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Saturday, May 15, 2010

Low Testosterone linked to Poor Sleep; Beneficial Effects of Testosterone for Frailty


Poor Sleep in Aging Men Linked to Lower Testosterone

When men reach age 30, testosterone levels begin to drop by 1 to 2 percent annually, researchers say. Coincidentally, many men begin to complainat around age 40 about the quality of their sleep. Are the two linked?

Yes, one new study concludes.

The research revealed a link between testosterone levels in men over 50 and the amount of deep sleep they report.
"Deep sleep is when the recuperation of body and mind is optimal,"said study leader Zoran Sekerovic, a graduate student from theUniversity of Montreal Department of Psychology.

In young men, deep sleep represents 10 to 20 percent of total sleep, Sekerovic explained in a statement. By age 50, it decreases to as little as 5 percent. For menover 60, it can disappear altogether, the study found.

The study didn't find any correlation with other parts of the sleep cycle: falling asleep, light sleep, or paradoxical sleep, when most dreams occur. Men in their 20s don't have such a correlation, because their neuronal circuits are intact, the thinking goes.

"With age, there is neuronal loss and the synchronization ofcerebral activity isn't as good, which is why there is a loss of deep sleep," Sekerovic explained. "Low levels of testosterone intensify the lack of synchronization and can explain 20 percent of men's inability to experience deep sleep."

Sekerovic suggests dwindling testosterone levels are what impact sleep,not vice-versa, as other studies have suggested. He adds previous investigations measured daily fluctuations in testosterone levels,which are higher in the morning.

If his findings are true, there could be treatment options.

"The loss of deep sleep is a serious problem that could be treated with testosterone. That would be tremendous progress," he said. "But hormone therapy can have secondary effects.Therefore, it will be essential to better understand the mechanisms leading to the loss of deep sleep."

Other scientists have suggested, however, that older people need less sleep.

This study, announced Friday, was supervised by Julie Carrier, aprofessor of psychology at the University of Montreal. The findingswere presented at the annual conference of the Association francophone pour le savoir (ACFAS).

By LiveScience Staff
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Beneficial Effects of Testosterone for Frailty in Older Men Are Short-Lived, Study Finds

ScienceDaily (Nov. 4, 2010) — The beneficial effects of six months of testosterone treatment on muscle mass, strength and quality of life in frail elderly men are not maintained at six months post-treatment, according to a study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Frailty is an age-related state of physical limitation caused by the loss of muscle mass and function and can lead to adverse clinical outcomes such as dependency, institutionalization and death. Testosterone levels naturally decline with aging and testosterone replacement is a common therapy. Short-term testosterone treatment in frail elderly men has been shown to improve muscle mass and strength, but until now it has been unclear whether these effects could be maintained post-treatment.

"Since the use of testosterone in elderly men raises concerns regarding adverse effects on the prostate and cardiovascular system, it's important to determine if short-term treatment can lead to prolonged benefits beyond the duration of testosterone exposure," said Frederick Wu, MD, of the University of Manchester in the United Kingdom and lead author of the study. "Our findings suggest it may not be possible to break or interrupt the cycle of decline in physical function in frailty by short-term anabolic pharmacological intervention using testosterone supplementation for six months."

In this study, researchers evaluated 274 intermediate-frail and frail elderly men aged 65-90 years with low testosterone levels. Study participants received either a testosterone gel or placebo for six months. 
Assessments were carried out at baseline, the end of treatment and six months after treatment cessation. Researchers found that the increased lean body mass, muscle strength and quality of life after six months of testosterone treatment were not maintained six months after treatment.

"At present, the optimal duration of anabolic hormonal intervention to produce sustained benefits in treating frailty in older men is unknown," said Wu. "To best interrupt the downward spiral into frailty a greater emphasis should be placed on a multi-disciplinary interventional approach including resistance exercise, diet and other lifestyle options, in conjunction with pharmacological agents."

Other researchers working on the study include: Matthew O'Connell, Steven Roberts, Upendram Srinivas-Shankar, Abdelouahid Tajar, Judith Adams and Jackie Oldham of the University of Manchester in the United Kingdom; and Martin Connolly of the University of Auckland in New Zealand.

The article, "Do the Effects of Testosterone on Muscle Strength, Physical Function, Body Composition and Quality of Life Persist Six Months Post-treatment in Intermediate-Frail and Frail Elderly Men," will appear in the February 2011 issue of JCEM.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

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