scholarly journals The Association of Testosterone Levels with Overall Sleep Quality, Sleep Architecture, and Sleep-Disordered Breathing

2008 ◽  
Vol 93 (7) ◽  
pp. 2602-2609 ◽  
Author(s):  
Elizabeth Barrett-Connor ◽  
Thuy-Tien Dam ◽  
Katie Stone ◽  
Stephanie Litwack Harrison ◽  
Susan Redline ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleep Apnea ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Older Men ◽  
Sleep Efficiency ◽  
Total Testosterone ◽  
Testosterone Levels ◽  
Low Testosterone ◽  
Disordered Breathing

Abstract Context: Little is known about the association of low endogenous testosterone levels and abnormal sleep patterns in older men, although pharmacological doses of testosterone are associated with increased severity of sleep apnea and other sleep disturbances. Objective: The objective of the study was to examine the association between serum testosterone levels with objectively measured sleep characteristics. Design: This was a cohort study. Setting: Community-dwelling men aged 65 yr or older from six clinical centers in the United States participated in the study. Participants and Main Outcome Measures: A total of 1312 men had baseline total testosterone levels measured in 2000–2002, followed 3.4 yr later by 72-h (minimum) actigraphy and one-night in-home polysomnography to assess sleep duration, sleep fragmentation, and sleep apnea. Analyses were performed by quartile of total testosterone and categorically defined low vs. higher total testosterone (<250 ng/dl vs. ≥250 ng/dl). Lifestyle and body size were covariates. Results: Total testosterone levels were unrelated to age or duration of sleep. Men with lower testosterone levels had lower sleep efficiency, with increased nocturnal awakenings and less time in slow-wave sleep as well as a higher apnea-hypopnea index and more sleep time with O2 saturation levels below 90%. Low testosterone levels were associated with overweight, and all significant associations were attenuated or absent after adjusting for body mass index or waist circumference. In a post hoc analysis in men with higher body mass index (>27 kg/m2), testosterone was significantly associated with more periods awake after sleep onset and lower sleep efficiency. Conclusion: Low total testosterone levels are associated with less healthy sleep in older men. This association is largely explained by adiposity. Clinical trials are necessary to determine whether body weight acts directly or indirectly (via low testosterone) in the causal pathway for sleep-disordered breathing in older men.

Clinical Staging for Sleep-Disordered Breathing

2002 ◽  
Vol 127 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Michael Friedman ◽  
Hani Ibrahim ◽  
Lee Bass
Keyword(s):  
Body Mass Index ◽  
Success Rate ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Staging System ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Clinical Staging ◽  
Disordered Breathing

OBJECTIVE: The purpose of this study was to identify prognostic indicators that would lead to stratification of patients likely to have successful surgery for sleep-disordered breathing (SDB) versus those destined to fail. STUDY DESIGN: We retrospectively reviewed 134 patients to correlate palate position and tonsil size to the success of the UPPP as based on postoperative polysomnography results. Similar to our previously published data on the Friedman Score as a predictor of the presence and severity of SDB, the palate position was determined on physical examination of the oral cavity and was graded for each patient. This grade combined with tonsil size was used to stage the patients. Stage I was defined as having palate position 1 or 2 combined with tonsil size 3 or 4. Stage II was defined as having palate position 3 or 4 and tonsil size 3 or 4. Stage III patients had palate position 3 or 4 and tonsil size 0, 1, or 2. Any patient with body mass index of greater than 40 was placed in the stage III group. The results of uvulopalatopharyngoplasty (UPPP) were then graded as success or failure and success rates were compared by stage. SETTING: Academically affiliated tertiary care referral center. RESULTS: Stage I patients who underwent UPPP had a success rate of 80.6%, stage II patients had a success rate of 37.9%, and stage III patients had a success rate of 8.1%. CONCLUSION: A clinical staging system for SDB based on palate position, tonsil size, and body mass index is presented. It appears to be a valuable predictor of the success of UPPP. Additional studies and wider use of the staging system will ultimately define its role in the treatment of SDB.

scholarly journals The association of body mass index values with severity and phenotype of sleep-disordered breathing

