Testosterone is most well-known as the male sex hormone. It’s responsible for things like sperm production, libido, and facial hair, but it does a whole lot more than that.
Firstly, the hormone is critical to men’s health and well-being, but women have testosterone, too, just at lower levels. And the hormone is responsible for everything from bone strength to fat distribution to mood. And yes, it can affect your sleep, too.
But, what many of us don’t know about testosterone is that not getting enough sleep can drastically lower your production of the hormone.
Plus, many of the symptoms of low testosterone — think fatigue, low mood, and difficulty concentrating — are also symptoms of sleep deprivation. So, it may be that you’re sleep deprived and fixing this problem could improve your symptoms and ensure your body can make all the testerone it needs.
Below, we’ll answer your testosterone and sleep questions and show you how the RISE app can help you improve your sleep and perhaps your testosterone levels, too.
Note: Most research into testosterone and sleep is on men, but we’ve included as much information on women as we can.
Low testosterone may get in the way of a good night’s sleep. More research needs to be done, but there is some evidence to show it can cause insomnia, low sleep efficiency, sleep-disordered breathing, and nocturia.
But first up, what causes testosterone deficiency? Levels of testosterone are at their highest during adolescence and early adulthood and then decline as you get older. Total testosterone levels fall by about 1.6% per year, whilst free and bioavailable testosterone levels fall by 2% to 3% per year.
Low testosterone (also known as hypogonadism or low t) may be caused by aging, but it can also be caused by:
Symptoms of low testosterone include:
Here’s how low levels of testosterone can impact your nights.
Research is sparse, but low testosterone in cancer patients has been linked to insomnia, along with symptoms like decreased daytime energy, depression, and decreased sexual function.
Research suggests men with lower testosterone levels have lower sleep efficiency, which is the measure of how long you spend in bed actually sleeping. The lower your sleep efficiency, the more time you spend awake in bed.
Women may have the same problem. Research shows lower levels of testosterone are linked to an increased wake time after sleep onset — or in non-science speak, more time awake during the night after you’ve initially fallen asleep.
More research needs to be done to examine the link between sleep-disordered breathing and low testosterone. In one study of men 65 years or older, the association between lower total testosterone levels and less healthy sleep was attenuated or absent after adjusting for BMI and other variables. The researchers write, “clinical trials are necessary to determine whether body weight acts directly or indirectly (via low testosterone) in the causal pathway for sleep-disordered breathing in older men.
Low testosterone can lead to body weight gain, however, which can up your odds of developing sleep-disordered breathing, or make existing breathing problems worse.
Consider getting tested for sleep apnea if you have risk factors such as hypertension (high blood pressure), cardiovascular disease, or diabetes.
You can learn more about how to know if you have sleep apnea here.
Nocturia is when you wake up once or more to use the bathroom during the night on a regular basis (although it is sometimes defined as waking up to use the bathroom more than once a night). Waking up during the night will obviously fragment and shorten your sleep, which can lead to lower testosterone levels (more on that soon). But low testosterone may also lead to the development of nocturia, creating a vicious cycle.
You can learn more about why you pee so much at night here.
High testosterone levels may also impact your sleep, but the research is sparse.
High testosterone can be caused by:
Symptoms of high testosterone include:
High testosterone in overweight and obese men has been linked to more shallow sleep. And this was the case even when factors like age, race, and sleep apnea severity were taken into account.
Even if naturally high testosterone doesn't impact your sleep, it may impact how poor sleep makes you feel and function the next day. Men with higher natural total testosterone levels have been shown to feel more sleepiness and have more impaired mental performance after not getting enough sleep, compared to those who have lower levels of the hormone.
If low testosterone levels impact your sleep, you’d think testosterone supplements or injections could help, right? But that’s not always the case.
As with everything testosterone, more research needs to be done to know for sure. Most studies are small or focus on sleep apnea or older men, for example.
The good news? Testosterone-treated mice have been found to get more sleep after treatment when their natural testosterone levels were low.
The bad news? Short-term high-dose testosterone injections in men over 60 decreased the amount of sleep they got by about an hour and made their sleep apnea worse.
Abusing testosterone, or taking it when you don’t need to medically for powerlifting or bodybuilding, for example, can also impact sleep.
