As
sleep apnea is more prevalent in men and
testosterone has known effects on
sleep apnea and chemosensitivity, reduction of
androgen activity may influence
sleep-disordered breathing and respiratory control. We studied the effect of 1 wk of treatment with
flutamide, a nonsteroidal
antiandrogen, on sleep, respiration, and ventilatory control in eight men with
sleep apnea. Results on
flutamide were compared with two baseline studies performed before and after the
drug treatment period. Although effective
androgen blockade was achieved as evidenced by increased
hormone levels,
flutamide had no effect on sleep architecture or chemoresponsiveness to
hypoxia and
hypercapnia. There was a trend towards a reduction in respiratory disturbance index in both NREM and REM sleep (41 +/- 4 baseline versus 34 +/- 3
flutamide, p = 0.09 NREM; 53 +/- 4 baseline versus 48 +/- 3
flutamide, p = 0.16 REM), but this was not significant. Our results indicate that
androgen blockade had no clinically significant effect on sleep,
sleep-disordered breathing, or chemosensitivity in patients with moderate to severe
sleep apnea. More specific blockers such as gonadotrophin-releasing
hormone analogs may have more clinical effect or, alternatively,
androgen blockade may be more beneficial in patients with milder
sleep apnea.