March 28, 2023

Is Testosterone Therapy for Transgender Males a Risk Factor for Sleep Apnea?

Photo of medicine book, Sleepless and Sleepy. Jordan Stern, MD authors a case on transgender hormone therapy and sleep apnea.

Dr. Jordan Stern, Founder and CEO of BlueSleep, publishes his clinical research.

Testosterone therapy in the transgender male is likely a risk factor for the development of obstructive sleep apnea (OSA). Snoring that develops after the onset of masculinizing hormonal therapy may be the only sign that there is an underlying obstructive sleep apnea syndrome. Gender and sex hormones impact OSA.

Sleep apnea is more common in cisgender males, in postmenopausal females, and in women with polycystic ovary syndrome (PCOS). Testosterone is thought to be in part responsible for the difference in prevalence of OSA in males and females, as well as the increased risk of OSA in patients treated with testosterone replacement therapy.

We present a case study of the sudden onset of snoring and sleep apnea that developed in a transgender male, shortly after beginning masculinizing therapy.

Find more about the book Sleepless and Sleepy at