Case Report
Obstructive Sleep Apnea Due to Endogenous Testosterone Production in a Woman

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Obstructive sleep apnea (OSA) is a common condition characterized by snoring, recurrent episodes of cessation of breathing (obstructive apneas), disrupted sleep, and excessive daytime somnolence. Associated serious complications are hypertension, increased risk of heart disease, stroke, and increased susceptibility to industrial and motor vehicle accidents. OSA is considerably more common in men than in women. In postmenopausal women, the incidence of OSA increases. These factors suggest that reproductive hormones have a role in the cause of OSA. Treatment with testosterone has been reported to cause OSA in men, and exogenous androgen administration has been reported to cause OSA in one woman. In a review of the English literature, we found no previous reports of OSA that was induced by endogenous testosterone in women. Herein we describe a nonobese 70-year-old woman with clinically significant OSA and a benign testosterone-producing ovarian tumor. After successful removal of the tumor, her OSA resolved, and her testosterone level normalized. This unique case supports the theory of male hormonal (testosterone) influence in the OSA syndrome.

Section snippets

DISCUSSION

Obstructive sleep apnea (OSA) is a common medical condition characterized by repetitive episodes of upper airway obstruction that manifest clinically with snoring, apneas, restless sleep, daytime somnolence, and hypertension.2, 3 It is more common in men than in women4 and is more common in postmenopausal women than in premenopausat women.5 These findings have led to the hypothesis that reproductive hormones have a role in the cause of OSA.

In one study, a treatment trial of medroxyprogesterone

CONCLUSION

Our patient's symptoms resolved after her tumor was removed. This unique case further supports the theory of male hormonal influence in the OSA syndrome.

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