Neuroendocrine changes in sleep apnea.
OBJECTIVE
To review recent investigations examining the effects of neuroendocrine changes in obstructive sleep apnea.


RESULTS
Gonadal hormones have long been implicated in the pathogenesis of obstructive sleep apnea. Recently, exogenous testosterone has been shown to exacerbate obstructive sleep apnea, whereas hormone replacement therapy in menopausal women may be protective in obstructive sleep apnea. Effective treatment of obstructive sleep apnea with nasal continuous positive airway pressure has been associated with improved insulin sensitivity and testicular function in individuals with obstructive sleep apnea.


CONCLUSIONS
It is important to consider the potential development of sleep apnea in any patient who has an endocrine disorder or is receiving certain hormonal therapies. Effective assessment and management of obstructive sleep apnea with nasal continuous positive airway pressure may lead to a reduction in insulin resistance and hypertension as well as other markers of vascular risk in patients with metabolic syndrome.
Yee
Brendon
B
Woolcock Institute of Medical Research, Royal Prince Alfred Hospital, Sydney, NSW, Australia. brendony@mail.med.usyd.edu.au
Liu
Peter
P
Phillips
Craig
C
Grunstein
Ron
R
D045422:Continuous Positive Airway Pressure; D005260:Female; D042341:Gonadal Hormones / Q000502:physiology; D020249:Hormone Replacement Therapy; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D009490:Neurosecretory Systems / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D013739:Testosterone / Q000009:adverse effects
D042341:Gonadal Hormones; D013739:Testosterone