Sleep is connected to wellness in plenty of obvious ways that you already know about: it affects energy levels, concentration, mood, and other observable factors that influence how we feel each day.
But it’s not always a straight line between cause and effect, which can make it frustrating to figure out exactly where symptoms of low energy, fatigue, or brain fog might be coming from.
Sleep quality is tied to your body’s production and absorption of numerous nutrients, vitamins, and hormones. Because of that, poor sleep can cause various deficiencies, which can in turn create a multitude of symptoms and side effects.
Testosterone is one of a few different hormones linked to sleep. This particular hormone plays an important role in sexual function, bone/muscle strength, puberty and sexual development, mood regulation, energy levels, and more. All people need testosterone to be healthy, and people of any gender can experience negative side effects from low T.
If you’re wondering whether your symptoms are coming from testosterone deficiency or something else, this is a good place to start.
Worried about low testosterone?
Take our quiz to build a bespoke testing plan that will help you understand your testosterone levels (and how to improve them!)
Does sleep loss lower testosterone?
Sleep loss can result in lower testosterone levels, even for people who are young and healthy. In fact, most daily testosterone release happens while people are sleeping, and sleep disorders like sleep apnea and insomnia are directly associated with lower T levels.
What happens to testosterone if you don’t sleep enough
Research indicates that sleep restrictions to five hours per night can decrease testosterone levels by as much as 10 to 15 percent. This is a pretty extreme amount; for comparison, normal aging typically decreases testosterone by one to two percent each year.
While only getting five hours of sleep per night may seem like a severe scenario, this is actually a situation experienced by a significant portion of the U.S. working population. And, in general, chronic sleep reduction is symptomatic of modern Western lifestyles; many adults fail to achieve the recommended seven to nine hours of sleep each night.
It might feel challenging to fit in that much sleep alongside your work schedule or family responsibilities, or you may feel resistant to spending that much time asleep if the nighttime is the only time when you can focus on projects and hobbies outside of your other obligations. But be aware: if your lifestyle involves a self-inflicted short sleep schedule due to your job or family responsibilities, you might be experiencing decreased T for preventable reasons. However, even if you aren’t intending to restrict your sleep, disorders like sleep apnea and insomnia can result in low testosterone as well.
Do testosterone levels fluctuate during the day?
Daily testosterone levels fluctuate in relationship with a person’s circadian sleep/wake rhythm. Levels of this hormone typically peak in the mornings, falling throughout the day and reaching a low point around bedtime. In general, testosterone levels increase while you sleep and decrease while you’re awake, which means that less sleep, lower quality sleep, or longer time spent awake can lead to lower testosterone levels.
The sleep-testosterone connection is a complicated one, because poor sleep can lead to low testosterone, and low testosterone can lead to poor sleep --- creating a self-perpetuating cycle.
Symptoms of low testosterone
There are many possible symptoms of low testosterone. These are some common ones:
- Low sex drive or impaired sexual function
- Depression
- Mood swings or irritability
- Fatigue
- Weakness or muscle loss
- Brain fog or difficulty concentrating
- Increased body fat
Most of these experiences are also connected with poor sleep quality in general, so if you aren’t getting enough sleep and you’re noticing any of these symptoms, you might want to get your testosterone levels checked.
That’s where Base comes in: the sleep testing plan can help you determine the root cause of your symptoms, whether that cause is low testosterone or something else entirely, like imbalanced melatonin, cortisol, or vitamin D. This testing can help you cut out the frustrating guesswork of figuring out the source of your symptoms, and once you have lab work detailing your various hormone and nutrient levels, Base’s personalized lifestyle and sleep recommendations can help you get back on track.
Who can have low testosterone?
Older people are more likely to have naturally lower testosterone levels, as levels often peak around age 18 to 20 and then decline throughout the rest of adulthood. Though testosterone production is supposed to decrease over time, older people can experience lower-than-healthy T levels and can experience the negative symptoms associated with this deficiency.
While too-low testosterone is most common in older people who were assigned male at birth, anyone of any age or gender can experience low T. There’s also plenty of individual variation when it comes to hormones, and normal testosterone levels have a wide range: anywhere from around 300 to 1,000 nanograms per deciliter (ng/dL) is considered healthy for people with testosterone-based systems, while between 15 to 70 ng/dL is considered healthy for people with estrogen-based systems.
What stage of sleep is testosterone produced in?
Testosterone is produced during rapid eye movement (REM) sleep, which derives its name from the fact that your eyes move around rapidly during this stage of sleep. REM is the fourth of four sleep stages that occur in a cycle each night.
The first three stages of sleep are non-REM:
- Stage one: During this five-to-10-minute stage of light sleep, your muscle activity, brain waves, and eye movement begin to slow down as you move from wakefulness into slumber.
- Stage two: This is another light-sleeping stage in which muscles relax even further, eye movement stops, body temperature decreases, and heart rate slows. Brain waves slow down with occasional bursts of activity, and the body prepares itself to enter deep sleep.
- Stage three: Also called “deep sleep,” this is the stage at which you experience no muscle activity or eye movement and your brain produces very slow delta waves. It’s difficult to wake up at this stage, and this is when your body experiences the restful, restorative sleep needed to feel refreshed the next day.
Your body completes many important functions during non-REM sleep such as bone and muscle growth, tissue repair, immune system strengthening, and processing daily events and stressors.
The fourth stage of the sleep cycle is REM, during which brain waves and bodily functions (like breathing, blood pressure, and heart rate) more closely resemble the patterns of wakefulness. Most dreaming happens during this stage, and it’s also critical for memory and learning.