2019 ◽  
Vol 67 (4) ◽  
pp. 265-271
Author(s):  
Çiğdem ÖZDİLEKCAN ◽  
Tarkan ÖZDEMİR ◽  
Mustafa Hamidullah TÜRKKANI ◽  
Halil Yılmaz SUR ◽  
Maram Gamal KATOUE
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals Differences in the Apparent Metabolic Clearance Rate of Testosterone in Young and Older Men with Gonadotropin Suppression Receiving Graded Doses of Testosterone

2006 ◽  
Vol 91 (11) ◽  
pp. 4669-4675 ◽  
Author(s):  
Andrea D. Coviello ◽  
Kishore Lakshman ◽  
Norman A. Mazer ◽  
Shalender Bhasin
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Young Men ◽  
Serum Testosterone ◽  
Older Men ◽  
Total Testosterone ◽  
Metabolic Clearance ◽  
Clearance Rates ◽  
Testosterone Levels ◽  
Age Related

Abstract Background: Recently we found that testosterone levels are higher in older men than young men receiving exogenous testosterone. We hypothesized that older men have lower apparent testosterone metabolic clearance rates (aMCR-T) that contribute to higher testosterone levels. Objective: The objective of the study was to compare aMCR-T in older and young men and identify predictors of aMCR-T. Methods: Sixty-one younger (19–35 yr) and 60 older (59–75 yr) men were given a monthly GnRH agonist and weekly testosterone enanthate (TE) (25, 50, 125, 300, or 600 mg) for 5 months. Estimated aMCR-T was calculated from the amount of TE delivered weekly and trough serum testosterone concentrations, corrected for real-time absorption kinetics from the im testosterone depot. Results: Older men had lower total (316 ± 13 vs. 585 ± 26 ng/dl, P < 0.00001) and free testosterone (4 ± 0.1 vs. 6 ± 0.3 ng/dl, P < 0.00001) and higher SHBG (52 ± 3 vs. 33 ± 2 nmol/liter, P < 0.00001) than younger men at baseline. Total and free testosterones increased with TE dose and were higher in older men than young men in the 125-, 300-, and 600-mg dose groups. aMCR-T was lower in older men than young men (1390 ± 69 vs. 1821 ± 102 liter/d, P = 0.006). aMCR-T correlated negatively with age (P = 0.0007), SHBG (P = 0.046), and total testosterone during treatment (P = 0.02) and percent body fat at baseline (P = 0.01) and during treatment (P = 0.004). aMCR-T correlated positively with lean body mass at baseline (P = 0.03) and during treatment (P = 0.01). In multiple regression models, significant predictors of aMCR-T included lean body mass (P = 0.008), percent fat mass (P = 0.009), and SHBG (P = 0.001). Conclusions: Higher testosterone levels in older men receiving TE were associated with an age-related decrease in apparent testosterone metabolic clearance rates. Body composition and SHBG were significant predictors of aMCR-T.

Excess weight and sleep-disordered breathing

2005 ◽  
Vol 99 (4) ◽  
pp. 1592-1599 ◽  
Author(s):  
Terry Young ◽  
Paul E. Peppard ◽  
Shahrad Taheri
Keyword(s):  
United States ◽  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Population Studies ◽  
Strong Support ◽  
The United States ◽  
Excess Weight ◽  
Apnea Hypopnea Index ◽  
Disordered Breathing

Excess weight is a well-established predictor of sleep-disordered breathing (SDB). Clinical observations and population studies throughout the United States, Europe, Asia, and Australia have consistently shown a graded increase in the prevalence of SDB as body mass index, neck girth, or other measures of body habitus increases. Clinical studies of weight loss and longitudinal population studies provide strong support for a causal association. The role of excess body weight, a modifiable risk factor, with SDB raises many questions relevant to clinical practice and public health. The topic takes on added importance with the alarming rate of weight gain in children as well as adults in industrialized nations. Among adults ages 30–69 yr, averaging over the estimated United States 2003 age, sex, and BMI distributions, we estimate that ∼17% of adults have mild or worse SDB (apnea-hypopnea index ≥ 5) and that 41% of those adults have SDB “attributable” to having a body mass index of ≥25 kg/m2. Similarly, we estimate that ∼5.7% of adults have moderate or worse SDB (apnea-hypopnea index ≥ 15) and that 58% of those adults have SDB attributable to excess weight. Clearly, if the expanding epidemic of obesity seen in the United States continues, the prevalence of SDB will almost certainly increase, along with the proportion of SDB attributable to obesity.

