TOPLINE:

Severe or decompensated obstructive sleep apnoea syndrome (OSAS) was significantly associated with functional hypogonadism in men with severe obesity. Continuous positive airway pressure (CPAP) therapy, monitored using overnight pulse oximetry, improved testosterone levels in newly diagnosed patients with OSAS.

METHODOLOGY:

• Researchers in Italy conducted a cross‑sectional study to determine how the severity of OSAS affects testosterone levels in men with severe obesity and to evaluate effects of 3 months of successful CPAP therapy on gonadal function in patients newly diagnosed with OSAS.
• They included 204 men (mean age, 56.71 years) with grade 2 complicated or grade 3 obesity, of whom 112 had severe or decompensated OSAS and 127 had low total testosterone levels (≤ 10.4 nmol/L).
• In a subset of 14 newly diagnosed patients with severe OSAS who adhered to CPAP therapy, total testosterone levels and BMI were measured after 3 months of successful CPAP therapy to assess the treatment's independent effect on gonadal function.
• Inflammatory markers, glycaemic measures, and lipid and hormonal profiles were evaluated; patients without a prior diagnosis of OSAS underwent polysomnography, whereas those previously diagnosed had overnight pulse oximetry during CPAP therapy.

TAKEAWAY:

• Severe or decompensated OSAS (P = .014), along with BMI (P = .039), type 2 diabetes (P = .006), and C-reactive protein levels (P = .003), was significantly associated with lower total testosterone levels.
• After 3 months of CPAP therapy, testosterone levels significantly improved (P = .009), with an average improvement of 3.75 nmol/L.
• A significant negative correlation was observed between total testosterone levels and the oxygen desaturation index (P = .04), independent of BMI.

IN PRACTICE:

"In patients with obesity-related functional hypogonadism, a successful treatment of OSAS could help, along with weight loss and management of metabolic alterations, to restore proper gonadal function," the authors wrote.

SOURCE:

This study was led by Alessandro Amodeo, Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy. It was published online on November 24, 2025, in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

A complete assessment of sex hormone profiles was performed in a subset of patients. Data on hypogonadism-related manifestations were not collected systematically. The longitudinal study was limited to a small number of patients.

DISCLOSURES:

This study was funded by the Italian Ministry of Health-Ricerea Corrente. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.