Does sleep affect testosterone? What the research shows

Yes, sleep affects testosterone. Testosterone rises during the night, and in a well-known 2011 study, a week of 5-hour nights cut daytime testosterone by 10% to 15% in healthy young men. The wider research is more mixed than the headlines suggest, and sleep apnea complicates the picture, so if you have symptoms of low testosterone, the answer is a doctor and a proper blood test rather than guesswork.

This article covers what happens to testosterone overnight, what the sleep loss studies found, where sleep apnea fits, and how to protect your sleep in the meantime.

How does sleep affect testosterone?

Sleep affects testosterone because much of the hormone's daily release happens at night. In a small 1999 study in the Journal of Andrology, researchers took blood every 15 minutes from six healthy young men while recording their sleep. Testosterone was lowest in the evening while the men were awake. It began to rise as they fell asleep, peaked at about the time of their first REM period and stayed at that level until they woke up.

The authors of the 2011 JAMA study described below put it simply: the majority of daily testosterone release in men occurs during sleep. That's why researchers have asked what happens when sleep gets cut short.

Age changes the pattern too. In a 2007 study in Sleep, 12 healthy men aged 64 to 74 had their sleep measured in a lab. The amount of nighttime sleep was an independent predictor of their morning testosterone, so the men who slept more tended to have higher levels. It was a small observational study, so it shows a link rather than cause and effect.

Does lack of sleep lower testosterone?

Lack of sleep can lower testosterone, and the clearest example comes from a 2011 study in JAMA by Rachel Leproult and Eve Van Cauter at the University of Chicago. Ten healthy men with an average age of 24 spent three nights with 10 hours in bed, then eight nights with only 5 hours in bed, in a sleep lab.

Their sleep fell from just under 9 hours a night to under 5. After a week of short nights, their daytime testosterone was 10% to 15% lower than in the rested condition, and the drop was clearest between 2pm and 10pm. Their vigor scores, a self-rating of energy, fell steadily over the week. Cortisol, a stress hormone that can suppress testosterone, didn't change.

For context, the authors noted that normal aging lowers testosterone by about 1% to 2% a year. A week of 5-hour nights produced a larger drop than that in men in their twenties.

The study has real limits. It included only 10 men, all young and lean, and lasted about a week, so it can't tell us what years of short sleep do, or how much the drop matters for everyday health.

What does the wider research say?

The wider research says total sleep loss lowers testosterone fairly consistently, while the evidence on partial sleep loss is mixed. A 2021 meta-analysis in Sleep Medicine pooled 18 studies with 252 healthy men. Going 24 hours or more without any sleep lowered testosterone. Short-term partial sleep deprivation, such as a few short nights, had no significant effect across the studies combined.

So the 2011 result isn't the whole story. Some studies of short nights found a drop and others didn't, which is common when studies are small and use different methods. The authors still concluded that sleep duration plays a key role in maintaining testosterone in men.

Is sleep apnea linked to low testosterone?

Sleep apnea is linked to lower testosterone in men. A 2023 meta-analysis in Sleep and Breathing combined 24 case-control studies and found that men with obstructive sleep apnea had significantly lower testosterone than men without it. There was no difference in women. Results varied a lot between studies, and race, age, body mass index and testing method explained much of that variation.

Cleveland Clinic lists obstructive sleep apnea among the risk factors for low testosterone, along with being older than 45, obesity and poorly managed type 2 diabetes. Among the habits it says may help keep testosterone normal, it includes sleeping seven hours a night and treating sleep apnea if you have it.

What's less clear is whether treating sleep apnea raises testosterone. A 2019 meta-analysis in Frontiers in Endocrinology pooled 12 studies with 388 patients and found that CPAP wasn't linked to a significant change in total testosterone. The authors suggested other strategies for managing low testosterone in men with sleep apnea. CPAP is still worth using for the breathing problem itself.

