How Does Testosterone Affect Sleep?

The Relationship Between Sleep and Testosterone

Testosterone levels typically increase during sleep as part of a natural rhythm of rising and falling levels over a 24-hour period. Studies have found Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source testosterone levels are typically highest around 8 a.m. and lowest around 8 p.m., and sleep facilitates this normal cycle of testosterone production. 

Research suggests that insufficient sleep and sleep disorders like sleep apnea may affect testosterone levels. At the same time, irregular testosterone levels may be linked Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source with sleeping problems.

How Low Testosterone Levels Affect Sleep?

In men and people assigned male at birth, a low testosterone level may cause insomnia-like problems, Trusted Source Merck ManualFirst published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers.View Source including difficulty falling asleep or staying asleep.

Symptoms of Low Testosterone

In adult males, symptoms of low testosterone Trusted Source Medline PlusMedlinePlus is an online health information resource for patients and their families and friends.View Source can include: 

• Loss of muscle or bone mass
• Decreased sex drive
• Problems getting or maintaining an erection
• Depression
• Lack of concentration
• Rise in body fat

Very low levels of testosterone may cause hot flashes with excess sweating. 

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How High Testosterone Levels Impact Sleep?

In males, high testosterone may not cause symptoms or impact sleep. However, some research has found a link between poor sleep and high testosterone, Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source such as from treatment with high doses of synthetic testosterone.

In people assigned female at birth, high testosterone levels may be caused by conditions like polycystic ovary syndrome (PCOS), which are associated with poor sleep.

Symptoms of High Testosterone

High testosterone does not always cause symptoms in males. Rather, low testosterone is more likely to cause symptoms. However, abuse of synthetic testosterone may cause symptoms such as:

• High blood pressure
• Unhealthy cholesterol levels
• Acne
• Liver or kidney conditions

In women and people assigned female at birth, potential signs of high testosterone include: 

• Excess hair growth on the face and body
• Male-patterned hair loss 
• Deepening of the voice
• Acne
• No menstrual periods or periods that occur irregularly

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Will Lack of Sleep Affect Testosterone?

Some evidence suggests that insufficient sleep can lower testosterone levels, but not all studies have found the same results. 

Sleep influences the daily rhythm of testosterone production, which may be thrown off by sleep disruptions. In one study of healthy young males, a week of sleeping less than five hours per night was linked to a 10-15% decrease Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source in testosterone levels. 

A number of studies have found an association between obstructive sleep apnea (OSA) and low testosterone, but it is not clear if OSA directly causes low levels. Some evidence indicates that treating OSA may increase testosterone levels.

Can Testosterone Replacement Therapy Improve Sleep?

Some males receive testosterone replacement therapy if they are diagnosed with low testosterone. When low testosterone causes poor sleep, testosterone treatment may improve sleep.

In some people, though, testosterone replacement therapy can interfere with sleep, especially if it is a high-dose treatment.

In addition, testosterone therapy may increase the risk of developing or worsening obstructive sleep apnea, which causes fragmented sleep. In people with untreated OSA, testosterone replacement therapy may worsen breathing problems Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source during sleep.

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