Although an important hormone for male health, testosterone is also present in women. With good and quality sleep, our bodies are able to replenish this important hormone. Testosterone can play its role successfully when balanced properly – excessive or deficient amounts of it are linked to numerous problems in both men and women. Adult men possess 240 to 950 ng/dL whereas this level in adult women is significantly lower – 8 to 60 ng/dL.
In both genders, testosterone regulates good sleep, sexual desire, brain function, bone mass, it helps build muscle mass and gain strength and has a role in the distribution of fat. In men, testosterone promotes beard growth, deep voice, and sperm production. In women, it helps produce estrogen and repair reproductive tissues. Everyone naturally loses testosterone with age.
To understand the importance of testosterone and its relation to sleep, we have to take a look at numerous studies and their findings.
What are hormones?
Hormones are chemicals produced by endocrine glands (glands which let their product out into the blood). Their role is to carry a certain message. Hormones can instruct a cell to grow, get activated, or stop growing; they can inform our body that we are sleepy, hungry, or that we are full. Some hormones are produced in the brain – for example, hypothalamus excretes melatonin, the hormone which makes us sleepy, and cortisol, the hormone whose levels rise when we are in a stressful situation. They can also be excreted by the gonads (reproductive glands) – ovaries in women and testes in men, and other glands of our endocrine system.
Testosterone production and ultradian rhythm
Our circadian rhythm is our daily biological clock which regulates when we are awake, productive, sleepy, how our body temperature and hormone levels fluctuate throughout the day. Our ultradian rhythm is the 24-hour rhythm which encompasses both day and night.
Testosterone levels with both men and women are the highest in the morning, upon waking up. From that point until the end of the day, testosterone levels take a general downward trend, with a few rises throughout the day.
After falling asleep, testosterone levels begin increasing. In general, testosterone is the highest before waking up. Sleep stage-wise, it peaks during the REM sleep – and the most REM sleep we get is in the second half of our night, that is, after we’ve been asleep for at least three hours.
How are low testosterone levels linked to sleep deprivation and other sleep disorders?
A study published by the Journal of the American Medical Association has examined the effect of 8-day sleep deprivation on a group of adult males in their twenties. They reported no sleep problems or other health conditions.
After a period of 8-hour sleep per night, their total sleep time was reduced to about 5 hours. Their daily testosterone levels were decreased by 10-15% after sleep restriction. This is an enormous decrease if we compare it with the age-related testosterone decline, which happens after the age of 40 and equals about 1% per year. This shows that testosterone in men is closely related to hours of sleep and sleep loss.
Other symptoms observed were reduced libido, low energy, and concentration and increased daytime sleepiness.
People who suffer from obstructive sleep apnea (OSA), a condition in which a person wakes up several times a night due to obstructed breathing, usually have lower testosterone levels. However, it seems that OSA itself isn’t the cause for this. Researchers have found that using CPAP machine which restores quality sleep doesn’t restore testosterone. On the other hand, OSA sufferers are usually obese, and obesity is linked to low testosterone (low-T). Losing weight shows an improvement with this problem.
Other disorders which can cause low testosterone are those that impair the overall sleep quality, some of which are circadian rhythm disorders, sleep-disordered breathing, and restless leg syndrome.
There are many behavioral (lifestyle) factors which lower testosterone, like alcohol and drug abuse. Men who use opioids have 50% lower testosterone levels – this drop hasn’t been found in women who use opioids.
How low and high testosterone affect our sleep
Many studies have been conducted regarding testosterone level and sleep. Low testosterone is linked to fragmented sleep due to frequent awakenings and bad sleep quality, which are also linked to the above-mentioned sleep disturbances.
On the other hand, high testosterone levels (the hormone distributed in high doses) has many more short-term and long-term adverse consequences. Short-term consequences include – OSA aggravation, worsening in sleep-related hypoxemia (oxygen deficiency), shorter sleep time, and overall disrupted sleep and breathing.
However, long-term consequences of taking testosterone for therapeutical purposes are a lot more concerning because they are related to serious life-threatening diseases and conditions and will be discussed below.
Testosterone replacement therapy and its side effects
Testosterone replacement therapy (TRT) is a type of hormonal therapy usually used for men who have very low testosterone levels. However, taken the numerous side effects, it should not be taken unless absolutely necessary. FDA doesn’t approve TRT for women.
There are many symptoms of low testosterone and they may have a negative effect on one’s overall quality of life. These include:
- Decreased libido
- Erectile dysfunction
- Poor sleep or lack of sleep
- Fatigue, sleepiness
- Deteriorating muscle mass
- Loss of hair (body and face)
- Difficulty concentrating
- Depression and easy irritability
- Mood swings
TRT should be taken seriously and with extra care, if prescribed by a doctor. One should be fully aware of all potential risks which may come with the use of testosterone.
One study was discontinued after an alarming number of those who used testosterone experienced a heart attack. This is not the only risk testosterone carries – blood clots tend to develop only three weeks after consumption, which carries a risk of stroke, and many men were diagnosed with prostate cancer after undergoing testosterone therapy for erectile dysfunction. High testosterone dosage may have positive effects on fertility at the very beginning of therapy, but later it leads to deleterious effects on sperm production and, in the words of Dr. E. Scott Sills, ‘it should be avoided’.
How to naturally increase testosterone levels
If you are certain that your testosterone levels are too low for your body to properly function, you can first try to fix the problem safely in the following ways.
Testosterone-boosting food: tuna, bananas, salmon, oyster, spinach, lemons, porridge oats, and almonds.
Exercise: weight lifting and high-intensity interval training can boost testosterone levels if performed regularly. Low body fat is linked to higher testosterone.
Avoid stress – stressful situations may lead to an increase in cortisol – a hormone which lowers testosterone.
Avoid alcohol and drugs because they lower testosterone levels.
Have a good night’s sleep. Make sure you have good sleep habits – stick to the same sleep-wake rhythm, don’t use technology before bed and sleep in a comfortably cool room.
- Al-Dujaili E, Sharp M. Female Salivary Testosterone: Measurement, Challenges and Applications. https://www.researchgate.net/figure/Typical-testosterone-ELISA-standard-curve-mean-with-SD-N10_fig4_259150838 doi: 10.5772/53648
- Wittert G. The relationship between sleep disorders and testosterone in men. Asian Journal of Andrology. https://www.ncbi.nlm.nih.gov/pubmed/24435056 doi: 10.4103/1008-682X.122586
- Bawor M, Bami H. Testosterone suppression in opioid users: A systematic review and meta-analysis. Drug and Alcohol Dependence. Volume 149, April 1, 2015, Pages 1-9
https://www.sciencedirect.com/science/article/pii/S0376871615000733 Accessed December 31, 2018.
- Barrett-Connor E, Dam T. T, et al.The Association of Testosterone Levels with Overall Sleep Quality, Sleep Architecture, and Sleep-Disordered Breathing. The Journal of Clinical Endocrinology & Metabolism. Volume 93, Issue 7, 1 July 2008, Pages 2602–2609. https://academic.oup.com/jcem/article/93/7/2602/2598749 Accessed December 31, 2018.
- Peter L. Y, Yee B, et al. The Short-Term Effects of High-Dose Testosterone on Sleep, Breathing, and Function in Older Men. The Journal of Clinical Endocrinology & Metabolism. Volume 88, Issue 8, 1 August 2003, Pages 3605–3613. https://academic.oup.com/jcem/article/88/8/3605/2845283
- Testosterone Therapy Side Effects. Drugwatch. https://www.drugwatch.com/testosterone/side-effects/ Accessed December 31, 2018.
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