Relationships of Craniofacial Morphology and Body Mass Index with Sleep-Disordered Breathing in Japanese Men

2004 ◽  
Vol 114 (10) ◽  
pp. 1838-1842 ◽  
Author(s):  
Masayuki Yao ◽  
Naoko Tachibana ◽  
Mutsumi Okura ◽  
Takeshi Tanigawa ◽  
Kazumasa Yamagishi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Craniofacial Morphology ◽  
Japanese Men ◽  
Disordered Breathing

scholarly journals 0849 Association Of Sleep Disturbance With Neck Circumference, Body Mass Index & Blood Pressure In Pregnant Japanese Women

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A323-A323
Author(s):  
A Morioka ◽  
y Asaka
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Sleep Disturbance ◽  
Pregnant Women ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Japanese Women ◽  
Neck Circumference ◽  
Physical Factors ◽  
Disordered Breathing

Abstract Introduction Snoring is one of the symptoms of sleep-disordered breathing. Sleep-disordered breathing is associated with blood pressure in pregnant women. However, studies reporting this association have been conducted overseas, and there is a lack of research in the Japanese context, where women have different lifestyles and physical attributes. The aim of this study is to clarify the association of sleep disturbance with physical factors in pregnant Japanese women. Methods A cross-sectional study was conducted with 80 pregnant Japanese women. The assessments for statistical analysis included the Japanese versions of the Pittsburgh Sleep Quality Index (J-PSQI) and Epworth Sleepiness Scale (JESS), as well as snoring frequency, blood pressure, and body mass index (BMI) before and during pregnancy. Results Participants’ average gestational age was 26.23±7.56 weeks, and the J-PSQI and JESS scores were 5.5±2.6 and 9.7±4.2, respectively. The average neck circumference was 33.4±2.6cm, and BMI before and during pregnancy was 21.0±2.9cm and 23.1±3.1cm, respectively. Among the participants, 42.5% displayed habitual snoring. These women had significantly higher BMI and weight before and during pregnancy than those who did not snore habitually. Participants with lower diastolic blood pressure and pre-pregnancy weight had significantly higher JESS scores. Participants with thick necks (neck circumference≥33.4cm) had significantly higher BMI and weight before and during pregnancy, as well as lower J-PSQI scores, than those with thin necks. Conclusion In pregnant Japanese women, neck circumference and BMI before and during pregnancy were lower than among pregnant women from other countries. However, Japanese women displayed a greater tendency toward snoring during pregnancy compared to women from other countries. Snoring was associated with obesity before and during pregnancy. However, the results suggest that thinness of physique prior to pregnancy is a risk factor for sleep disturbance during pregnancy. Support  

Relationship between body mass index, preeclampsia, and sleep disordered breathing

2004 ◽  
Vol 191 (6) ◽  
pp. S42
Author(s):  
Jamison Morgan ◽  
Sig-Linda Jacobson ◽  
Robert Sack ◽  
George Saade
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals d-Chiro-Inositol improves testosterone levels in older hypogonadal men with low-normal testosterone: a pilot study

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Maurizio Nordio ◽  
Philip Kumanov ◽  
Alfonsina Chiefari ◽  
Giulia Puliani
Keyword(s):  
Body Mass Index ◽  
Pilot Study ◽  
Waist Circumference ◽  
Sexual Function ◽  
Body Mass ◽  
Older Men ◽  
Testosterone Replacement Therapy ◽  
Limited Information ◽  
Physical Strength ◽  
Testosterone Levels

