of nights and then return to their pre-treatment phase.

Any change in medications can make a change in how your body responds to it. I found that increased use of aspirin reduced my events, but then that didn't last.
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#15
Home sleep apnea tests are inexpensive. If you want to really know where you stand, that might be a way to get it done for under $300. Just have your doctor prescribe it. Supplier #30 offers a test for $299 if you work with your own doctor. It's certainly accurate enough to determine your untreated AHI and give you the information needed to make a decision.
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