Objectives. To assess the combined use of CPAP treatment (constant positive airway pressure) and testosterone replacement therapy (transdermal formulation – Androgel) on measures of polysomnographic monitoring with simultaneous investigation of erectile dysfunction and total testosterone levels. Materials and methods. The study included 26 men with diagnoses of combined moderately severe obstructive sleep apnea and age-related androgen deficit (mean age 46.1 ± 8.4 years, body mass index 35.2 ± 4.6 kg/m2). Subjects were divided into two groups depending on treatment type. Patients of group 1 (n = 14) received CPAP monotherapy, while patients of group 2 (n = 12) received combined therapy using CPAP and Androgel (50 mg once daily). CPAP was selected and delivered using automated Prisma 20 A (Weinemann, Germany) and iSleep (Breas, Sweden) devices. Treatment duration was two months. Results. After two-month treatment courses using these schemes, patients receiving combined treatment (CPAP + Androgel) showed a two-fold increase in the testosterone level (p < 0.05) and a statistically significant improvement in the altered measures of nocturnal penile episodes as compared with the analogous parameters in patients of the background of CPAP monotherapy. There were significant improvements in objective status, though no changes in polysomnographic characteristics were seen in either group. Conclusions. The study results demonstrated that combined treatment (CPAP + Androgel) was more effective in patients with obstructive sleep apnea syndrome and age-related androgen deficiency.
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