Men’s Sleep: How Male Sleep Differs In Rhythm, Hormones, Problems

Quick Summary

• Men’s Internal Clocks Run Longer: On average, men have a slightly longer intrinsic circadian period, or internal body clock, than women. This biological tendency makes them more likely to be "evening types," or night owls, which can lead to misalignment with typical day-oriented schedules (Duffy et al., 2011).

• Sleep Loss Directly Reduces Testosterone: Insufficient sleep has a rapid and significant impact on testosterone. One study found that restricting sleep to five hours per night for just one week decreased daytime testosterone levels by 10-15% in healthy young men - an effect equivalent to aging 15 to 20 years (Leproult & Van Cauter, 2011).

• Males More Likely To Suffer From Sleep Apnea : Obstructive Sleep Apnea (OSA) is far more common in men and is known to lower testosterone levels.

• Deep Sleep Declines More Sharply with Age In Males: Men experience a more pronounced age-related decline in slow-wave sleep, the most physically restorative stage of sleep, compared to women. This loss can impact physical recovery, memory, and hormone regulation (Mong & Cusmano, 2016).

Understanding Men’s Sleep

While we often talk about sleep in universal terms, a growing body of science makes it clear: men experience sleep differently from women. From the fundamental timing of the male internal clock to risk for specific sleep disorders, these sex-specific patterns have significant consequences for a man's long-term health, hormonal balance, and daily performance.

So here we’re taking a more detailed look at key aspects of men's sleep, from how it changes over a lifetime to its direct impact on testosterone, and the specific sleep disorders that are more likely to affect men.

So how does a man’s sleep change over his lifetime?

How Does a Man's Sleep Change with Age?

As men get older, the quality and structure of their sleep often decline more noticeably than in women, particularly the amount of deep, restorative sleep they get.

While the basic sleep patterns of young adult men and women are generally similar on a regular seven to eight-hour schedule, measurable differences in sleep architecture, the pattern of different types of sleep your body cycles through each night, emerge and become more pronounced with age.

One of the most significant changes is the reduction in deep sleep (also called slow-wave sleep or NREM Stage 3). The decline in SWS begins during adolescence and continues steadily throughout a man's life.

Studies consistently suggest that men experience a larger age-related drop in this critical deep sleep stage compared to women (Mong & Cusmano, 2016; Redline et al., 2004). Research on older adults further highlights these differences. A large-scale meta-analysis found that older men had a higher arousal index (how often they woke up during the night) and a significantly higher apnea-hypopnea index (a score that shows how severe sleep apnea is) than women of the same age (Boulos et al., 2019).

Okay, so men get less deep sleep. Is this a problem?

Why is Losing Deep Sleep a Problem?

Losing deep sleep is a problem because this is the stage most responsible for physical repair, hormone regulation, and memory consolidation. During slow-wave sleep, the body releases the majority of its daily human growth hormone, which is essential for repairing tissues, building bone, and maintaining muscle mass. It is also a time when the brain clears out metabolic waste products that accumulate during waking hours.

Furthermore, the brain processes and strengthens memories during this stage, transferring important information from short-term to long-term storage. A consistent decline in SWS can therefore lead to feeling physically unrefreshed upon waking, slower recovery from exercise, and subtle cognitive deficits.

This age-related shift in sleep structure has real-world effects, but it isn't the only biological factor at play. A man’s natural sleep timing also follows a distinct pattern that differs from females.

How does a man’s sleep timing differ from a woman’s?

Why Are Men More Likely to Be 'Night Owls'?

Men are more likely to be "night owls" because their internal circadian rhythm, or body clock, tends to run a little longer than women’s. This makes men more likely to be ‘night owls’ - preferring to go to bed and wake up later.

Our sleep-wake cycle is governed by a master clock in the brain called the suprachiasmatic nucleus (SCN), which operates on a roughly 24-hour cycle. However, this internal cycle isn't exactly 24 hours for everyone.

In controlled laboratory studies that removed all external time cues like sunlight, researchers discovered that men’s intrinsic circadian period averaged 24 hours and 11 minutes. In contrast, women’s averaged 24 hours and 5 minutes (Duffy et al., 2011). This six-minute difference may seem small, but its effects are cumulative and significant.

What does a longer internal clock mean?

What Does a Longer Internal Clock Mean in the Real World?

A longer internal clock means men are more susceptible to a mismatch between their internal body time and the external 24-hour day.

This six-minute daily difference can lead to a "fourfold greater difference in how well your body’s internal clock matches up with the outside world’s schedule" compared to women (Wright et al., 2005). In simple terms, it creates a wider gap between when a man’s body wants to sleep and when his work or social schedule forces him to sleep.

This phenomenon, often called "social jetlag," can lead to chronic sleep deprivation, daytime fatigue, and difficulty maintaining alertness, especially in jobs that require early start times or around-the-clock operations.

This internal timing system doesn't just control when we feel sleepy; it also orchestrates the release of key hormones.

So, what happens to a man's hormones when sleep is disrupted?

What Is the Connection Between Sleep and Testosterone?

Testosterone production is closely linked to sleep, with levels naturally rising after sleep onset and peaking in the morning; therefore, insufficient sleep severely reduces these levels.

The endocrine system, the collection of glands that produce hormones, is tightly synchronized with our sleep architecture. For men, the primary sex hormone, testosterone, follows a clear daily rhythm dictated by the sleep-wake cycle. Testosterone levels are at their lowest in the late evening. After falling asleep, they begin to rise steadily, reaching their peak in the early morning hours, often around the time of waking (Luboshitzky et al., 1999).

