Testosterone decline is a common health issue men face as they age. Decreased testosterone levels cause several adverse effects, including a lowered sex drive, moodiness, loss of muscle mass, body hair, and even sleep. But inadequate sleep can also be why testosterone decline occurs, so how do these two issues impact each other?

Let's take a better look at this below:

Quick Facts Overview
  • Peak testosterone production occurs while the body is asleep;
  • Sleep deprivation can cause a significant decrease in testosterone production;
  • After testosterone levels reach their peak during sleep, it decreases during waking hours.

Sleep and Testosterone Production

The connection between sleep and testosterone is quite complicated. A continuous lack of sleep can cause testosterone levels to drop, and low testosterone levels can contribute to poor sleep quality and duration. It's essentially an odd coupling of health issues that feed off each other. To better understand this concept, let's look at some facts from a practical standpoint. 

Results from a research study focused on the effect of sleep restriction on testosterone levels. The evidence concluded:

Sleep restriction caused a 10-15% decrease in testosterone levels. This is a significant decline as the normal rate of decline due to aging is pinned at 1-2% a year.

Another study shows that sleep disorders can also lower testosterone levels, further supporting the link between the two. According to experts, peak testosterone production occurs during sleep hours, which means if you lose out on sleep, you're losing out on valuable testosterone production time. 

This would explain why fatigue or excessive tiredness is a confirmed symptom of low testosterone. On the other hand, inadequate testosterone production can cause a decrease in sleep quality, as mentioned earlier. Fluctuating levels of testosterone cause cortisol levels to rise. High cortisol levels promote wakefulness, resulting in shallow and short periods of sleep.

At What Point in the Sleep Cycle Do We Produce Testosterone

We've confirmed that sleep helps buy us more testosterone production time, but that doesn't mean that every 40 winks equate to a testosterone boost. Daily testosterone levels fluctuate in conjunction with a person's circadian rhythm. Testosterone levels are highest in the morning (when we wake up) and start to fall throughout the day. Testosterone levels are at their lowest point by the end of the day or bedtime. During sleep, testosterone and other hormones used during the day are replenished. This means less sleep, low-quality sleep, or extended periods of wakefulness can cause lower testosterone levels. 

The sleep cycle is made up of 5 different stages, each with its own time frame. According to research, testosterone production is at its peak at Stage 4: REM sleep. This stage happens approximately 90 minutes after you fall asleep. Although this is quite a deep level of sleep, body processes do not go dormant. In REM sleep, brain waves increase, eye movements are rapid, breathing and heart rates speed up. In addition to this, other functions, like testosterone production, are active.

Testosterone and Sleep Quality

Sleep quality refers to the satisfaction one receives after sleep. Studies show that decreased sleep quality is a contributing factor to low testosterone levels. An absence of quality sleep can also further aggravate some symptoms of low testosterone. These symptoms include:

  • Depression;
  • Chronic fatigue;
  • Reduced sex drive;
  • Fatigue and stress;
  • Increased body fat;
  • Poor concentration.

As mentioned earlier, low testosterone levels can also affect sleep, more specifically, sleep quality. Research shows that men with lower testosterone levels experienced lower sleep efficiency, with increased nighttime awakenings. Considering these aspects are indicators used to determine sleep quality, this is a prime example of how testosterone can affect sleep.

Testosterone and Sleep Apnea

The National Sleep Foundation states that more than 18 million adults in the USA suffer from sleep apnea, with a large percentage of men with the condition ranging between the ages of 45 and 64—an age group highly susceptible to experiencing low testosterone. Sleep Apnea, also known as Obstructive Sleep Apnea (OSA), is a sleep disorder that causes breathing issues while individuals are asleep. 

These issues occur when muscles at the back of the throat fail to keep airways open, which hinders proper breathing. The pause in breathing between open and closed airways can last 10 seconds or more, resulting in poor blood oxygen levels and fragmented sleep. So, what's the link between Sleep Apnea and testosterone?

After looking at several research studies, we found one study that explains it quite well. The results showed men suffering from severe OSA had lower testosterone levels than those without mild sleep issues. This is simply because the condition does not allow individuals to achieve a sleep deep (REM sleep) enough to support testosterone production.


