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T prescriptions have increased worldwide during the last decade, including to those with undiagnosed or untreated <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>. The effect of T administration on sexual function, neurocognitive performance and quality of life in these men is poorly defined. The aim of this study was to examine the impact of T administration on sexual function, quality of life and neurocognitive performance in obese men with <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>. We also secondarily examined whether baseline T might modify the effects of T treatment by dichotomizing on baseline T levels pre\u2010specified at 8, 11 and 13\u00a0nmol\/L. This was a randomized placebo\u2010controlled study in which 67 obese men with <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> (mean age 49\u00a0\u00b1\u00a01.3\u00a0years) were randomized to receive intramuscular injections of either 1000\u00a0mg T undecanoate or placebo at baseline, week 6 and week 12. All participants were concurrently enrolled in a weight loss program. General and sleep\u2010related quality of life, neurocognitive performance and subjective sexual function were assessed before and 6, 12 and 18\u00a0weeks after therapy. T compared to placebo increased sexual desire (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.004) in all men, irrespective of baseline T levels. There were no differences in erectile function, frequency of sexual attempts, orgasmic ability, general or sleep\u2010related quality of life or neurocognitive function (all <jats:italic>p<\/jats:italic>\u00a0=\u00a0<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>). In those with baseline T levels below 8\u00a0nmol\/L, T increased vitality (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.004), and reduced reports of feeling down (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002) and nervousness (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03). Our findings show that 18\u00a0weeks of T therapy increased sexual desire in obese men with <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> independently of baseline T levels whereas improvements in quality of life were evident only in those with T levels below 8\u00a0nmol\/L. These small improvements would need to be balanced against potentially more serious adverse effects of T therapy on breathing.<\/jats:p>","DOI":"10.1111\/andr.12132","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T02:32:37Z","timestamp":1448591557000},"page":"55-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Increased sexual desire with exogenous testosterone administration in men with obstructive sleep apnea: a\u00a0randomized placebo\u2010controlled study"],"prefix":"10.1111","volume":"4","author":[{"given":"K. L.","family":"Melehan","sequence":"first","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal Prince Alfred Hospital Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Hoyos","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. J.","family":"Yee","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal Prince Alfred Hospital Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. K.","family":"Wong","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal Prince Alfred Hospital Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Buchanan","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Department of Respiratory Medicine Liverpool Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. R.","family":"Grunstein","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"},{"name":"Department of Respiratory and Sleep Medicine Royal Prince Alfred Hospital Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"NHMRC Centre for The Integrated Research and Understanding of Sleep Woolcock Institute of Medical Research Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney Sydney NSW Australia"},{"name":"Division of Endocrinology Department of Medicine David Geffen School of Medicine at UCLA Harbor\u2010UCLA Medical Center and Los Angeles Biomedical Research Institute Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105311433347"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)60963-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2009.01372.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2012.02783.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1939-4640.2003.tb02708.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2013.05.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12536"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03200977"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2007.51"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03744.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03345209"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1872"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-68-2-352"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12146"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2012.04413.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-0525"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.08.048"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53817-8.00003-7"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2005.09.007"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/9780203091715-57"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0143"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.710"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030236"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2007.03.002"},{"key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"3394","DOI":"10.1210\/jcem.87.7.8663","article-title":"Decreased pituitary\u2010gonadal secretion in men with obstructive sleep apnea","volume":"87","author":"Luboshitzky R","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_8_27_1","first-page":"463","article-title":"Pituitary\u2010gonadal function in men with obstructive sleep apnea. 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