Abstract Background Several recent journal articles report that d-chiro-inositol (DCI), primarily known as insulin second messenger, influences steroidogenesis. In particular, new evidence is arising on DCI ability to regulate aromatase expression and testosterone biosynthesis. In this regard, DCI administration could represent a good therapeutic opportunity in case of reduced levels of testosterone. Older men generally have lower testosterone concentrations than younger men, and recent randomized controlled trials have examined whether testosterone treatment might improve health outcomes in this age group. There is limited information about the safety of testosterone replacement therapy in these men, hence DCI could represent an interesting alternative for future trials. Therefore, this study aims to evaluate the effect of DCI treatment on testosterone levels in older male patient. Results Ten older men with basal low testosterone levels were enrolled in this study. Patients took 600 mg of DCI, two-times per day, for 30 days. We evaluated hormonal and glycaemic parameters, weight, waist circumference, and Body-Mass Index at baseline (T0) and after 30 days (T1). Finally, all patients also filled in the standardized International Index of Erectile Function questionnaire and performed the Handgrip test at T0 and T1. Men receiving DCI showed increased androgen and reduced oestrogen concentrations, and improved glycaemic profiles. DCI was also associated with reduced weight, Body-Mass Index, waist circumference, and improved grip strength and self-reported sexual function. All these effects led to the improvement of sexual function and physical strength. Conclusions In this pilot study, DCI treatment improved the levels of testosterone and androstenedione at the expense of oestrogens in elder men with low basal levels of these hormones without adverse effects. Trial registration Clinicaltrials.gov: D-chiroinositol Administration in Hypogonadal Males, NCT04708249

scholarly journals Vascular Dysfunction among Malaysian Men with Increased BMI: An Indication of Synergistic Effect of Free Testosterone and Inflammation

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 575 ◽  
Author(s):  
Amilia Aminuddin ◽  
Norizam Salamt ◽  
Ahmad Faiz Ahmad Fuad ◽  
Kok-Yong Chin ◽  
Azizah Ugusman ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Testosterone Level ◽  
Vascular Function ◽  
Vascular Dysfunction ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Normal Body Mass Index ◽  
The Mean ◽  
Low Testosterone

Background and objectives: Obesity is associated with poor vascular function and may lead to future cardiovascular disease (CVD). Obesity is also related to increased inflammation and a low testosterone level. This study was conducted to determine the relationship between inflammation, testosterone level, and vascular function among subjects with an increased body mass index (BMI) and to determine whether both low testosterone and high inflammation have synergistic effects towards vascular dysfunction. Materials and Methods: A total of 303 men aged 40–80 years were recruited from Klang Valley, Malaysia. Their height, weight, blood pressure (BP), lipid, blood glucose level, total testosterone (TT), free testosterone (FT), and C-reactive protein (CRP) were measured. The carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) were also recorded as markers of vascular function. Results: The mean age of all the subjects was 54.46 ± 9.77 years. Subjects were divided into a low/normal body mass index (BMI) group (BMI < 25 kg/m2; NG, n = 154) and high BMI group (BMI ≥ 25 kg/m2; OG, n = 149). The mean BMI for NG was 22.20 ± 1.94 kg/m2 while for OG was 28.87 ± 3.24 kg/m2 (p < 0.01). The level of TT (OG = 21.13 ± 6.44 versus NG = 16.18 ± 6.16 nmol/L, p < 0.01) and FT (OG = 0.34 ± 0.12 versus NG = 0.39 ± 0.11 nmol/L, p < 0.01) were reduced while the level of CRP [OG = 1.05 (2.80) versus NG = 0.50 (1.50) mmol/L, p = 0.01] was increased in OG compared to NG. PWVCF (OG = 8.55 ± 1.34 versus NG = 8.52 ± 1.42 m/s, p = 0.02) and AI (OG = 16.91% ± 6.00% versus 15.88% ± 5.58%, p < 0.01) were significantly increased in OG after adjustment for other CVD risk factors. The subjects that had both a low FT and an increased CRP had higher AI when compared to those with a high CRP and high FT (p < 0.01). Conclusions: The increased BMI was associated with vascular dysfunction, mediated by a low testosterone level and increased inflammation. Furthermore, having both conditions concurrently lead to higher vascular dysfunction. Weight loss, testosterone supplementation, and the anti-inflammatory agent may be beneficial for men to prevent vascular dysfunction.

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