Self-administration of large doses of testosterone has been linked to many sleep problems. The side effects of testosterone from abusing steroids include:
Testosterone can impact your sleep, but the link goes both ways — the amount of sleep you get can impact your testosterone levels.
That’s because testosterone production is dependent on sleep. Testosterone production starts to rise when you first fall asleep, and production reaches its peak during your first bout of rapid-eye-movement (REM) sleep. It stays high as you sleep, but reduces all the time you’re awake.
You cycle through different sleep stages throughout the night, but the REM part of your sleep cycle gets longer as the night goes on. So, when you don’t get enough sleep or something changes your sleep architecture — how long your body spends in different sleep stages — your testosterone production is compromised.
The link between sleep and testosterone may not be direct, however. It may be that sleep is impacting sex hormone binding globulin (SHBG) — a protein that binds to sex hormones and transports them around the body — and this is what’s lowering testosterone. More research needs to be done.
Sleep problems that can lower testosterone production include:
Let’s dive into each of these in more detail.
As testosterone production happens at night, the amount of sleep you get impacts how much of the hormone your body produces.
Testosterone levels are already lower with age, but lack of sleep may make things worse. Research suggests sleep deprivation lowers testosterone levels more in older rats than in younger rats. And when they start getting enough sleep again, testosterone levels recover more slowly in older rats than younger rats.
It’s not just older men who need to worry about sleep, though. One study found that after sleeping five hours a night for eight nights — something that’s not all too uncommon for some of us — participants had 10% to 15% lower testosterone levels. And the study was on healthy young men.
But you don’t need a whole week of sleep loss for testosterone levels to take a hit. Another study found participants had lower morning testosterone levels after just one night of sleeping 4.5 hours.
Beyond duration, the timing of your sleep can also impact testosterone. In the study above, losing out on sleep in the second half of the night, compared to the first half of the night, lowered testosterone levels.
You might have this kind of sleep restriction if you cut your sleep short to wake up early or have trouble staying asleep towards the end of the night.
It’s not all about the hours of sleep you get; sleeping through the night is also important.
When your sleep is fragmented, you wake up often during the night. This leads to getting less sleep overall, but it also changes your sleep architecture as it disrupts your natural sleep cycles.
Research shows when your sleep is fragmented, you get less REM sleep and have lowered testosterone.
While one night of sleep loss can impact your testosterone levels, accumulated sleep debt is a major contributor to lowered levels.
Sleep debt is the running total of how much sleep you owe your body. It’s compared against your sleep need, the genetically determined amount of sleep you need each night.
The RISE app can work out your individual sleep need and give you a number in hours and minutes. The app can also work out how much sleep debt you’re carrying — we measure it over your past 14 nights and recommend you keep it below five hours to feel your best.
You can use RISE to see if you’ve got high sleep debt, which may be contributing to low testosterone levels.
The app also tracks your sleep and shows you when your body naturally wants to wake up — we call this your Wake Zone. You can see how often you wake up during the night and whether fragmented sleep could be impacting testosterone, and whether you’re waking up before your Wake Zone and cutting sleep short.
If you find you have high sleep debt, fragmented sleep, or are waking earlier than your body naturally wants to, you can work to fix these problems (more on that soon) in an attempt to boost testosterone.
Even if these problems aren’t the cause of low testosterone, they do cause symptoms that look a lot like low testosterone — like fatigue, difficulty concentrating, and low mood. So it’s worth finding out if you’re saddled with high sleep debt and fragmented sleep, and working to improve your sleep (more on sleep hygiene shortly).
RISE users on iOS 1.202 and above can click here to view their sleep need.
RISE users on iOS 1.202 and above can click here to view their sleep debt.
Obstructive sleep apnea (OSA) is a sleep disorder that causes you to stop breathing temporarily during the night. When your brain notices low oxygen levels, it wakes you up to kickstart your breathing again. You might wake up gasping for breath, or not even remember waking up during the night.
When you don’t remember waking up, this is called retrograde amnesia. It’s the reason we often don’t remember the minutes before falling asleep or the micro-awakenings (usually less than 10 minutes) that can happen throughout the night.
These sleep apnea episodes cause sleep deprivation, sleep fragmentation, and shorter REM time — all of which can sabotage your testosterone production.