Symptoms are indicative factors that tell us whether we have a specific condition. When it comes to health issues like sleep apnea, the symptoms are quite noticeable and can be easily identified, which is great as it makes getting treatment easy. 

Symptoms of Sleep Apnea include:

  • Insomnia
  • Loud snoring
  • Mood swings
  • Excessive tiredness
  • Gasping for air while sleeping
  • Waking up with a dry mouth or headache

Some symptoms like insomnia, mood swings, and excessive tiredness can also indicate low testosterone levels. When both conditions exist simultaneously, their common symptoms increase in intensity.

Does Sleep Apnea Impact Testosterone Levels?

Considering Sleep Apnea is a sleeping disorder that does not support proper sleep, it is quite likely to hinder testosterone production. Studies show that those with Sleep Apnea experience less REM sleep, which means decreased deep sleep time, frequent nighttime awakenings, sleep fragmentation, and reduced sleep efficiency. This does not set the stage for optimal testosterone production during sleep hours. 

So, by the time morning comes around, optimal testosterone levels are not nearly reached. The continuous lack of sleep does not allow testosterone levels to recover, which means individuals enter into an endless cycle of lack of sleep and low testosterone levels until treatment is received for both.

What Can You Do to Improve Sleep? 

We all know that sleep is like the support structure of our lives. It keeps the body functions moving at an optimum pace and helps regulate several systems. As we mentioned previously, sleep affects testosterone production, so it's important to encourage and stimulate sleep. You can do several things to improve the duration and quality of sleep. 

Let's look at some of the approaches you can take:

  • Increase exercise or physical activity in your daily routine. According to research, the effect exercise has on sleep is similar to the effects of sleeping pills. Exercise also improves testosterone production, so it's a win-win situation.
  • Avoid heavy meals before bed as this can cause indigestion or delayed digestion which keeps the body awake.
  • Do not go to bed hungry. Hunger is quite a strong feeling. It can disrupt sleep which results in poor sleep quality and duration.
  • Create a sleep schedule. Allocate 8 hours for sleep and ensure you are in bed at an appropriate time to facilitate this.
  • Create a peaceful, stress-free, restful environment. A cool, dark, and quiet room is always the best way to go.

In addition to the above, you can also engage in frequent sex if circumstances permit it. A healthy sex life can reduce stress and manage sleep problems.

Testosterone Replacement Therapy 

Testosterone replacement therapy, more commonly known as TRT, is a treatment that helps treat low testosterone levels. TRT involves the supervised use of testosterone-boosting products that contain the testosterone hormone. The therapy is a form of hormone replacement therapy (HRT) and is often prescribed when the testes cannot produce enough testosterone or the body cannot process it effectively.

There are 5 different ways to take testosterone, these include:

1. Transdermal

This is a topical method that involves the application of creams, liquids, gels, or patches onto the skin. These medicines last for approximately 4 days.

2. Injection

One of the more known ways of TRT. There are both long and short-acting forms of testosterone injections. The short-acting is injected under the skin, while the long-acting is injected into the muscle. Injections are typically administered once a week, every two weeks, or monthly.

3. Buccal

This is an oral form of treatment. Buccal is a patch treatment that resembles a tablet. It should not be swallowed or chewed. It must be placed above the incisor tooth to dissolve and release slowly over 12 hours.

4. Intranasal

This form of TRT comes in a gel form which must be pumped into each nostril three times daily.

5. Pellets

Pellets must be put under the skin. The treatment is done by a doctor and involves local anesthetic followed by a cut in the skin of the upper buttocks or hips and insertion of the pellet inside the fatty tissues. This medication dissolves slowly over 3-6 months, depending on the number of pellets used.


After looking through several studies, we've noticed quite a significant link between sleep and testosterone levels. When sleep is scarce, and a rapid decline of testosterone follows, symptoms of low testosterone become visible much faster. The intensity of the symptoms can also be quite severe, so implementing proper sleep schedules is imperative for symptoms to subside and optimum testosterone levels to be achieved and maintained.

About the Author Tim Rockwell

Tim Rockwell is a highly skilled and knowledgeable fitness expert. With a background in exercise science and years of experience in the fitness industry, Tim is passionate about sharing his expertise with others through his writing. He currently contributes articles to Eurasc, where he shares practical tips and strategies for leading a healthy, active lifestyle.

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