The effect of hormone therapy on sleep-disordered breathing in transgender patients has not been described. We present three cases of patients undergoing gender reassignment and treated with hormone replacement. The first case was a transgender woman (assigned male at birth) with a prolonged history of severe obstructive sleep apnea (OSA) that resolved following initiation of female sex hormones. The second and third cases both address transgender males (assigned female at birth) in whom OSA developed following initiation of male sex hormones (with pretreatment polysomnography documenting absence of OSA). The growing interest in transgender health warrants further evaluation of the effects of related therapies on sleep and sleep-disordered breathing.
Twelve infants and toddlers who exhibited spontaneous awakening and crying episodes during the night were subjected to scheduled awakenings by their parents. Scheduled awakenings were determined from individual baseline data, and these consisted of awakening, feeding, and consoling the child about 15 to 30 minutes before typical spontaneous awakening times. Once spontaneous awakenings were precluded, scheduled awakenings by the parents were faded out and posttreatment data were collected. The technique appeared effective for most children when the parents complied with the procedure.
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