New problem

[Dwhit]

Sleep issues

On trt 5 yrs. Initially poorly managed on too much T (200 mg IM qweek) and too much AI (1 mg 2x/wk) with very little labwork. Past couple years have been essentially managing myself, 100 mg IM qweek, no AI, and 250iu HCG 3x/wk. Most recent labs total T=850, and free T=29 (upper limit normal=21), and E2 non-sensitive upper limit normal. Past couple months I have some new symptoms, waking up short of breath and heart racing. As I'm falling asleep feel like I sometimes lose respiratory drive, then suddenly gasp. Sleep study pending. 6'2" and 200 lbs, thin neck--not classic for obstructive apnea . My theory is I might have low shbg (based upon my elevated free T), and that this is making me sensitive to dht, which I read can induce/exacerbate central sleep apnea. I say this because I briefly switched to topical T (known to increase dht) and my symptoms got much worse. But it's a mystery. Full labs including shbg, tsh, and sensitive E2 also pending.

Curious if anyone else has experienced this.

 

[Vince]

I sure would be tested for sleep apnea or some type of anxiety attack, some men on TRT complain of sleep apnea.

 

[AbsoluteZ3R0]

It definitely sounds to me like bouts of central sleep apnea, which testosterone can worsen. I had a sleep study done once before trt and had a couple of incidences of central apnea, but not enough to be significant. I used to notice myself waking up and gasping for air once or twice a week. Ironically, since trt, the frequency of these apneas (to my knowledge) has actually decreased, now occurring to me maybe once every other week. It is good that you already have a sleep study lined up. If you've never had one, you're going to be intrigued by all of the details it will show you about your sleep.

 

[madman]

On trt 5 yrs. Initially poorly managed on too much T (200 mg IM qweek) and too much AI (1 mg 2x/wk) with very little labwork. Past couple years have been essentially managing myself, 100 mg IM qweek, no AI, and 250iu HCG 3x/wk. Most recent labs total T=850, and free T=29 (upper limit normal=21), and E2 non-sensitive upper limit normal. Past couple months I have some new symptoms, waking up short of breath and heart racing. As I'm falling asleep feel like I sometimes lose respiratory drive, then suddenly gasp. Sleep study pending. 6'2" and 200 lbs, thin neck--not classic for obstructive apnea . My theory is I might have low shbg (based upon my elevated free T), and that this is making me sensitive to dht, which I read can induce/exacerbate central sleep apnea. I say this because I briefly switched to topical T (known to increase dht) and my symptoms got much worse. But it's a mystery. Full labs including shbg, tsh, and sensitive E2 also pending.

Curious if anyone else has experienced this.

What are your hemoglobin/hematocrit lab values?

 

[Dwhit]

High. Hct is 51. That was on a higher dose of T. Had to give blood. Now on 100mg qweek. Hopefully will be lower. Rechecking H&H. If it is not lower I will be even more suspicious of apnea. Strange thing is I seem to sleep better if I take 10mg DHEA before bed.

 

[Dwhit]

I'm not really an anxious person, and I don't experience anxiety during the day, so I think it is primarily a breathing issue, though I have to admit when I wake up in the middle of the night, it is in somewhat of a mild panic. I have been having suffocation dreams as well. The sleep doc thinks it is classic apnea, probably mixed type, but it is all speculation until the studies are in.

 

[Dwhit]

It definitely sounds to me like bouts of central sleep apnea, which testosterone can worsen. I had a sleep study done once before trt and had a couple of incidences of central apnea, but not enough to be significant. I used to notice myself waking up and gasping for air once or twice a week. Ironically, since trt, the frequency of these apneas (to my knowledge) has actually decreased, now occurring to me maybe once every other week. It is good that you already have a sleep study lined up. If you've never had one, you're going to be intrigued by all of the details it will show you about your sleep.

Hmm... Maybe my problem is that I've been decreasing my T levels after years at a high level (I was always at the upper limit, sometimes above). I had zero sleep problems back then.

 

[madman]

High. Hct is 51. That was on a higher dose of T. Had to give blood. Now on 100mg qweek. Hopefully will be lower. Rechecking H&H. If it is not lower I will be even more suspicious of apnea. Strange thing is I seem to sleep better if I take 10mg DHEA before bed.

Shortness of breath/lethargy can be related to high hematocrit as once blood starts to become too thick oxygen deprivation can happen.

 

[meanbreen]

Do you have any breathing problems during the day? Like difficulty taking a deep breath?

 

[Dwhit]

Do you have any breathing problems during the day? Like difficulty taking a deep breath?

No breathing problems during the day, but I occasionally have this feeling of increased pressure in my head, and a weird sort of lightheadedness. Otherwise I feel healthy and workout regularly at the gym. I just got back from HIIT training on the Stairmaster tonight, so I don't think it's cardiovascular or pulmonary. I think it's more of a neurological thing or a sleep apnea thing or maybe the hct thing, which may have continued to increase despite lowering my T dose. Never had anything like this in the past. Anxiously awaiting my labs, which for some reason are taking Labcorp an entire week.

Thanks for the input.

 

[meanbreen]

No breathing problems during the day, but I occasionally have this feeling of increased pressure in my head, and a weird sort of lightheadedness. Otherwise I feel healthy and workout regularly at the gym. I just got back from HIIT training on the Stairmaster tonight, so I don't think it's cardiovascular or pulmonary. I think it's more of a neurological thing or a sleep apnea thing or maybe the hct thing, which may have continued to increase despite lowering my T dose. Never had anything like this in the past. Anxiously awaiting my labs, which for some reason are taking Labcorp an entire week.

Thanks for the input.

Gotcha, I was going to say perhaps acid reflux, but I get the S.O.B daytime as well. I used to wake up in a similar way.