Sleep Apnea: Effect on Testosterone and High Hematocrit

[Nelson Vergel]

Table of Contents​

• Sleep Apnea and Testosterone
• Sleep Apnea and Cortisol
• Health Consequences of Sleep Apnea
• Sleep Apnea Solutions
  • REFERENCES:

Do you snore? Do you feel fatigued every day? Do you wake up frequently throughout the night? It may be that the shallow breathing or breaks in breathing caused by sleep apnea are the reason. There are different types of sleep apnea, one of which is obstructed sleep apnea (or OSA), which is when breathing is interrupted by a physical block to airflow. With OSA, snoring is common.

Sleep Apnea and Testosterone​

What does apnea have to do with testosterone? Everything! Your precious shuteye is responsible for a host of all-important physiological functions, including rebuilding your testosterone and neurotransmitters, optimizing stress hormones, and mapping memory. Therefore, any condition, such as apnea that lowers the quality or quantity of sleep, is a physical and hormonal train wreck waiting to happen.

Apnea is one of the nastiest sleep disorders because it is so disruptive. After all, what could interfere with sleep more than having your airways and oxygen blocked off? Unfortunately, one study after another has rolled out showing how complex apnea is on the body, and hormones are no exception.

One early study looked at just how severe the damage can be and found that apnea sufferers went from an average low testosterone test of 391ng/dL to a much closer-to-normal 487ng/dL after corrective surgery. [1] That's a jump of 25% in testosterone after their apnea was corrected! However, a later study of guys in their 40's, showed an astonishing 68% difference between controls and males with apnea. [2] Regardless of the exact number, you get the idea: apnea is devastating to your most precious hormone, testosterone.

However, there is actually a logical explanation for the difference in the two numbers above: the first number comes from a comparison after apnea correction and the second before correction. Researchers have found that guys who have had apnea for a significant amount of time are often overweight, even obese. [3] In other words, if you've built up a big spare tire during your sufferings with apnea, CPAP or other therapy cannot get you back to where you were before because your own body is fighting against itself.

The researchers found that apnea subjects appeared more like aged subjects where LH (Luteinizing Hormone) cycles at night were increased, yet without a corresponding increase in testosterone as is experienced by younger males. Young guys get a pulse of luteinizing hormone followed by one of testosterone and so on. This cycle is dampened increasingly in males as they age, and apnea appears to accelerate this process.

In other words, once you get your apnea corrected, you must take care to also lose any excess weight in order to re-optimize your testosterone as much as possible. The good news is that just getting treated for apnea will give you a nice jump in testosterone, and then as you lose weight and control cortisol, you should increase it even further. Studies have even verified this in obese men with a BMI of 32, which isn't what would even called obese, by the way. When they lost weight, they regained their testosterone. [4]

Sleep Apnea and Cortisol​

Similarly, apnea also leads to elevated cortisol level. One study found that subjects had 50% percent higher cortisol before CPAP when compared to after. [6] This is truly nasty: cortisol is not something you want to be elevated by even the smallest amount. Higher cortisol elevations, especially in the middle age and beyond years, can lead to memory damage, lowered testosterone, increased fat mass, lower immunity, poor sleep and a host of other ills. In the last ten years, researchers have uncovered the fact that most apnea is actually lifestyle-related and not simple genetics or aging.

Health Consequences of Sleep Apnea​

Sleep apnea has been shown to increase the incidence of these health problems:

1. Heart Disease.
2. Blood Glucose Control and Diabetes. If you have diabetes, sleep apnea can make it more difficult to manage your diabetes.
3. Increased blood viscosity due to high hematocrit: As you starve your body of oxygen at night with sleep apnea, the body compensates by producing more oxygen-carrying hemoglobin and red blood cells, which increases hematocrit and blood viscosity. This can cause heart disease, high blood pressure and require frequent blood donations if you are on testosterone replacement therapy (TRT). Note: TRT can worsen sleep apnea in some men [10]
4. Memory Loss and Dementia Risks. Heavy snoring and sleep apnoea may be linked to memory and thinking decline at an earlier age, according to a study published in the April 15, 2015, online issue of the journal Neurology. The research also suggests that treating the disorders with a breathing machine may delay the decline. “Abnormal breathing patterns during sleep such as heavy snoring and sleep apnea are common in the elderly, affecting about 52% of men and 26% of women,” said Ricardo Osorio, MD, at the NYU Langone Medical Center.
5. Fatigue and daytime sleepiness.
6. Depression.
7. Irritability.

Sleep Apnea Solutions​

One interesting aspect of apnea research is that researchers are finding that there are many natural solutions that can often help apnea sufferers and sometimes even cure their apnea. This is important for several reasons. First of all, in some cases, it shows that there is a root cause of apnea, i.e., there is not some inherent genetic weakness causing this debilitating condition but rather some lifestyle change that can help significantly. Secondly, the medical solutions for apnea are rather invasive: surgery (somnoplasty and snoreplasties) and/or a cumbersome CPAP machine worn through the night. Many of those with apnea would like to avoid such solutions and find something more natural.

However, it should be noted that there is one other medical procedure, the Pillar procedure, that is significantly less invasive. This is performed by a dentist and involves tiny polyester implants in the soft palate of an apnea (or snoring) sufferer. It is actually the vibration of the soft palate that can lead to snoring and often apnea, so this can be an easy fix in some cases since it is done with minimal anesthetics.

