TOPLINE

Recreational androgen abuse in men was associated with a significant but modest increase in indices of sleep-disordered breathing, with the most pronounced changes observed at approximately 3 months after cycle cessation rather than during active abuse. Sleep architecture was largely preserved aside from a modest reduction in deep sleep, and subjective sleep quality did not worsen.

METHODOLOGY

• Researchers in Netherlands conducted a prospective cohort study to evaluate effects of supraphysiologic androgen abuse on sleep-disordered breathing, sleep architecture, and subjective sleep quality in men.
• They included 23 men aged 18 years or older who planned to initiate a self-administered androgen cycle lasting at least 6 weeks, with a cumulative weekly androgen dose of at least 250 mg.
• Participants were evaluated at three timepoints: before the initiation of the cycle, at approximately 8 weeks during the cycle, and at approximately 3 months after cycle cessation.
• Sleep was monitored using an ambulatory sleep diagnostic device, and subjective sleep experiences were assessed at each visit using validated questionnaires.
• The primary outcome was a longitudinal change in the peripheral arterial tone-derived apnoea-hypopnoea index (pAHI) across three timepoints; secondary outcomes included changes in the peripheral arterial tone-derived respiratory distress index (pRDI) and oxygen desaturation index (pODI), sleep architecture, and other parameters.

TAKEAWAY

• During active androgen abuse, the pRDI increased significantly by 3.0 events per hour (P = .035), but no significant increases were observed in the pAHI or pODI.
• At approximately 3 months after cycle cessation, the pAHI increased significantly by 2.7 events per hour (P = .029), the pRDI increased by 4.4 events per hour (P = .003), and the pODI increased by 3.0 events per hour (P = .021) compared with baseline.
• Sleep architecture was largely preserved; however, the proportion of deep sleep decreased modestly during the androgen cycle (P = .022); the average heart rate also increased by 4 beats/min during the cycle (P = .017).
• No significant changes were observed in subjective sleep experience scores.

IN PRACTICE

"[The study] findings suggest that androgen abuse may subtly influence sleep-disordered breathing parameters, but are unlikely to translate into overt or clinically meaningful sleep apnea in most androgen abusers," the authors wrote.

SOURCE

This study was led by Tijs Johannes Verdegaal, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands. It was published online on July 20, 2026, in the Journal of Endocrinological Investigation.

LIMITATIONS

The small sample size restricted statistical power to detect small changes. Data on androgens were collected from the unregulated market, which introduced uncertainty about the exact composition and dosage. The ambulatory sleep device may be less sensitive to subtle changes in sleep stage transitions and microarousals.

DISCLOSURES

This study did not receive any specific funding. Three authors reported being co-founders and shareholders of Android Health Clinic.

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