How Low Testosterone Affects Sleep

Testosterone is an important hormone for men and women, but its effects aren't limited to the reproductive system.

Your mood, bone strength, and sleep cycles are just a few of the functions that are also impacted by testosterone levels. Too much or too little testosterone can cause problems, but a high testosterone level is not a problem that many men experience naturally.

Low testosterone levels are more common, and this article will explore the impact this can have on sleep in particular. Read on to learn more about normal testosterone ranges and what testosterone replacements are recommended.

Man and woman asleep in bed

Willie B. Thomas / Getty Images

Low vs. Normal Testosterone

Normal testosterone levels are different for men and women and change throughout our lifetimes. For men, testosterone levels drop gradually with age at a rate of 1% to 2% each year.

In women, testosterone production peaks in a woman's 20s and then declines gradually. However, unlike estrogen, testosterone is still produced in women after menopause.

Normal Testosterone Ranges

Men: 300-1,000 ng/dL

Women: 15-70 ng/dL

Low testosterone levels are anything below those normal ranges and can occur for a number of reasons. Some common reasons for testosterone levels to drop are:

  • Chronic diseases like diabetes
  • Malfunctions or tumors in the pituitary gland
  • Obesity
  • Stress
  • Advanced age
  • Alcohol abuse
  • Testicular diseases or trauma
  • Poor thyroid function
  • Obstructive sleep apnea
  • Medication side effects

How Does Testosterone Affect Women?

Testosterone isn't just a male hormone. It's also an important part of women's health and is made in the ovaries and adrenal glands. This chemical plays a role in many of the same systems as it does in men, including:

  • Reproduction
  • Bone health
  • Cognition
  • Energy


Symptoms of low testosterone levels are different for men and women.

In men, the most common symptoms of low testosterone include:

  • Low sex drive
  • Impotence
  • Depressed mood
  • Inability to concentrate or loss of memory
  • Infertility
  • Loss of muscle mass
  • Hair loss
  • Weakened or brittle bones
  • Male breast enlargement (gynecomastia)

In women, symptoms of low testosterone are often dismissed as psychological, but can include:

  • Fatigue
  • Depressed mood
  • Memory loss
  • Poor sleep
  • Low sex drive

Why A Healthy Testosterone Level is Important

Testosterone isn't just a reproductive hormone. It plays a role in a number of other body systems, impacting muscle and bone development, hair growth, behavior, cognition, and more.

There are several risk factors for a testosterone imbalance, including obesity, pituitary gland tumors, and congenital disorders like Klinefelter syndrome. Talk to your healthcare provider if you are concerned about how your testosterone level may be impacting your health.

Sleep and Testosterone Levels

There are many things that can impact our sleep quality, and testosterone is one of them.

Testosterone plays a role in the timing and organization of circadian rhythms, a type of internal clock. During puberty, testosterone levels increase and we start to stay awake later. Sleep deprivation or restriction, on the other hand, can cause testosterone levels to drop.

Testosterone levels and sleep typically work in harmony, with levels rising when we wake and dropping throughout the day. There are bursts of testosterone production throughout the day, too, usually about every hour-and-a-half. During sleep, testosterone levels are replenished, rising gradually and peaking for most men during the REM sleep cycle.

Although low testosterone levels at the start of sleep are natural, the longer it takes to reach REM sleep, the longer it will take for testosterone levels to rise. Disruptions in REM sleep—the deepest sleep stage where dreaming usually occurs—can be caused by things like:

Limiting things that can disturb sleep or addressing conditions that can lower testosterone levels may help, but there is some debate on when testosterone replacement works best. In one study, obstructive sleep apnea was linked not to testosterone levels, but to obesity. Weight loss helped improve the condition, while testosterone replacement didn't help or worsen the severity of sleep apnea.

Are Low Testosterone and Sleep Apnea Related?

A number of studies have linked low testosterone levels to sleep apnea in one way or another. The leading theory is that low testosterone levels are caused in part by sleep disorders that are common in people with sleep apnea like:

  • Loss of REM sleep
  • Fragmented sleep
  • Reduced overall sleep time
  • Increased wakings
  • Lower sleep efficiency

Many of these are caused by apnea, or lack of breathing, and the resulting hypoxia it causes. Interrupted breathing causes a host of sleep problems, which in turn can impair testosterone production.

How to Increase Testosterone

There are several ways to increase your testosterone level. Some of these deal with removing lifestyle factors or issues that can cause your testosterone level to drop, and others involve supplementing to make up for low testosterone.

Below are a number of options for addressing a low testosterone level. You should talk to a healthcare professional to find the best option for your specific situation.

Reduce Testosterone Loss

One way to address low testosterone is to prevent testosterone loss caused by things like:

  • Drug use
  • Alcohol abuse
  • Poor sleep
  • Obesity or weight gain
  • Diabetes or other metabolic syndromes

Increase Testosterone Naturally

There are also some ways that could help you increase your testosterone levels naturally. These include:

  • Maintaining a healthy weight
  • Exercise
  • Reduce stress
  • Quit smoking
  • Practice good sleep habits

Testosterone Supplementation

If these methods don't work for you, your healthcare provider may consider prescribing you testosterone replacement therapy. These can be taken a variety of ways including:

  • Topical gel or cream
  • Injections, long- or short-acting
  • Oral pills
  • Pellets inserted below the skin
  • Intranasal gel

There are also a number of over-the-counter products that claim to boost testosterone production, but a recent study found little proof to back up these promises.

According to the study, while 90% of the 50 products tested claimed to increase testosterone, strength, and sex drive, just 24.8% were able to provide data to support their claims. The study also noted that 10% of the ingredients in the tested products are actually known to have a negative effect on testosterone levels.

A Word From Verywell

Low testosterone levels can have a big impact on both men and women. Loss of muscle and sex drive are commonly associated with low testosterone, but it is linked to poor sleep as well.

If you have symptoms of low testosterone or a known condition or injury that may reduce your testosterone production, talk to your healthcare provider about safe ways to boost your testosterone with medications or natural methods. Living a healthy lifestyle, avoiding drugs and alcohol, maintaining a healthy weight, and having a good sleep schedule may also help keep testosterone levels in balance.

Frequently Asked Questions

  • How can you tell if you have low testosterone levels?

    Your doctor may suspect your testosterone levels are low based on your symptoms and a physical examination, but a blood test is a more accurate way to diagnose an abnormal testosterone level.

  • What is considered a low level of testosterone?

    For men, under 300 ng/dL is considered low, and under 15 ng/dL is low for women.

  • What causes low testosterone levels in women?

    Just like in men, testosterone in women decreases with age. Lifestyle choices like alcohol and drug use can also play a role.

  • Where is testosterone produced?

    Testosterone is produced mainly in the testicles for men, and in the ovaries for women. Both men and women also produce some testosterone in the adrenal glands.

  • What are the effects of high testosterone?

    High testosterone is rare in men without the use of steroid replacements, but it can cause things like aggression, acne, and sleep problems. In women, high testosterone can develop with polycystic ovary syndrome.

  • What foods increase testosterone levels?

    Foods cannot increase testosterone levels, but too much of certain foods—like sugar—can cause increased obesity and other issues that can cause your testosterone levels to drop.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Rachael Zimlich, BSN, RN
Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.