Weight loss has been shown to boost testosterone levels in those with sleep apnea, whereas using a continuous positive airway pressure (CPAP) machine doesn’t.
The link may go the other way, too. There is some evidence to show testosterone therapy may cause sleep apnea or make it worse. Worsening symptoms after testosterone administration have been seen in both men and women.
Currently, it’s recommended those with sleep apnea either don’t get testosterone replacement therapy, or doctors prescribe it cautiously, especially if patients aren’t getting CPAP treatment.
You can learn more about testosterone and sleep apnea here.
In the study mentioned above on rats, when the rats started getting enough sleep, testosterone levels recovered in both older and younger rats — it just took longer for older rats to recover.
Another study — this time on humans — found testosterone levels increased in men after they slept for 10 hours, compared to sleeping for just six hours.
Plus, research shows that testosterone levels increase as your sleep duration increases. The benefit goes up to 9.9 hours — after this, testosterone starts decreasing again.
Use the RISE app to find out your individual sleep need and aim to get this amount of sleep each night. Overall, focus on keeping your sleep debt low.
If you find you’ve got high sleep debt you can pay it back by:
You can learn more about sleep debt here.
As we’ve shown, not meeting your sleep need, fragmented sleep, and sleep loss towards the end of the night can all lower testosterone production, so doing your best to avoid these things will keep your testosterone production higher.
To help you meet your sleep need and sleep soundly through the night, focus on your sleep hygiene. Sleep hygiene is the set of healthy sleep habits you can do to help you fall and stay asleep. These habits don’t just happen before bedtime, though. They start the moment you wake up.
Sleep hygiene can also ensure your sleep is healthy and natural, meaning nothing stops your body from cycling through the sleep stages it needs to produce the optimum hormone levels for you.
Good sleep hygiene includes:
To stay on top of sleep hygiene, RISE can coach you through 20+ habits each day and the best time to do them based on your body clock to make them more effective.
RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.
As well as getting light first thing to help you sleep — which can boost testosterone levels — sunlight may also increase testosterone directly.
Research shows UVB treatment in male mice boosts levels of testosterone. And in humans, sunlight exposure has been associated with increased testosterone levels, as well as romantic passion in men and women and aggression in men.
Aim to get 30 minutes of light exposure a day onto your skin to reap the UV benefits.
You can learn more about how to increase testosterone naturally here.
Science is lacking in this area, especially for women and younger men, but from what we do know, testosterone and sleep are tightly linked.
Poor sleep — including not meeting your sleep need, getting fragmented sleep, or cutting sleep short at the end of the night — can lead to lowered testosterone levels. And having both low or high testosterone levels can also cause sleep problems, including insomnia and poor sleep efficiency.
To break the link, use the RISE app to find out your individual sleep need and how much sleep debt you’re carrying. You can also use the app to monitor how fragmented your sleep is and whether you’re cutting it too short in the mornings.
RISE can then coach you through 20+ sleep hygiene habits to help you keep your sleep debt low and stop things like ill-timed coffee and alcohol or late-night bright light keeping you up or waking you up during the night.
Even if sleep debt and fragmented sleep aren’t the reason for low testosterone, fixing them will lead to increased energy, mood, and productivity.
Yes, having both too low and too high testosterone levels can cause sleep problems such as insomnia, more nighttime awakenings, and more shallow sleep.
Testosterone may help you sleep better in some cases. Testosterone-treated mice get more sleep when their natural levels were low. But, research in humans has found testerone, either from hormone replacement therapy or abusing steroids, can lead to sleep problems like reduced sleep time and sleep apnea.
Yes, low testosterone can cause sleep issues. Research suggests having too low levels of the hormone can lead to insomnia, nighttime awakenings, sleep-disordered breathing, and nocturia — or needing to pee during the night.
High testosterone affects sleep. Having high levels naturally has been linked to more shallow sleep and feeling more tired after sleep deprivation. Having high levels from testosterone replacement therapy or abusing steroids has been linked to reduced sleep time and sleep efficiency, and increased light sleep.
Testosterone administration may cause you to develop sleep apnea, or it may contribute to worsening symptoms if you already have the sleep disorder. Plus, sleep apnea itself may cause low testosterone levels.
Sleep deprivation and missing out on sleep in the second half of the night have been shown to lower your testosterone levels, so doing these things before a testosterone test can impact the results.
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