Choi, KL

Chow, MS

Ip, MSM

Lam, B

Lam, KSL

Ooi, CGC

Tiu, SC

Hong Kong Medical Journal

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Title A study on the effect of testosterone replacement on thedevelopment of obstructive sleep apnoea (OSA)Author(s) Lam, B; Chow, MS; Choi, KL; Ooi, CGC; Tiu, SC; Lam, KSL; Ip,MSMCitationThe 8th Medical Research Conference Abstracts, Hong KongMedical Journal, Hong Kong, China, 25-26 January 2003, v. 9 n. 1Supp 1, p. 87Issued Date 2003URL http://hdl.handle.net/10722/45752Rights Creative Commons: Attribution 3.0 Hong Kong LicenseHKMJ Vol 9 No 1 February 2003 Supplement      87A study on the effect of testosterone replacement on the development of obstructivesleep apnoea (OSA)Lam B, Chow WS, ªChoi KL, ºOoi CGC, ªTiu SC, Lam KSL, Ip MSM, University Department of Medicine, ªDepartment ofMedicine Queen Elizabeth Hospital, and ºDepartment of Diagnostic Radiology, University of Hong Kong, Hong Kong SARIntroduction: Obstructive sleep apnoea syndrome (OSA) is a common disease, it is characterised by snoring,repetitive occlusion episodes of upper airway resulting in desaturation and excessive daytime sleepiness. The malepreponderance of this disorder, coupled with the reported development of OSA in patients following testosteroneadministration, suggest that androgens play a role in the pathogenesis of this disorder. One of the reasons fortestosterone replacement lead to OSA might be redistribution of fat at neck region lead to decrease in muscle tone,or increase in muscle bulk around neck region result in narrowing of upper airway. The primary goal of the study isto find out the role and mechanism of androgen in the pathogenesis of OSA.Method: Subjects were recruited from Endocrine Clinic of one regional hospital and one University hospital.Recruitment was aimed at newly diagnosed hypogonadal male requiring testosterone administration. Polysomnogram(PSG) was performed at baseline, 24 and 48 weeks after testosterone treatment. Body habitus, body fat and serumtestosterone level were monitored regularly. Magnetic resonance imaging of the neck and abdomen wereperformed at baseline, 6 and 12 months after testosterone replacement for measuring.Results: Four subjects recruited and two had been reassessed with PSG after 24 weeks of testosterone replacement.Their body mass index increased as well as apnea hypopnea index (AHI). One of them who had mild OSA atbaseline showed moderate OSA on reassessment PSG. The other one who had no OSA at baseline remained freefrom OSA.Conclusion: To be drawn after study finished*This study was supported by the UDM research fundA randomised controlled study of the effectiveness of continuous positive airwaypressure, oral appliance and conservative measures in the treatment of mild to moderateobstructive sleep apneaLam B, ºSam K, ªCheung MT, Mok W, Lam J, Tsang KWT, ªYam L, Chan MMW, 2Chow SK, Lam WK, Ip MSMUniversity Department of Medicine, ªDepartment of Medicine and _Surgery Pamela Yould Hospital, and ºDepartment ofOrthodontics, University of Hong Kong, Hong Kong SARIntroduction: Continuous positive airway pressure (CPAP) is considered the standard treatment for severeobstructive sleep apnea (OSA) but studies on the effectiveness of different treatment options for mild to moderateOSA are limited. The aim of our study was to evaluate the effectiveness of lifestyle modification measures (CM)alone and in combination with CPAP or oral appliance (OA) in improving symptoms and quality of life of subjectswith mild to moderate OSA.Method: Subjects were recruited from two sleep laboratories of two hospitals in Hong Kong. Recruitment wasaimed at newly diagnosed mild to moderate sleep apnea subjects. These subjects were then randomized into threedifferent treatment groups: CM, CM + CPAP, and CM + OA. Polysomnogram was performed both at baseline and10 weeks after treatment while still using the assigned treatment. Sleepiness were assessed with EpworthSleepiness Score, and quality of life were assessed with generic and disease specific questionnaires (health relatedquality of life score SF-36 and sleep apnea quality of life index SAQLI) at inclusion and after 10 weeks of treatment.Results: 94 subjects finished the study. There was moderate decrease in AHI in CM+OA group and a greaterdecrease in CM+ CPAP group, while the AHI of subjects managed with CM alone remained the same. The relief ofsleepiness was the greatest in CPAP group and smallest in CM group. Quality of life of subjects was also restoredto that of normal level in the CPAP and OA groups after treatment while no change was observed in the CM group.The self reported compliance to OA was better than that of objectively measured CPAP compliance.Conclusion: Both CPAP and OA are effective in treating symptomatic mild to moderate OSA while CM alone isof little effect.*This study was supported by the HSRC grant No. 831036RM-05RM-06

A study on the effect of testosterone replacement on the development of obstructive sleep apnoea (OSA)

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A study on the effect of testosterone replacement on the development of obstructive sleep apnoea (OSA)

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