Functional medicine doctors refer to the interplay of hormones throughout the body as the “hormone dance.” Having enough testosterone that works the way it is supposed to is not a simple formula of hormone in, function out. It is a much more complex interplay throughout our bodies.

Many men suffering signs of testosterone deficiency such as fatigue, lowered libido, loss of muscle mass, depression, and weak erections will find that numerous factors contribute to their hormonal dysfunctions.

How you live your life on a daily basis has a tremendous impact on how your hormones work. Sleep deprivation is a factor that is often overlooked because it isn’t easy to test for and treating it really requires comprehensive changes on the patient’s part. Knowing about these issues will help you put your health in your own hands!

The data on sleep and testosterone is extensive. At the severe end of the spectrum, men with obstructive sleep apnea have been found to have significant drops in testosterone levels throughout the day, as compared with those who do not have sleep apnea.[1]

But it is not just diseases like sleep apnea that cause problems. Both long-term (sleeping every night but not enough hours) and short-term (skipping an entire night of sleep) sleep deprivation bring down testosterone.

In a study of otherwise healthy men who missed just one night of sleep, the men had significant drops in their testosterone levels the very next day![2,3]

Men who only get 4 or 5 hours of sleep per night for just a few days also show drops in testosterone, even if they get 10 hours of sleep the night immediately before the period of sleep deprivation.[4] Testosterone levels drop by 10-15% in young healthy men after just one week of 5 hours of sleep, compared to the drop of 1-2% per year that is commonly seen with aging.[5]

In an attempt to make up for the missed sleep, researchers had subjects practice extended sleep (10 hours a night) versus regular sleep (8.5 hours a night) for 6 days before keeping them up for 24 hours. They found, as expected, significant drops in testosterone levels after being kept up for 24 hours and then getting a night of recovery sleep.[6] All the extra sleep before and after wasn’t enough to prevent the drop from just one night of sleep deprivation!

Another study has shown that in men with chronic sleep deprivation during the week, having 3 nights of “catch-up sleep” on the weekends (10 hours) did raise their testosterone levels.[7] Catch-up sleep is important if you are deprived of sleep, but continuing to not get enough sleep on a frequent basis will keep your testosterone levels far lower than you need for true well-being.

We can conclude from all of this data that one of the keys for producing healthy levels of testosterone every day is to get a good night’s sleep. If your lifestyle prevents this, look closely at what you can change. If you have medical issues keeping you from sleeping well, seek out a functional medicine practitioner or other health care provider who can help you sort this out!


  1. Ghiciuc CM, Dima-Cozma LC, Bercea RM, Lupusoru CE, Mihaescu T, Cozma S, Patacchioli FR. Braz J Otorhinolaryngol.Imbalance in the diurnal salivary testosterone/cortisol ratio in men with severe obstructive sleep apnea: an observational study. 2015 Dec 17. pii: S1808-8694(15)00241-4. doi: 10.1016/j.bjorl.2015.09.004. [Epub ahead of print]
  2. Jauch-Chara K, Schmid SM, Hallschmid M, Oltmanns KM, Schultes B. Pituitary-gonadal and pituitary-thyroid axis hormone concentrations before and during a hypoglycemic clamp after sleep deprivation in healthy men. PLoS One. 2013;8(1):e54209. doi: 10.1371/journal.pone.0054209. Epub 2013 Jan 10.
  3. Cote KA, McCormick CM, Geniole SN, Renn RP, MacAulay SD. Sleep deprivation lowers reactive aggression and testosterone in men. Biol Psychol. 2013 Feb;92(2):249-56. doi: 10.1016/j.biopsycho.2012.09.011. Epub 2012 Oct 6.
  4. Reynolds AC, Dorrian J, Liu PY, Van Dongen HP, Wittert GA, Harmer LJ, Banks S. Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men. PLoS One. 2012;7(7):e41218. doi: 10.1371/journal.pone.0041218. Epub 2012 Jul 23.
  5. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011 Jun 1;305(21):2173-4. doi: 10.1001/jama.2011.710.
  6. Arnal PJ, Drogou C, Sauvet F, Regnaud J, Dispersyn G, Faraut B, Millet GY, Leger D, Gomez-Merino D, Chennaoui M. Effect of sleep extension on the subsequent testosterone, cortisol and prolactin responses to total sleep deprivation and recovery. J Neuroendocrinol. 2015 Dec 9. doi: 10.1111/jne.12346. [Epub ahead of print]
  7. Killick R, Hoyos CM, Melehan KL, Dungan GC, Poh J, Liu PY. Metabolic and hormonal effects of ‘catch-up’ sleep in men with chronic, repetitive, lifestyle-driven sleep restriction. Clin Endocrinol (Oxf). 2015 Oct;83(4):498-507. doi: 10.1111/cen.12747. Epub 2015 Mar 6.

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