What is Low T
For middle-aged and older men, low testosterone is just a natural part of life. For the average male, they reach peak levels of testosterone around the age of 20 and see the levels decline each subsequent year, especially after the age of 30. This unfortunate byproduct of the aging process is considered a form of secondary hypogonadism, which refers to a testosterone deficiency that is the product of an issue with the pituitary gland and/or hypothalamus. While plenty of men struggle with primary hypogonadism, where the testosterone deficiency can be attributed to a problem with the testicles, secondary hypogonadism is a more common source of age-related testosterone deficiency. These low levels of testosterone lead to high estrogen, and that imbalance leads to a wide array of symptoms for men as they age.
How Low Testosterone Can Affect Sleep
The cause of insomnia in men often varies significantly from the causes of insomnia in women. The low testosterone associated with andropause (the male version of menopause) can contribute to sleep apnea in men, which can then lead to insomnia or other sleep problems. Sleep apnea is the interruption of or difficulty of breathing during sleep. It affects approximately 9 percent of adult males and is more common in obese males. The inhibited breathing and loud snoring, common of sleep apnea, tends to disrupt sleep many times throughout the night. The disruptions affect both the person suffering from sleep apnea as well as anyone who might be trying to sleep near them. Fortunately, testosterone therapy has been shown to improve the symptoms of sleep apnea. Furthermore, slow wave or deep sleep is easier to achieve with normal testosterone levels. Thus, men typically see improvement in sleep in various ways when testosterone levels are optimal.
In men, insomnia resulting from low testosterone and sleep apnea can lead to several other problems, including fatigue, reduced insulin sensitivity, low human growth hormone levels, and high cortisol levels. Cortisol, the stress hormone, will increase with prolonged insomnia because of the stress on the body. Constant high levels of cortisol can create a hormone pattern that further reduces testosterone production. It can also lead to adrenal fatigue which often worsens the fatigue and insomnia. All of these factors will feed off each other in a feedback loop if left unchecked.
Additionally, human growth hormone (hGH) is naturally made during the first 90 minutes of sleep. Therefore, if your sleep is disrupted, your growth hormone production is reduced. This can lead to lower levels of testosterone and reduced lean muscle mass. Sleep is also very important for proper insulin sensitivity and glucose control. If sleep is disrupted, the body stops utilizing insulin as effectively and the body begins to need more and more insulin to control blood sugar. This leads to weight gain and a pre-diabetic state that, if not well managed, can lead to diabetes.
Obstructive Sleep Apnea vs. Central Sleep Apnea
Obstructive Sleep Apnea (OSA) is caused by obstructed breathing, either due to too much tissue (as seen in obesity) or decreased muscle tone (which is a common symptom of low testosterone). This inhibits the air flow in the mouth and nose, which causes snoring and decreased ability for adequate oxygenation during sleep. As a result, men often wake up numerous times during the night and rarely achieve deep sleep. Central Sleep Apnea (CSA) is a central nervous system disorder in which the brain signal for breathing is delayed. CSA if often caused by injury or disease affecting the brain stem. However, most cases of sleep apnea caused by low testosterone is obstructive sleep apnea.
Other Common Symptoms of Low Testosterone
When it comes to discussing the symptoms of testosterone deficiency, poor sleep is really just the tip of the iceberg. The fact is, low levels of testosterone (and the correlating high estrogen levels) wreak havoc on men as they grow older. To make matters even worse, andropause is marked by a process in which testosterone converts to estrogen due to a reaction with an enzyme known as aromatase. This imbalance becomes harder to avoid as men age, especially if it is combined with poor diet and a lack of exercise. Here are just some of the other symptoms associated with testosterone deficiency and estrogen dominance:
- Erectile Dysfunction
- Reduced sex drive
- Hair loss
- Gynecomastia (male breasts)
- Vasomotor symptoms (hot flashes and night sweats)
- Weight gain
- Loss of muscle mass
- Memory loss
How to Treat Low Testosterone
There are ways to naturally boost levels of testosterone, mostly by eating foods that are rich in protein and other essential nutrients. Some of these foods include beef, beans, eggs, oysters, shellfish, and vitamin D milk. Eating this kind of healthy diet is crucial in maintaining the balance between testosterone and estrogen levels, but a healthy diet alone becomes less effective for men as they drift further into andropause.
However, combining testosterone replacement therapy with an individualized nutrition plan, a targeted supplement regimen, and other strategic lifestyle changes may be able to relieve sleep problems and other debilitating symptoms of inadequate levels of testosterone. Optimal levels of testosterone combined with proper nutrition and exercise can reduce the hormonal and lifestyle causes of obstructive sleep apnea. Furthermore, your BodyLogicMD-affiliated practitioner can measure and balance cortisol, insulin, and other hormone levels thrown off by the sleep apnea.
Contact a BodyLogicMD-affiliated bioidentical hormone specialist near you to schedule an appointment and learn more about sleep apnea treatment that includes bioidentical hormone replacement. See how a comprehensive treatment plan developed by a practitioner of the BodyLogicMD network can be used to restore normal testosterone levels and relieve the effects of sleep apnea.