This study evaluated the impact of obstructive sleep apnoea (OSA) and smoking on total serum testosterone levels in 96 men (mean age 43.3 years; range 25-60 years) attending a sleep clinic. Fifty-five men (57.3%) had OSA, defined as an apnoea–hypopnoea index of ≥ 15 events/h, recorded during overnight polysomnography, and 42 (43.8%) were current smokers. Mean serum total testosterone levels were significantly lower in OSA subjects (3.4 ng/ml) than in non-OSA subjects (3.9 ng/ml), whereas no significant difference was observed between current smokers and non-smokers. In a multiple linear regression analysis, serum testosterone was negatively correlated with body mass index and the apnoea–hypopnoea index, but not with age and pack-years of smoking. Our results support previous observations regarding testosterone levels in men with OSA, but, contrary to some earlier reports, there was no positive relationship between smoking and total testosterone in the present cohort.
SantamariaJDPriorJCFleethamJA: Reversible reproductive dysfunction in men with obstructive sleep apnea. Clin Endocrinol1988; 28: 461–470.
4.
GrunsteinRRHandelsmanDJLawrenceSJBlackwellCCatersonIDSullivanCE: Neuroendocrine dysfunction in sleep apnea: Reversal by continuous positive airways pressure therapy. J Clin Endocrinol Metab1989; 63: 352–358.
5.
SemplePAGrahamAMalcolmYBeastallGHWatsonWS: Hypoxia, depression of testosterone, and impotence in Pickwickian syndrome reversed by weight reduction. Br Med J1984; 289: 801–802.
6.
KaracanIKaratasM: Erectile dysfunction in sleep apnea and response to CPAP. J Sex Marital Ther1995; 21: 239–247.
7.
FieldAEColditzGAWillettWCLongcopeCMcKinlayJB: The relation of smoking, age, relative weight, and dietary intake to serum adrenal steroids, sex hormones, and sex hormone-binding globulin in middle-aged men. J Clin Endocrinol Metab1994; 79: 1310–1316.
8.
SvartbergJMidtbyMBonaaKHSundsfjordJJoakimsenRMJordeR: The associations of age, lifestyle factors and chronic disease with testosterone in men: The Tromso Study. Eur J Endocrinol2003; 149: 145–152.
9.
TrummerHHabermanHHaasJPummerK: The impact of cigarette smoking on human semen parameters and hormones. Hum Reprod2002; 17: 1554–1559.
10.
LaaksonenDENiskanenLPunnonenKNyyssonenKTuomainenTPValkonenVP: The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: A prospective cohort study. J Clin Endocrinol Metab2005; 90: 712–719.
11.
RechtschaffenAKalesA: A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages in Human Subjects. Los Angeles: Brain Information Service, UCLA, 1968.
12.
American Academy of Sleep Medicine Task Force: Sleep related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. Sleep1999; 22: 667–689.
13.
LaviePHererPHoffsteinV: Obstructive sleep apnoea syndrome as a risk factor for hypertension: Population study. BMJ2000; 320: 479–482.
14.
HaffnerSM: Sex hormones, obesity, fat distribution, type 2 diabetes and insulin resistance: Epidemiological and clinical correlation. Int J Obes Relat Metab Disord2000; 24 (suppl 2): S56–S58.
15.
FreedmanDSO'BrienTRFlandersWDDeStefanoFBarboriakJJ: Relation of serum testosterone levels to high density lipoprotein cholesterol and other characteristics in men. Arterioscler Thromb1991; 11: 307–315.
16.
HaffnerSMKarhapaaPMykkanenLLaaksoM: Insulin resistance, body fat distribution, and sex hormones in men. Diabetes1994; 43: 212–219.
17.
LaaksonenDENiskanenLPunnonenKNyyssonenKTuornainenTPValkonenVP: Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care2004; 27: 1036–1041.
18.
Barrett-ConnorE: Lower endogenous androgen levels and dyslipidemia in men with non–insulin-dependent diabetes mellitus. Ann Intern Med1992; 117: 807–811.
19.
WilcoxIMcNamaraSGCollinsFLGrunsteinRRSullivanCE: 'Syndrome Z': The interaction of sleep apnoea, vascular risk factors and heart disease. Thorax1998; 53 (suppl 3): S25–S28.
20.
ShabsighRKatzMYanGMakhsidaN: Cardiovascular issues in hypogonadism and testosterone therapy. Am J Cardiol2005; 96: 67–72.
21.
PekerYHednerJNorumJKraicziHCarlsonJ: Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: A 7-year follow-up. Am J Respir Crit Care Med2002; 166: 159–165.
22.
TrummerHHabermannHHaasJPummerK: The impact of cigarette smoking on human semen parameters and hormones. Hum Reprod2002; 17: 1554–1559.
23.
YardimciSAtanADelibasiTSungurogluKGuvenMC: Long-term effects of cigarette-smoke exposure on plasma testosterone, luteinizing hormone and follicle-stimulating hormone levels in male rats. Br J Urol1997; 79: 66–69.
24.
GambineriAPelusiCPasqualiR: Testosterone levels in obese male patients with obstructive sleep apnea syndrome: Relation to oxygen desaturation, body weight, fat distribution and the metabolic parameters. J Endocrinol Invest2003; 26: 493–498.
25.
StewartDAGrunsteinRRSullivanCEHandelsmanDJ: Neuroendocrine changes in sleep apnea are not related to a pituitary defect. Sleep Res1989; 18:308.
26.
MestonNDaviesRJMullinsRJenkinsonCWassJAStradlingJR: Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea. J Intern Med2003; 254: 447–454.
27.
MendelsonJHSholarMBMutschlerNHJaszyna-GasiorMGoletianiNVSiegelAJ: Effects of intravenous cocaine and cigarette smoking on luteinizing hormone, testosterone, and prolactin in men. J Pharmacol Exp Ther2003; 307: 339–348.
28.
BratelTWennlundACarlstromK: Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoea. Effects of continuous positive airway pressure treatment (CPAP). Respir Med1999; 93: 1–7.
