Low Testosterone and Sleep Apnea: What’s the Connection?

Have you - or someone you know - been diagnosed with obstructive sleep apnea? If so, you are likely already aware of many of the most common symptoms

These include excessive snoring, breathing difficulties, waking often during the night, gasping for breath, fatigue throughout the day, trouble concentrating, and drowsy driving. However, it is just as important to remember that OSA also impacts your body’s ability to function – including metabolism and diabetes. 

One lesser-known example of the long-term risks is associated with decreased libido (sex drive) in males. What is the exact relationship between sleep apnea and low testosterone? In order to answer this question, we will first need to briefly examine OSA from a biological point of view.

The Effects of OSA

Most experts agree that the human body requires between seven and nine hours of sleep each night to function properly. This will help to prevent issues such as fatigue, a lack of mental focus, and mood swings. However, some additional effects of OSA occur "behind closed doors". These are directly attributed to metabolism. 

The term "metabolic syndrome" is often used to describe certain conditions related to sleep apnea. These include:

  • A higher percentage of visceral fat (fat within the abdomen that is located between the muscles and the organs).
  • A greater risk of developing type 2 diabetes.
  • General obesity
  • Increased levels of cortisol (the stress hormone).
  • A condition known as hypogonadism, aka, low testosterone.

In relation to poor libido, these final two observations are extremely important. This also leads us to the next section.

The Root Causes of Low Testosterone in Males

Nearly one-third of males between 18 and 44 get less than seven hours of sleep each night. And low testosterone is said to impact one out of every four men over the age of 30. 

While not all cases of low libido are associated with sleep apnea, we can clearly see a link. 

Scientists are not exactly certain whether or not a single culprit exists. Testosterone changes could instead be caused by multiple factors. For example, excessive levels of fat have been shown to negatively impact testosterone production in men. 

The excessive production of a stress-related hormone known as cortisol (yet another effect of sleep apnea) may likewise impede the body's ability to produce testosterone at adequate levels. 

A final issue is associated with a clinical condition known as hypogonadism – characterized by little or no production of testosterone. 

While research is ongoing, it is believed that excess stored fat plays an important role. 

In other words, those who suffer from OSA - and are also overweight - will be at a higher risk of experiencing low libido

Other Factors to Take Into Account

Sleep plays a crucial role in balancing many other metabolic functions in the body. Indeed, the restorative aspect of sleep has been known for centuries. 

Once again, testosterone production comes into play. 

Many males are unaware that their testosterone levels fluctuate throughout the day. They tend to be the highest during the morning hours and slowly decrease during the day. 

When we sleep, the brain sends a signal to the pituitary gland to produce more testosterone, helping to restore the natural "balance" – and ensuring adequate testosterone levels in the morning. 

The issue here is that those who are currently grappling with sleep apnea are not getting seven to nine hours of rest. Their libidos could suffer as a direct result. 

A Chronic or Acute Condition?

How long can it take to begin experiencing low testosterone levels? 

Readers will likely be surprised to learn that drops of between 10 and 15 percent can occur after only one week of poor sleep. Of course, these very same problems will become more pronounced over time if sleeping patterns are not corrected. 

This is even more of a concern for younger males (such as those in college) as they may not have been diagnosed with OSA – and they rarely get sufficient sleep. 

You can learn if you have symptoms of OSA by taking an in-home sleep apnea test. Learn more: https://www.sleepquest.com/services/home-sleep-test/

What Treatment Options Are Available?

So, why not instead opt for some type of testosterone replacement therapy? This might appear to be a wise decision at first glance. 

However, a very real problem should be highlighted. It has been shown that testosterone therapy can actually exacerbate the symptoms associated with obstructive sleep apnea. In other words, this strategy will produce more harm than good. 

The best way forward is to first consult with your physician or a qualified sleep specialist. He or she will perform several tests in order to determine whether or not you have OSA (as well as its severity). 

If this is found to be the case, most individuals will vastly benefit from the use of a CPAP machine

CPAP is an acronym for continuous positive airway pressure machine. This apparatus consists of a motor, a fan, a hose, and a mouthpiece. The mouthpiece will be connected during the night, allowing the device to provide a source of air at a slightly higher pressure. 

As a result, the airways are more likely to remain open and the body will obtain the oxygen that it requires to breathe normally. Most users also experience dramatically improved sleeping patterns within a relatively short period of time. 

A Fixable Problem

Although a decreased libido and low levels of testosterone may cause some men to feel embarrassed, there are indeed solutions to consider. Strategies included determining whether or not sleep apnea is the primary cause, leading a healthier lifestyle, embracing a balanced diet, and utilizing a CPAP machine. 

Of course, scientists are always discovering additional treatment options and the chances are high that even more effective approaches will be available in the near future. Be sure to speak with your physician to learn more about the possible solutions.

Could you have sleep apnea? The in-home sleep study will provide a comprehensive report.



  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912002/
  2. https://wmuro.com/low-testosterone-are-you-one-in-four/
  3. https://www.healthcentral.com/slideshow/low-testosterone-and-sleep