Effects of CPAP on Testosterone Levels in Patients With Obstructive Sleep Apnea: A Meta-Analysis Study.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis predominantly composed of non-randomized prospective cohort studies (10 cohort studies, 2 RCTs)
PubMed 31496991 · doi:10.3389/fendo.2019.00551
What was done
A systematic review and meta-analysis (registered on PROSPERO) evaluated the effect of continuous positive airway pressure (CPAP) on endocrine outcomes in male patients with obstructive sleep apnea (OSA). Databases (PubMed, Scopus, CENTRAL, Clinicaltrials.gov) were searched up to June 2018. Eligible studies evaluated total testosterone, free testosterone, SHBG, FSH, LH, and prolactin. Subgroup analyses were conducted based on baseline gonadal status (hypogonadal versus eugonadal).
What was found
Across 12 studies (10 prospective cohort studies and 2 randomized controlled trials) encompassing 388 patients, CPAP therapy was not associated with a statistically significant change in total testosterone levels (mean difference 1.08, 95% CI -0.48 to 2.64). CPAP also showed no significant effect on free testosterone, SHBG, FSH, LH, or prolactin. Subgroup analysis by baseline hypogonadal versus eugonadal status confirmed the overall lack of significant effect.
Why it matters
Treating obstructive sleep apnea with CPAP is unlikely to resolve low testosterone levels, indicating that hypogonadism in patients with OSA requires independent therapeutic strategies.
Limits
The total sample size is modest (388 patients across 12 studies), and the evidence base consists primarily of non-randomized prospective cohort studies (10 of 12) rather than randomized trials. Numerical data for secondary hormone outcomes, treatment duration, and CPAP adherence were not reported in the abstract.
Cited by
- contradicts Treating sleep apnea can increase testosterone levels by up to 200 ng/dL.