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Impact of an interdisciplinary weight loss and lifestyle intervention on testosterone and scores for sexual activity on the FOSQ in men with obesity and obstructive sleep apnea: secondary analyses of data from the INTERAPNEA randomized trial

Authors

Herrera-Quintana L. , Vázquez-Lorente H. , Ruiz J.R. , Amaro-Gahete F.J. , CARNEIRO BARRERA, ALMUDENA

External publication

No

Means

Maturitas

Scope

Article

Nature

Científica

JCR Quartile

1

SJR Quartile

1

Publication date

01/01/2026

ISI

001826627900001

Scopus Id

2-s2.0-105044993463

Abstract

Background: Low circulating testosterone and reduced sexual activity are common in men with obstructive sleep apnea. Objectives: To evaluate the effect of an interdisciplinary weight loss and lifestyle intervention on circulating testosterone concentrations and, secondarily, on scores on the intimate relationships and sexual activity subdomain of the Functional Outcomes of Sleep Questionnaire (FOSQ). Methods: Eighty-nine men were assigned to either usual care (n = 49) or an 8-week interdisciplinary intervention (n = 40). Assessments were conducted at baseline, at the end of the intervention (8 weeks), and 6 months post-intervention. Plasma testosterone was measured by chemiluminescence immunoassay. Sexual activity was assessed using the intimate relationships and sexual activity subdomain of the FOSQ. Sleep parameters and body weight and composition were also evaluated. Results: Compared with the control group, higher plasma testosterone concentrations were observed in the intervention group at 8 weeks (between-group difference 77.6 [95% CI 4.2 to 150.1] ng/dL; p = 0.042) and at 6 months (between-group difference 90.4 [95% CI 11.7 to 169.0] ng/dL; p = 0.027). Scores on the FOSQ intimate relationships and sexual activity subdomain increased in the intervention group both at 8 weeks (between-group difference 1.0 [95% CI 0.5 to 1.5]; p = 0.004) and 6 months (between-group difference 0.8 [95% CI 0.2 to 1.3]; p = 0.003) compared with controls. Changes in testosterone and FOSQ-derived sexual activity scores correlated with favorable changes in sleep quality, body weight and body composition, particularly from baseline to 6 months and from 8 weeks to 6 months (all p < 0.05). Conclusions: In men with overweight or obesity and moderate to severe obstructive sleep apnea, an interdisciplinary weight loss and lifestyle intervention increased circulating testosterone concentrations compared with usual care. Improvements were also observed in scores on the intimate relationships and sexual activity subdomain of the FOSQ; however, these findings should be considered exploratory because this subdomain does not assess erectile function, libido, hypogonadal symptoms, or validated multidimensional domains of male sexual function. Further studies using comprehensive endocrine profiling and validated male sexual function instruments are warranted. Clinical trial registration: ClinicalTrials.gov NCT03851653. © 2026

Keywords

Adult; Humans; Life Style; Male; Middle Aged; Obesity; Sexual Behavior; Sleep; Sleep Apnea, Obstructive; Surveys and Questionnaires; Testosterone; Weight Loss; Weight Reduction Programs; gonadorelin; testosterone; testosterone; adult; aerobic exercise; aged; apnea hypopnea index; Article; body composition; body weight; body weight loss; chemiluminescence immunoassay; clinical article; comorbidity; continuous positive airway pressure; dual energy X ray absorptiometry; exercise; fat mass; follow up; functional outcomes of sleep questionnaire; health behavior; heart rate; human; intra-abdominal fat; lifestyle modification; male; obesity; obstructive sleep apnea; oxygen desaturation index; randomized controlled trial (topic); sexual behavior; sexual function; sleep efficiency; sleep hygiene; sleep parameters; sleep quality; sleep time; testosterone blood level; time in bed; transtheoretical model; blood; complication; controlled study; lifestyle; middle aged; obesity; questionnaire; random

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