High Testosterone Levels Predict More Shallow Sleep in Overweight and Obese Men, Independently of Obstructive Sleep Apnea

Program: Abstracts - Orals, Poster Preview Presentations, and Posters
Session: MON 0001-0021-Effects of Regulating Sex Hormone Levels in Men
Monday, June 23, 2014: 1:00 PM-3:00 PM
Hall F (McCormick Place West Building)

Poster Board MON-0005
Lisa L Morselli, MD, PhD, Karla A Temple, PhD, RD, Florian Chapotot, PhD, Rachel Leproult, PhD, David A Ehrmann, MD, Eve Van Cauter, PhD and Babak Mokhlesi, MD
University of Chicago, Chicago, IL
Slow-wave activity (SWA) is a marker of sleep depth and a stable within-subject characteristic that has been implicated in the control of glucose homeostasis and blood pressure. Studies exploring the predictors of the large inter-individual differences in SWA have been performed mainly in lean individuals. As 75% of men are now overweight or obese in the United States, the aim of this study was to identify predictors of SWA in overweight and obese men.

Forty-four overweight and obese men aged 20-50 years (mean±SE: 35±1 years) were recruited from the community and underwent an overnight in-laboratory polysomnogram. SWA was computed as the average absolute spectral EEG power in the frequency band 0.75-4.5 Hz during non rapid eye movement (NREM) sleep, in the first 6 hours of sleep. Obstructive sleep apnea (OSA) was defined by an apnea-hypopnea index (AHI) ≥5. Total plasma testosterone was measured on the morning following the polysomnogram. Multivariate regression models were run to explore the predictors of SWA.

Obstructive sleep apnea was present in 66% of the men, and the median AHI was 16 (interquartile range 9-26) events/hour. In a model including only demographic characteristics, NREM SWA was negatively predicted by African-American race (β=-0.25, p<0.0001) and age (β=-0.03, p=0.004), but not BMI. When total testosterone was added, it improved the percentage of variance accounted for by the model and was independently and strongly associated with SWA (β=-0.75, p=0.005). In order to maintain statistical power, BMI was dropped from the last model, which examined the simultaneous contribution of AHI and total testosterone levels.  In this model, the negative association of total testosterone (β=-0.56, p=0.02) and race (β=-0.26, p<0.0001) with NREM SWA persisted, whereas AHI (β=-0.11, p=0.08) and age (β=-0.02, p=0.08) only weakly predicted SWA.

In conclusion, in overweight and obese men under 50 years old, NREM SWA is negatively predicted by total circulating testosterone levels, in addition to race, age and AHI. These results have potential clinical implications as exogenous testosterone is being increasingly prescribed to middle-aged men.

Nothing to Disclose: LLM, KAT, FC, RL, DAE, EV, BM

*Please take note of The Endocrine Society's News Embargo Policy at https://www.endocrine.org/news-room/endo-annual-meeting

Sources of Research Support: NIH grants P50 HD057796, P60 DK020595, PO1 AG-11412; ResMed Foundation; Brussels Institute for Research and Innovation "Brains Back to Brussels" grant (RL)