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Fri, Dec. 06

Studies find sleep apnea can lower testosterone levels

Dear Dr. Rosenberg:

I was recently diagnosed with low testosterone levels. I told my endocrinologist I am always tired and asked if testosterone therapy would help me. When I told him I snored, he insisted I get a sleep study done. He said it would be dangerous to start treating me without one. What is the relationship?

A: There actually are several issues to consider. First of all, sleep apnea has been shown to cause low testosterone levels. Secondly and more importantly, the institution of testosterone therapy in a person with sleep apnea can make the disease worse. So your physician is rightly concerned. He would want you diagnosed and treated if you have sleep apnea before starting testosterone therapy. Finally, the symptom of tiredness is more likely due to a sleep-related disorder than low testosterone.

Dear Dr. Rosenberg:

Recently, I had my oxygen levels checked while asleep. They were below normal. As a result, my health care professional ordered several types of tests run on me, which were all normal. I am obese and one of the consultants I saw said that my low oxygen levels might be due to my obesity. Does this make any sense?

A: Yes. Marked obesity can cause low oxygen levels. This is most likely to occur while lying on our backs and therefore during sleep. Basically, if you carry most of your weight in your abdomen, it can restrict your lung capacity. The increased weight inhibits the diaphragm from expanding. Add to that the fact that when we sleep our average breath normally decreases. This is the reason for decreasing oxygen levels in obese patients when sleeping. In fact, it has been referred to as the hypoxemia (low oxygen levels) of obesity.

Dear Dr. Rosenberg:

I got a CPAP machine a few months ago. I was in the process of moving and never received much in the way of instruction in its use. Now I'm having all kinds of problems using it. I feel that the air coming out of it is too dry. The pressure comes on full blast as soon as I turn it on. I have a hard time falling asleep. Any ideas as to what I can do?

A: You need to establish a relationship with a DME (durable medical equipment) company here in town. These companies specialize in equipment such as yours. They can show you how to increase the humidification your machine delivers. Additionally, there is a feature called "ramp" which allows the pressure to build up gradually over a predetermined time period. Bottom line: You need to be educated about the features of your machine.

Dear Dr. Rosenberg:

My 24-year-old son lives at home with us. He was diagnosed with schizophrenia several years ago. Recently he was placed on a medication called Zyprexa. He has done very well on this medication, but he wants to sleep all the time. Could this be due to the medication?

A: Yes, it is quite possible. The newer anti-psychotic

medications are excellent; however, some of them, like Zyprexa, are very sedating. If this continues, I recommend you inform his psychiatrist. There are alternatives amongst the newer drugs that are less sedating.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him

at or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Dr., Prescott Valley, AZ 86314.

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