Decreased Sleep Associated With Lower Testosterone Levels Interview with:
Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​Premal Patel, MD, PGY-5
University of Manitoba What is the background for this study? What are the main findings? What should readers take away from your report?

Response: Within the literature there has only been small experimental studies which looked at impaired sleep and testosterone. To our knowledge, there has been no study that has evaluated sleep and testosterone using a population dataset. We utilized the National Health and Nutrition Examination Survey to assess the association of sleep with serum testosterone. NHANES examines a nationally representative sample of about ~5000 persons each year.

After performing a multivariate linear regression of numerous variables within the NHANES database (age, marital status, prior co-morbidities, number of hours of sleep, etc…) we found that a reduction in the number of hours slept, increasing body mass index and increasing age were associated with lower testosterone levels.

Given that this is a cross-sectional analysis, we are unable to provide causality of this relationship but we do feel it is important to counsel patients with low testosterone about the importance of living a healthy lifestyle which includes a well-balanced diet, exercise and sufficient sleep. What recommendations do you have for future research as a result of this work?

Response: The next steps are to continue to probe this relationship between altered sleep habits and altered testosterone levels. We will likely evaluate other large datasets to further confirm the relationship between these variables but will also need to determine the clinical applicability of these findings. Does impaired sleep lead to lower serum testosterone levels and subsequently signs/symptoms of low testosterone? These important questions will only be able to be answered with well-constructed prospective studies. Is there anything else you would like to add?

Response: This is a cross-sectional study and therefore has inherent limitations that need to be understood when taking home our results. We are unable to say a reduction in the number of hours of sleep causes low testosterone but that we found that in men aged 16-80 within the NHANES database that there is an association between low number of hours of sleep and decreasing serum testosterone. This is very important because the only way to truly conclude that reducing your sleep will impair your testosterone is with a prospective study.

Citations: AUA 2018 abstract

Impaired Sleep is Associated with Low Testosterone in U.S. Adult Males: Results from the National Health and Nutrition Survey:

Prem lPatel, TaylorKohn, Ranjith Ramasamy

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Last Updated on May 23, 2018 by Marie Benz MD FAAD