"To the Editor: I appreciated the recent comprehensive review of androgen deficiency and replacement therapy in men by Handelsman and Zajac.1 I ask their opinion of the importance of obstructive sleep apnoea as a cause of secondary hypogonadism, and also of the safety of androgen replacement in men with hypogonadism who have obstructive sleep apnoea but are intolerant of continuous positive airway pressure (CPAP) treatment.
In my practice, obstructive sleep apnoea is one of the most common associations, if not indeed causes, of hypogonadotropic hypogonadism. Several studies have shown that obstructive sleep apnoea is associated with secondary hypogonadism, which is partly or completely reversed by both CPAP treatment and uvulopalatopharyngoplasty.2-4 Secondary hypogonadism is also a feature of several conditions in which there is a high prevalence of obstructive sleep apnoea, including chronic spinal cord injury and cardiac failure. Of concern, studies have shown that androgen replacement may precipitate or worsen obstructive sleep apnoea."
http://www.mja.com.au/public/issues/181 ... _fm-5.html
"Our findings suggest that OSA in men is associated with dysfunction of the pituitary-gonadal axis. The relation between LH-testosterone profiles and the severity of OSA suggests that sleep fragmentation and, to a lesser extent, hypoxia in addition to the degree of obesity and aging may be responsible for the central suppression of testosterone in these patients.
The reduced amounts of LH and testosterone and their significant association with RDI suggest that the pituitary-gonadal dysfunction is a consequence of OSA, rather than an independent primary disorder of the hypothalamic-pituitary-gonadal axis."
http://jcem.endojournals.org/cgi/content/full/87/7/3394
YOU GOTTA READ THIS CHART! It shows the direct relationship between obesity, sleep apnea and secondary hypogonadism. It rocks!
http://www.andrologyjournal.org/cgi/con ... 5/619/FIG1
"CONCLUSIONS: OSA in men is associated with dysfunction of the pituitarygonadal
axis. The central suppression of nocturnal testosterone in these
patients is partially corrected during chronic CPAP treatment"
http://www.nel.edu/pdf_/24_6/NEL240603A ... itzky_.pdf
Bottom line? If your LH is low and T is low, you have central AKA secondary hypogonadism. Any doctor will tell ya that. Doctors are discovering CPAP can reverse pituitary-gonadal axis suppression and by doing that, raise testosterone.