WARNING: It is critical to get your apnea treated. One study looked at 380 participants with moderate or severe sleep apnea over a 14-year period and found that one-third of the patients died! [9] That's in comparison to 8 percent without apnea.

Those suffering from apnea or other sleep disorders should definitely consider green tea, as they get their condition under control. The oxidative stress from apnea typically affects memory and the ability to learn. Researchers have found that green tea, at least in animals, protects the brain from oxygen-deprived states that occur in apnea and related disorders. Green tea for the rats in this study actually protected their brains and memory from the ravages of apnea sleep loss. [4]

Below is a summary of additional natural solutions that researchers have found for apnea:

1. Weight Loss. Research shows that mild apnea can often be significantly helped or even cured simply by losing those extra pounds. One recent study found that almost two-thirds of study participants who dropped 23 pounds through diet and exercise were actually completely cured of their apnea. [2] Therefore, assuming your apnea isn't too severe, you may want to try simple weight loss first as a solution and, as a side benefit, you may have your testosterone significantly restored as well. In other words, dropping those pounds has the potential to boost your testosterone and cure your apnea at the same time.

1. If your apnea is severe, however, simple weight loss will not do the trick, and you will likely end up with a CPAP (Continuous Positive Airway Pressure) These masks can be testosterone and life and saver, literally. There are also dental mouthpieces and surgery of the throat as options as well, but these are considered less effective in most cases. Your doctor can order a sleep study for you to get tested at a sleep lab or using a home-based system. There are also telemedicine services for sleep apnea. A study done in Portugal and published in 2017 found that after people used CPAP machines for six months, their red blood cell count, hemoglobin, hematocrit, and platelet count showed a significant decrease [11]

1. Treat Hypothyroidism. Apnea can result from hypothyroidism, an underactive thyroid that will be unresponsive to standard treatments. It is estimated that 2-3% of apnea sufferers fall into this category. [3]

1. Improve Sleep Position. Some practitioners have noticed that sleeping on the side can significantly help with apnea. Another solution is to sleep in a partial sitting position. One study showed that half of all apnea sufferers could actually cure their condition by sleeping in this position! [5]

1. Avoid Alcohol at Night. If I got woken up a couple of hundred times during the night from lack of oxygen, I might want a few drinks, but researchers have found that this decidedly exacerbates apnea. [6]

1. Stop Smoking. Smoking makes apnea significantly worse because it inflames airway tissues and is associated with an increased incidence of this condition. [7]

1. Avoid Sitting for Long Periods. Sitting a lot during the day pools water and blood in the legs, and this aggregation of liquids then migrates to your neck region when you go to Sleep leading to apnea in many cases. Keep moving throughout the day. [8] Download a step counter App to your phone, carry your phone in your pocket, and measure the total steps you take daily. If you’re sedentary, add 2,000 more daily steps so that you average at least 4,400 daily steps. While 2,000 steps equals one mile, it’s not necessary to walk it all at once. Instead, try to take extra steps over the course of each waking hour.

1. Monitor Your Oxygen Saturation. Use an oximeter connected to a Bluetooth enabled App to see how many times your blood oxygen level drops during your sleep cycle. Bluetooth Oximeter syncs the measurement readings to the free ViHealth app via Bluetooth automatically and securely. The app can store unlimited history data, which gives you a quick overview and helps you monitor your health.

As you can see, reversing sleep apnea can not only extend your life span but also its quality. Giving your body the oxygen it needs will change your life!

REFERENCES:​

1) Journal of Sexual Medicine, 6(11):3147-3157, Published Online: 29 Jun 2009, "Sleep Apnea is an Independent Correlate of Erectile and Sexual Dysfunction"

2) Consumer Reports on Health, Jul 2009, p. 10.

3) Am. J. Respir. Crit. Care Med., Aug 1999, 160(2):732-735, "Screening for Hypothyroidism in Sleep Apnea"

4) Amer J of Respiratory and Critical Care Med, May 15 2008, Goza

5) Am Rev Respir Dis, 1986 Apr, 133(4):662-6, "The effects of posture on obstructive sleep apnea"

6) Amer J of Medicine, Aug 1981, 71(2):240-245, "Alcohol increases sleep apnea and oxygen desaturation in asymptomatic men"

7) SLEEP AND BREATHING, 5(4):167-172, "Higher Prevalence of Smoking in Patients Diagnosed as Having Obstructive Sleep Apnea"

8) Men's Health, May 2009, p. 33.

9) Sleep, 2008 Aug , ;31(8):1079-85, "Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study"

10) The Journal of Clinical Endocrinology & Metabolism, Volume 88, Issue 8, 1 August 2003, Pages 3605–3613. “The Short-Term Effects of High-Dose Testosterone on Sleep, Breathing, and Function in Older Men”

11) Revista Portuguesa de Pneumologia (English Edition) Volume 23, Issue 2, March–April 2017, Pages 71-78. "Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure"

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[DixieWrecked]

I have been looking but haven't found much conclusive data. When I wear my oximeter without a CPAP it measures numerous drops throughout the night, between 20-60. But my average O2 is around 94. How bad is 94?