As people age, they tend to spend less time in REM, which is directly tied to lowered testosterone levels later in life. Other factors that can affect REM sleep include antidepressant use, tobacco use, hot or cold sleeping temperatures, insomnia, sleep disorders like sleep apnea, and chronic sleep deprivation. Disruptions of the REM cycle for people of any age are associated with disruptions to testosterone production.
Can improving your sleep help boost testosterone?
Since testosterone production is tied to sleep quality and quantity, sleep disorders or disturbances can result in lowered testosterone levels. But even one to two nights of improved sleep per week can help boost testosterone levels.
The best-case scenario, of course, would be getting your seven to nine hours of sound slumber every night --- but this isn’t always possible. If you’re in a situation that involves sleep restriction of some kind, you should take any chance you can get to catch up on ZZZs. What happens when you cut down on sleeping hours is that you accrue a “sleep debt,” which is exactly what it sounds like: the difference between how much sleep your body needs and how much you actually get.
You should keep in mind, though, that getting recovery sleep, which is something many people do on the weekends when they don’t have to wake up early for work or school, is only a short-term solution. While you might experience positive effects (like boosted testosterone levels, higher energy, and better cognition) on the days following extra sleep, you won’t actually be addressing the long-term health problems associated with chronic sleep deprivation like high blood pressure, heart attacks, strokes, anxiety, depression, memory loss, a weakened immune system, etc.
The best way to support healthy testosterone production and your overall wellbeing is to get sufficient amounts of high-quality sleep most nights. There’s no replacement for good sleep, and
Sleep apnea and testosterone
Obstructive sleep apnea, or OSA, is actually pretty common in the US, and it happens when the muscles in your throat relax intermittently while you sleep, blocking your airway. There are multiple types of sleep apnea, but OSA is the most common. It’s specifically linked to T levels in that it occurs most frequently and most severely in people with testosterone-based systems --- i.e., people who are assigned male at birth.
Symptoms can include:
- Loud snoring
- Waking up with a dry mouth or headache
- Insomnia
- Gasping for air while sleeping
- Excessive tiredness
- Mood swings
It’s a serious sleep disorder with serious consequences, and the long-term effects can be life-threatening: cardiovascular disease, high blood pressure, stroke, increased incidence of car accidents, etc.
The connection between sleep apnea and testosterone is complicated, but it’s been linked to the upper airway anatomy, neck circumference, aging process, bodily fat distribution, and breathing control in people for whom testosterone is the dominant sex hormone.
Continuous positive airway pressure (CPAP) is the most commonly prescribed treatment for OSA. A CPAP machine is a device that delivers a steady stream of oxygen through a mask you wear over your nose and mouth while sleeping. The mask is connected by a tube to a machine that creates a constant supply of pressurized air. This air is meant to push against obstructions, keeping your airways open all night so you can sleep without disturbances.
However, while CPAP treatment can improve sleep quality, it may not improve testosterone levels for those with deficiencies related to OSA.
Does sleep apnea lower testosterone?
Despite the fact that sleep apnea is most commonly diagnosed in people for whom testosterone is the dominant hormone, this sleep disorder is actually associated with low T levels rather than normal or high ones. Studies show that the quality and quantity of sleep have an effect on testosterone production, and since OSA disrupts REM sleep, reduces nightly sleep time, and causes reduced sleep efficiency, it can in fact lead to lowered testosterone.
Can testosterone replacement therapy (TRT) cause sleep apnea?
There’s mixed information about the connection between TRT and OSA. Some research suggests that some side effects of TRT --- like thickening of the blood or changes to the airways or metabolism --- can lead to an increased occurrence of OSA. However, other research argues that the evidence isn’t strong enough to establish a connection between TRT and OSA.
With this in mind, it’s best to talk to your doctor if you’re taking TRT and are concerned about developing or aggravating OSA.
Other common causes of low testosterone
Sleep disruption isn’t the only possible cause of low T. As people get older, their bodies produce less testosterone, but some people experience dips below healthy levels during this natural progression.
While testosterone deficiencies are most often associated with older adults, the truth is that people of any age can experience low testosterone. Hypogonadism, which can result from genetics, illness, or injury, can lead to underactive testes, pituitary gland, or hypothalamus. There are multiple types of hypogonadism, and it’s associated with the following disorders that precipitate low T:
- Undescended testicles
- HIV/AIDS
- Pituitary disorders
- Inflammatory diseases
- Kallmann syndrome
- Klinefelter’s syndrome
Beyond that, there are also external conditions that can inhibit testosterone production, like cancer treatment, damage to the testicles, some medications, or a mumps infection.
How to achieve better sleep
There are plenty of things you can do to achieve better sleep, but sometimes they’re easier said than done.
For starters, it’s critical to set aside a healthy amount of time for sleep each night. Beyond that, practicing sleep hygiene is a positive habit for anyone. This involves developing a routine with regular sleep and wake times, setting up a dark and quiet bedroom environment, and avoiding screens, exercise, caffeine, large meals, and other disruptions before bed.
However, if you’ve made lifestyle or environmental adjustments and you’re still having trouble sleeping, it might be time to check out Base or talk to a doctor to see what’s going on beneath the surface. Even with a slumber-friendly bedroom and a perfected nighttime routine, insomnia, sleep disorders, and hormone imbalances can keep you up at night. That’s why the best way to address ongoing sleep disturbances is to understand their root cause instead of continuing to treat the symptoms.
Worried about low testosterone?
Take our quiz to build a bespoke testing plan that will help you understand your testosterone levels (and how to improve them!)
