A Hidden Consequence: The Link Between Sleep Apnea and Low Testosterone

Testosterone is a hormone produced by both men and women. Its role goes beyond the reproductive system and someone’s sex drive. Testosterone also impacts bone strength, behavior and mood. 

When testosterone levels are low, you can experience a decreased sex drive, infertility, cognitive problems and fatigue.

Low testosterone has also been linked to poor-quality sleep. This link to sleep is cyclical, with sleep deprivation one of the possible contributing factors for low levels of testosterone. 

Sleep disorders such as sleep apnea can result in excessive daytime fatigue caused by repetitive arousals leading to sleep deprivation – and a reason why treating one condition could help manage the other.

Testosterone and Sleep

Sleep is an important restorative tool and is key to good mental and physical health. It is also an important time for the production of hormones. 

The peak time for testosterone production tends to occur during the REM phase of deep sleep, although there are boosts to levels during the waking hours too.

Sleep and testosterone production work in close harmony. The levels of the hormone will begin to drop as the day wears on, to be replenished overnight as we sleep. 

Therefore, if that sleep is disturbed or fragmented for any reason, including a sleep disorder, there are fewer levels of the hormone produced. The longer it takes to reach the REM phase of sleep, the longer it will generally take for testosterone levels to rise.

The Symptoms of Low Testosterone

Testosterone levels will naturally drop off in men as they get older, and this can be up to 2% every year. For women, production levels peak in the mid-twenties, before starting to gradually fall.

As well as age and poor sleep, obesity, health conditions like diabetes, alcohol, medication and poor thyroid function can all be contributing factors to low testosterone levels. The symptoms can be different for men and women.

Symptoms of low testosterone in men include:

  • Impotence
  • Low sex drive
  • Memory issues
  • Depression
  • Brittle bones
  • Loss of hair
  • Infertility

For women, the symptoms of low testosterone can include:

  • Low sex drive
  • Poor quality of sleep
  • Fatigue
  • Memory problems
  • Depression

The Link Between Sleep Apnea and Low Testosterone

Disorders that impact the quality of your sleep will affect the levels of testosterone produced. Sleep apnea is a common sleep disorder that causes fragmented sleep and sleep deprivation. The most common form is obstructive sleep apnea.

Obstructive sleep apnea is caused by a narrowing of the upper airways as you sleep and the resulting difficulties in breathing. The brain responds to the drop in oxygen levels by prompting the body to wake for air. For people with severe obstructive sleep apnea, this can occur over 30 times every hour.

Such fragmented sleep disrupts hormone production. The body may only wake briefly for air, but the accumulated episodes can have a significant impact on all the important restorative roles that sleep plays. 

Sleep disorders like sleep apnea are one of the leading causes of sexual problems like erectile dysfunction due to low levels of testosterone production. Men who have obstructive sleep apnea are at greater risk of erectile dysfunction than those without the disorder.

One problem is that the vast majority of sleep apnea cases remain undiagnosed. By treating the underlying causes of sleep apnea you can return to better nights of sleep. 

This in turn could help balance the levels of testosterone produced as you reach the REM phase of sleep more consistently. Testosterone levels have been shown to recover quickly with good-quality sleep.

Therefore, recognizing the symptoms of obstructive sleep apnea is important. These include:

  • Frequent awakenings as you sleep
  • Waking gasping for air
  • Loud snoring
  • Excessive daytime fatigue
  • Morning headaches
  • Dry mouth in the morning
  • Poor concentration
  • Increased irritability
  • Loss of sex drive
  • Mood swings

If you recognize these symptoms, then you should consult with your doctor who may arrange a sleep study. Once diagnosed, sleep apnea can be treated to reduce or eliminate the symptoms and return you to restful sleep.

Improving Your Sleep to Boost Testosterone Levels

If you are diagnosed with obstructive sleep apnea you may be recommended CPAP or possibly an oral device to wear overnight. 

Both treatments work by keeping the airways free of obstruction to allow an unimpeded flow of air. Then the brain won’t prompt the body to wake for air, causing the fragmented sleep.

Sleep apnea and low testosterone have some of the same risk factors, including obesity. Therefore, lifestyle changes aimed at weight loss may help treat both conditions.

However, as well as sleep apnea treatments such as CPAP, improving your sleep habits can also help encourage testosterone levels through allowing you to reach the REM phase of sleep more often. Ways to improve your sleep hygiene include:

  • Stick to a bedtime routine of going to bed and getting up at the same time each day
  • Give afternoon naps a miss or limit them to 20 minutes
  • Ensure your bedroom is cool, quiet and dark enough to encourage sleep
  • Remove blue-light emitting tech from the bedroom
  • Switch off all screens at least an hour before going to bed
  • Exercise regularly to encourage tiredness in the evening, although you should avoid exercise in the three hours before going to bed
  • Engage in relaxing activities before bed like meditation or reading
  • Avoid stimulants such as alcohol and avoid heavy meals in the hours leading up to bed
  • Chat with your doctor if you are experiencing any issues with your sleep

Low levels of testosterone may also be addressed by reducing stress, quitting smoking and using testosterone supplements. Your doctor can advise you on the best plan for you.

Poor quality of sleep and sleep deprivation caused by a disorder like obstructive sleep apnea can result in low testosterone. This can have a significant impact on both men and women. Therefore, diagnosis and treatment of the symptoms of sleep apnea may provide the quality of sleep to help balance testosterone levels.