Sleep and Testosterone Levels: What's the Connection?

Take-home points

• ‍‍Testosterone levels vary during the day and are highest during sleep.
• Lack of sleep can reduce testosterone by 10–15% in healthy young men.
• Rapid eye movement sleep is particularly important for testosterone production.
• Low testosterone can also negatively affect sleep. If you are experiencing issues with sleep, it's recommended to visit your healthcare professional.

What is testosterone?  

Testosterone is a sex hormone that’s naturally found in the body. Whilst many people think of it as a male hormone, it’s also found in women.¹ In men, testosterone is mainly produced in the testicles, with some also made in the adrenal glands (special glands found on top of your kidneys).² It works all around the body, affecting muscle and bone strength, libido, brain function, and hair growth.

Naturally-occurring high testosterone is rare, although this may partly be because testosterone tests aren’t always very accurate.³ However, low testosterone is much more common, affecting between 10-40% of people globally.⁴

Ageing is a common cause of low testosterone. From 30 onwards, levels can drop up to 2% a year.⁵ Several other factors can lead to low testosterone, including thyroid issues, cancer treatment, long-term health conditions, and poor sleep. We’ll explore the relationship between testosterone and sleep below.

Learn more about how ageing influences testosterone levels

What’s the link between testosterone and sleep?  

Testosterone levels vary through the day and are linked to your circadian rhythm – regular body changes over a 24-hour period. The high and low points happen at regular fixed points in the day.⁶

During sleep, testosterone levels begin to rise before peaking between 7 am–10 am and eventually reaching a low point in the mid-afternoon.⁷ Levels slowly rise once you fall asleep, and rapidly increase during the first rapid eye movement (REM) cycle.⁸

What is REM sleep?

• REM sleep is the part of sleep where your brain is most active. Your eyes move quickly (although they’re still closed) and you’re most likely to dream. During REM, your body functions similarly to when it’s awake. Your brain is consolidating information and getting itself ready to wake back up.  

The first three hours of sleep are important, as this is the average time it takes for men to reach the first REM cycle. However, normal sleep throughout the night is also needed to maintain testosterone production.⁹

How does lack of sleep affect testosterone?

It’s clear that sleep is needed for your body to produce testosterone. But what happens if you’re not getting enough?

We mentioned the importance of REM sleep, which only happens after a few hours of non-REM sleep. If you’re not sleeping for long enough, or you’re waking up throughout the night, you don’t progress into REM sleep. This can disrupt your body’s production of testosterone.⁹

One study found that young healthy men who only slept for 5 hours a night had a 10-15% reduction in testosterone production.¹⁰ The lower levels of testosterone were associated with mood changes and lower energy levels.

Both lack of sleep and disrupted sleep can negatively impact testosterone levels.

Can sleep disturbance be a sign of hypogonadism (low testosterone)?

The relationship between sleep and testosterone goes both ways. Poor sleep can affect the production of testosterone, but low testosterone can also disrupt sleep.

Several studies have shown that low testosterone negatively affects sleep in both older and younger men.^7,11 Poor sleep may suggest an issue with low testosterone, meaning your testicles aren’t producing enough (hypogonadism). To confirm this, a doctor will need to measure your testosterone levels with a blood test and investigate the cause. With testosterone replacement therapy, sleep quality usually improves.⁷

Learn more about the benefits of testosterone replacement therapy for hypogonadism treatment

Tips on how to improve your sleep

We’ve discussed how important sleep is for normal testosterone levels, but many of us aren’t getting enough of it. With a few small changes, you can improve your sleep quality and your testosterone levels.

Our top 5 tips on how to improve your sleep include:

1. Stick to a set sleep routine

This means going to bed and waking up at the same time every day if you can. Even on the weekends.

2. Ditch the screen before bed

Electronic screens emit blue light that can interfere with your circadian rhythm. Try to avoid all screens (including your phone) for at least an hour before bed.

3. Make your bedroom comfortable

A quiet, dark bedroom will help you feel more relaxed and sleepier. Try to keep your bedroom temperature between 16-18°C for the best sleep.  

4. Avoid food and certain drinks before sleep

Caffeine and large meals before bed can keep you up – try to avoid them late in the evening. Alcohol can feel relaxing, but as even a small amount affects your sleep quality, it’s best to limit your drinking.

5. Make yourself tired in the day

Physical activity in the day can help you sleep better at night. Try to plan your exercise for earlier in the day though, as working out just before bed can make it harder to get to sleep.  

Avoid napping if you can. If you can’t, it’s better to nap earlier in the day, and for less than 30 minutes.

Is sleep that important for testosterone levels?

In short, yes.  Getting around 8 hours of good-quality sleep a night will help keep your testosterone levels healthy. If you’re sleeping badly and not sure why, or worried you might have low testosterone, talk to your doctor – it might be the sign of a medical condition.

References

1. ‍‍Davis SR, et al. Lancet Diabetes and Endocrinology 2015;3:980-992.
2. Jones H. Testosterone Deficiency in Men 2012;9–20.
3. Vesper HR, et al. Journal of Steroid Biochemistry and Molecular Biology 2010;121:513-519.
4. Anaissie J, et al. Translational Andrology and Urology 2017;6:183-191.  
5. McBride JA, et al. Therapeutic Advances in Urology 2016;8:47-60.
6. Shlykova N, et al. Journal of Urology 2020;203:817-823.  
7. Wittert G. Asian Journal of Andrology 2014;16:262-5.
8. Luboshitzky R, et al. Journal of Andrology 1999;20:731–7.
9. Luboshitzky R, et al. Journal of Clinical Endocrinology and Metabolism 2001;86:1134–9.
10. Leproult R, et al. JAMA 2011;305:2173-4.
11. Barrett-Connor E, et al. Journal of Clinical Endocrinology & Metabolism 2008;93:2602–2609.