Sleep, testosterone and cortisol balance, and ageing men

Abstract

Sleep serves important biological functions, and influences health and longevity through endocrine and metabolic related systems. Sleep debt, circadian misalignment and sleep disruption from obstructive sleep apnea is widespread in modern society and accumulates with life because recovery sleep is not completely restorative. Accumulated disordered sleep throughout life impacts the ageing process and the development of age-related diseases. When epidemiological and interventional studies are considered collectively, sleep loss and lower sleep duration are associated with lower morning, afternoon and 24-h testosterone; as well as higher afternoon, but not morning or 24-h cortisol. These reciprocal changes imbalances anabolic-catabolic signaling because testosterone and cortisol are respectively the main anabolic and catabolic signals in man. Fixing testosterone-cortisol balance by means of a novel dual-hormone clamp mitigates the induction of insulin resistance by sleep restriction and provided the first proof-of-concept that the metabolic harm from sleep loss can be ameliorated by approaches that do not require sleeping more. Obstructive sleep apnea is associated with lower testosterone, even after controlling for age and obesity whereas the conclusion that continuous positive airway pressure therapy has no effect on testosterone is premature because available studies are underpowered and better-quality studies suggest otherwise. High dose testosterone therapy induces OSA, but more physiological dosing may not; and this effect may be transient or may dissipate with longer term therapy. Studies investigating the origin of the diurnal testosterone rhythm, the effect of circadian misalignment on testosterone-cortisol balance, and methods to mitigate metabolic harm, are required.

Association of sleep traits with male fertility: a two-sample Mendelian randomization study

“…Moreover, disturbances in sleep homeostasis are often accompanied by increased activity of the hypothalamic-pituitary-adrenal (HPA) axis, leading to elevated circulating levels of stress hormones (e.g., cortisol in humans, corticosterone in rodents). Elevated corticosteroid levels lead to decreased testosterone production ( Gao et al, 2002 ; Nollet et al, 2020 ; Liu and Reddy, 2022 ). These findings are consistent with the results of the present study.…”

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

“…However, direct comparisons between these studies are challenging due to differing study populations and doses. The relationship between sex hormones and sleep is likely complex, involving interactions with other hormones such as cortisol and inflammatory markers (Liu and Reddy, 2022). Longitudinal studies are necessary to further explore this complex relationship, specifically monitoring effects of AAS during withdrawal and use.…”

Metabolomic profiles of sleep-disordered breathing are associated with hypertension and diabetes mellitus development

“…Underlying mechanisms proposed to associate SDB with the cardiometabolic conditions include: chronic hypoxemia, particularly nightly exposures to intermittent hypoxemia and re-oxygenation 10 ; dysregulated proinflammatory responses 11 ; increased oxidative stress 12 , imbalanced gut microbiome 13 , hormonal imbalance 14 , among others. Emerging evidence has shown that intermittent hypoxemia, especially high frequency desaturations, modulates the inflammatory response differently from chronic sustained hypoxemia 15 .…”