Is Testosterone Therapy Safe? Part 3: Sleep Apnea

The first two posts in this series went over the cardiovascular precautions taken and the prostate monitoring included in safe, medically guided testosterone replacement therapy (TRT) programs. The final commonly discussed potential risk related to TRT is a worsening of sleep apnea symptoms. Don't worry, folks, if you're a patient on TRT or considering starting TRT, this post will further reassure you that TRT is safe and effective.

Back in the 1970s and 1980s, a handful of case studies observed an association between testosterone replacement therapy and worsening symptoms of sleep apnea. While case studies are helpful, this type of research is not high quality enough to draw scientific conclusions on a large scale, as case studies only observe one patient, or case. Observations made by case studies require support from higher quality studies (such as randomized control trials, systematic reviews and meta-analyses) before they can be used to support medical decisions.

Luckily, higher quality studies on TRT and sleep apnea were not able to reproduce the results from these case studies. Investigation using higher quality research from larger studies failed to show and association between TRT and worsening sleep apnea. What more recent studies show is that patients who have sleep apnea that start TRT may experience worsening symptoms for a brief period initially (in the first 7 weeks of treatment). Luckily, according to the research, those symptoms subside shortly after (by the 18th week of treatment). In fact, most research today shows that symptoms of sleep apnea actually improve with long term TRT. With all of the research that we have now since the 1970s to draw from, we can confidently say that patients with sleep apnea are safe to use TRT. If patients experience a worsening of sleep apnea symptoms, that will most likely subside by the 4th month of treatment.

At FreshRx, we encourage our patients to remain on TRT for at least 3 months before considering any changes in their treatment plan. We ask this because we are confident that by the third month, our patients will be feeling amazing every day.

Uncomfortable side effects of TRT are rare altogether, but when they do occur, the vast majority subside by month 3 and never return. If you’re a current TRT patient or if you’re considering starting TRT, do your best to stick with it for 3 months- if after 3 months you feel that TRT is not right for you, you can certainly stop without causing any complications or harm to your body.

If you're interested in learning more about Testosterone Replacement Therapy, reach out to us at FreshRx for a free consultation!