Effects of CPAP withdrawal on sex hormone levels in patients with obstructive sleep apnoea: data from two randomised, controlled trials.

Sexual dysfunction (SD) is common in patients with obstructive sleep apnoea (OSA). Although continuous positive airway pressure (CPAP) therapy improves SD, it does not consistently modify testosterone or estradiol levels, suggesting involvement of other hormonal pathways. We analysed sex hormone levels in 70 patients with OSA before and after two weeks of CPAP withdrawal. No statistically significant treatment effects were observed for testosterone, androstenedione, gestagens, dehydroepiandrosterone sulfate, luteinizing hormone or follicle-stimulating hormone, whereas dehydroepiandrosterone (DHEA) increased after CPAP withdrawal. As DHEA secretion is adrenocorticotropic hormone-responsive, this increase may point to stress-related mechanisms, rather than direct sex steroid-mediated pathways, as potential contributors to OSA-related SD.