Obstructive sleep apnea syndrome and age-related hypohonadism

Abstract

Obstructive sleep apnea syndrome (OSAS) is a common disease that causes a different spectrum of life processes violations in the continuum of 'sleep-wakefulness'. OSAS in combination with age-specific hypogonadism as a systemic pathology requires certain interdisciplinary approaches involving both the correction of the obstruction, and testosterone therapy in men with hypogonadism. Assessment of the effect of combined use of CPAP (Continuous Positive Airway Pressure) and testosterone replacement therapy (transdermal form - Androgel) on indicators of polysomnography monitoring (PSG) with simultaneous study of erectile function and testosterone secretion. 26 men with OSAS and andropause (mean age - 46,1±8,4 years, BMI - 35,2±4,6 kg/m2) were examined. All patients were divided into 2 groups: men with therapy CPAP (n=14); men with combination therapy CPAP and Androgel (50 mg 1 times a day) (n=12). CPAP was carried out by automatic apparatus: Prisma 20A ('Weinemann', Germany) and iSleep 20i ('Breas', Sweden). Duration of therapy in both groups was 2 months. There were no statistically significant differences in the baseline characteristics of the physical examination, the level of total testosterone, PSG and nocturnal penile patterns in both groups of patients. After combination therapy (CPAP and Androgel) in men found the increase of total testosterone levels by 2 times (p<0,05) and improvement in indicators of altered nocturnal penile erection episodes (Tup, Tmax, Tm/R, Tup/R, the total number of NPT (p<0,05)) compared with similar parameters in men with only on CPAP-therapy was found. Indicators of the objective status were improved, although there were no changes in PSG characteristics in both groups. The results of this study indicate greater efficiency of the combined method of treatment (CPAP+Androgel) in patients with OSAS and andropause.