Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. It can affect your energy, mood, and long-term health. In some men, TRT may worsen or contribute to sleep apnea—especially if there are other risk factors present.
We start TRT with low doses and small, frequent injections to help maintain stable hormone levels and reduce side effects.
However, sleep apnea can still occur or worsen in some patients, especially if left undiagnosed or unmanaged.
Why TRT Can Contribute to Sleep Apnea
Increased Muscle Mass: TRT can increase neck and upper body muscle, which can narrow the airway during sleep.
Fluid Retention: Testosterone may increase fluid in tissues, further reducing airway space.
Respiratory Effects: TRT can alter breathing control, leading to more airway resistance during sleep.
Common Signs of Sleep Apnea
Loud snoring (often noticed by a partner)
Waking during the night, especially gasping or choking
Still feeling tired in the morning despite 7–8 hours of sleep
No symptom relief from TRT despite normal blood levels
Elevated haemoglobin or haematocrit on blood tests
Blood Markers That Might Suggest Sleep Apnea
Haemoglobin (HB): 180 g/L or higher
Haematocrit (HCT): 0.53 or higher
If these are elevated and you're not dehydrated at the time of the blood test, sleep apnea may be a contributing factor.
What to Do
If sleep apnea is suspected:
Speak to Your GP: Request a sleep study to confirm or rule out sleep apnea.
Start Treatment if Diagnosed: CPAP therapy and weight loss are the most effective treatments for obstructive sleep apnea.
Continue Monitoring: Your Hormn doctor may adjust your TRT protocol after addressing sleep issues.
Left untreated, sleep apnea can reduce the effectiveness of TRT and impact overall health. If you're noticing these signs or have elevated blood markers, take action early.