How does androgen replacement therapy influence sleep?
Exogenous testosterone may worsen existing OSA or lead to changes associated with OSA. One randomized controlled trial revealed that high-dose testosterone administration in hypogonadal, otherwise healthy, elderly men shortened total sleep time and worsened coexisting undiagnosed sleep apnea. Although there have been no substantiated reports of decreased cognition and impaired driving ability with hypogonadism, it is incumbent on the prescriber to screen patients for the possibility of undiagnosed OSA before prescribing androgen replacement therapy.