There's another reason sleep apnea matters here. The Endocrine Society's 2018 guideline recommends against starting testosterone therapy in men with untreated severe obstructive sleep apnea. Our guide to testosterone and sleep apnea explains why, and sleep apnea and erectile dysfunction covers a related overlap.

Can better sleep raise testosterone?

Better sleep may help, but the research can't promise it. The studies above mostly show what happens when sleep is cut short in healthy men. They don't show that a man with low testosterone will see his levels rise just by sleeping more.

That said, enough sleep is worth protecting for its own sake, and it costs nothing to try. A few habits help most people:

• Keep the same wake-up time every day, including weekends.
• Give yourself enough time in bed to get at least seven hours of sleep.
• Cut back on alcohol in the evening, which the NHS lists among the things that make snoring more likely.
• Stay off your back if you snore, since the NHS lists back sleeping as a snoring risk too.

Our guide to how much sleep adults need goes into the numbers, and can you catch up on sleep? explains what weekend lie-ins can and can't fix.

How does breathing at night fit in?

Breathing at night fits in because snoring can have a big impact on your life or your partner's, in the NHS's words, and is worth sorting out alongside your hours in bed. The NHS explains that snoring happens when the tongue, mouth, throat or nasal airways vibrate as they relax and narrow during sleep.

The NHS matches snoring treatments to the cause. For blocked or narrow airways in the nose, it lists nasal dilators or strips that hold the nose open. For a mouth that falls open during sleep, it lists a chin strap or a mouthpiece that helps you breathe through your nose. Our guide to nasal breathing and sleep quality explains why many people find nose breathing more comfortable at night.

If you snore, wake up with a dry mouth or suspect your mouth drops open at night, a nose-breathing routine such as the Titan Sleep System is one way to make your nights more comfortable. To be clear, no study shows that nasal strips or mouth tape change testosterone. The research in this article is about sleep, not about any product. Check your nose with our nose test first.

We don't recommend mouth tape for children.

When should you see a doctor?

See a doctor if you have symptoms of low testosterone or signs of sleep apnea. Cleveland Clinic says the most specific symptoms of low testosterone are sexual: low libido, loss of morning or spontaneous erections, and trouble getting or keeping an erection. Other signs it lists include depressed mood, trouble concentrating, more body fat and less muscle strength.

Don't rely on a single test or a home kit. The Endocrine Society recommends diagnosing low testosterone only in men with symptoms and consistently low levels, measured with fasting morning blood tests and repeated to confirm. Cleveland Clinic adds that being ill can temporarily lower testosterone, so mention it if you're unwell.

Sleep apnea needs its own check. The NHS says to see a GP if your breathing stops and starts while you sleep, you make gasping, snorting or choking noises, or you always feel very tired during the day. If someone has seen these symptoms, it can help to bring them along. Our list of sleep apnea warning signs has more detail.

See a doctor too if your nose is blocked most nights, since a long-term blockage deserves a proper look. If you're pregnant, ask your clinician before trying any new sleep product. This article is general information, not medical advice.

Our pick (paid partner): Titan Sleep System

For snoring or mouth breathing that's disturbing your sleep, our pick is the Titan Sleep System. We haven't tested or ranked sleep products ourselves; this is our recommendation, and it's about comfortable breathing at night, not testosterone.

Titan says the system pairs TitanAir Nasal Strips with Titan Bamboo Silk Mouth Tape as one nightly routine. Titan describes the strips as drug-free external nasal dilators with flexible spring-loaded bands, placed just above the flare of the nostrils on the soft part of the nose, not the bony bridge. It describes the tape as a soft, breathable bamboo silk strip worn horizontally across the lips, and suggests 20 to 30 minutes of daytime practice before the first night.

Titan says its products are third-party tested and certified PFAS-free, and its 30-night guarantee refunds you if your sleep isn't better after 30 nights.

Read next

• Testosterone and sleep apnea: can TRT make it worse?
• How much sleep do adults need?
• Sleep apnea warning signs

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.