Obstructive sleep apnea (OSA) is a condition characterized by pauses in breathing during sleep, occurring when the soft tissues of the throat collapse and block the airway. Sleep apnea can disrupt normal gas exchange and significantly reduce the quality of sleep. It may also increase hematocrit levels, thicken the blood, and raise the risk of other health issues, including hypertension and cardiovascular disease. Sleep apnea often goes undiagnosed for many years, as individuals may be unaware of the disturbances in their sleep. Symptoms of OSA include daytime sleepiness, snoring, nighttime awakenings, and morning headaches. Obstructive sleep apnea is most commonly found in overweight individuals and is associated with a combination of hormonal, metabolic, and physical factors.

Anabolic/androgenic steroids (AAS) may be associated with obstructive sleep apnea in a small number of individuals. However, the exact relationship between AAS and OSA remains unclear. This adverse effect seems to occur primarily in some patients undergoing testosterone therapy for hypogonadism. More detailed studies indicate that high testosterone levels can disrupt sleep and breathing, and increase sleep-related hypoxemia, potentially leading to obstructive sleep apnea. While OSA has not been definitively recorded in steroid abusers, androgens have been shown to alter the structure and function of the oropharynx, making individuals more susceptible to this condition. More research is needed to determine if steroid abuse can lead to OSA. Individuals with a history of obstructive sleep apnea should not use anabolic/androgenic steroids. Physicians recommend closely monitoring OSA symptoms in patients during AAS therapy.