Testosterone rises most during the first part of deep sleep, and this boost happens because you’re sleeping - not just because it’s nighttime. Studies have shown that even daytime sleep can trigger the release of gonadal hormones, highlighting the importance of getting adequate sleep for hormonal health (Axelsson et al., 2005).

However, this finely tuned system is easily disrupted. Chronic sleep loss has a profound and negative effect on testosterone production. In a landmark experiment, healthy young men had their sleep restricted to just five hours per night for one week. The results were striking: their afternoon and evening testosterone levels dropped by 10% to 15%. To put that in perspective, this reduction is equivalent to the normal hormonal decline seen after 15 to 20 years of aging (Leproult & Van Cauter, 2011).

What Sleep Disorders Are More Common in Men?

Men are significantly more likely to suffer from certain sleep disorders such as Obstructive Sleep Apnea, and REM Sleep Behavior Disorder. While some conditions like insomnia are more common in women, the overall landscape of sleep medicine reveals distinct areas of risk for men.

• Obstructive Sleep Apnea (OSA): OSA is the most prominent sleep disorder with a male predominance. Among adults aged 30 to 70, the estimated male-to-female ratio for moderate to severe OSA is about 2:1 (Peppard et al., 2013). In sleep clinics, that disparity can be even greater (Lin et al., 2008).

• REM Sleep Behavior Disorder (RBD): This is a condition where people move around or act out their dreams because their muscles aren’t paralyzed like they should be during REM sleep. Pooled data suggests that men account for nearly 80% of RBD cases. 

• Insomnia: While more women report insomnia, it carries a particularly serious risk for men. One major study found that men with insomnia who slept for less than six hours a night had a significantly increased risk of mortality compared to good sleepers (Vgontzas et al., 2010).

How Does Sleep Apnea Create a Vicious Cycle with Testosterone?

Testosterone replacement therapy is growing in popularity, driven by online influencers. Interestingly, obstructive sleep apnea (OSA), the most common male sleep condition, can create a vicious cycle by lowering testosterone through sleep disruption, while the common treatment for low testosterone - replacement therapy - can in turn make the sleep apnea worse. This dangerous feedback loop is a critical consideration for men's health, as one condition can mask and exacerbate the other.

The connection begins with Obstructive Sleep Apnea (OSA), a condition where breathing repeatedly stops and starts during sleep. As noted, OSA is significantly more common in men and is a primary driver of both sleep fragmentation and intermittent drops in blood oxygen levels, a state known as low oxygen levels in the blood during sleep.

How Does Sleep Apnea Lower Testosterone?

Sleep apnea lowers testosterone because the constant interruptions to sleep and drops in oxygen disrupt the brain's ability to regulate hormone production overnight. The nocturnal rise in testosterone is dependent on consolidated, healthy sleep, particularly the first few cycles of deep sleep. The frequent awakenings and physical stress on the body caused by OSA prevent this from happening effectively.

Multiple studies have confirmed a strong link between OSA and low testosterone, with the severity of the condition often correlating with the degree of hormonal suppression (Gambineri et al., 2003; Viana Jr et al., 2017). A man suffering from untreated OSA may go to his doctor complaining of classic low-T symptoms like fatigue, low energy, and reduced libido, leading to a potential prescription for testosterone. This is where the paradox begins.

Can Testosterone Replacement Therapy Make Sleep Apnea Worse?

Yes, testosterone replacement therapy (TRT) can make existing sleep apnea worse or even trigger it in susceptible individuals. While the exact mechanisms are still under investigation, it is believed that testosterone can affect the muscles and tissues of the upper airway, potentially reducing their stiffness and making them more likely to collapse during sleep. It may also alter the central nervous system's control over breathing patterns during sleep (Kim & Cho, 2018).

This creates a tricky situation: a man’s sleep apnea lowers his testosterone, so he gets testosterone therapy, but that therapy can actually make his sleep apnea worse.

What Is the Correct Treatment Sequence For Sleep Apnea And Low Testosterone?

The correct approach is to screen for and treat Obstructive Sleep Apnea before considering testosterone replacement therapy. Because of the risks, clinical best practice is to first evaluate a man's sleep health, especially if he presents with symptoms like loud snoring, daytime sleepiness, and fatigue alongside low testosterone.

If moderate to severe OSA is diagnosed, the primary treatment should be for the sleep disorder itself, most commonly with CPAP (a machine that gently blows air into your airway to keep it open during sleep). Once the OSA is effectively managed, a physician can then re-evaluate hormone levels to see if TRT is still necessary and, more importantly, if it is now safe to administer.

How Does Sleep Loss Impact Men in High-Performance Roles?

Sleep loss directly impairs performance by slowing reaction time, degrading judgment, and reducing physical output, which is a critical risk in high-stakes jobs and competitive athletics. In today's 24/7 world, many people, particularly men in demanding careers, trade sleep for longer work hours, but this trade-off comes at a steep cost to both cognitive and physical function (Basner et al., 2007).

Why is Sleep a Competitive Advantage for Athletes?

Sleep is a competitive advantage because it is essential for physical recovery, motor learning, and cognitive sharpness. Men involved in power sports like football and weightlifting may face an elevated risk for OSA due to factors like high body mass index and larger neck circumferences (George et al., 2003).

Conversely, prioritizing sleep can provide a significant edge. Sleep extension studies, where athletes intentionally sleep more than their usual amount, have demonstrated clear benefits, including faster sprint times in basketball players and improved serving accuracy in varsity tennis players (Mah et al., 2011; Schwartz & Simon, 2015).

What Practical Steps Can Men Take to Improve Their Sleep?

Men can take several practical steps to improve their sleep by aligning their lifestyle with their natural biology and proactively addressing potential disorders. Understanding the unique aspects of men's sleep is the key to making informed choices for your well-being.

How Can You Work With a 'Night Owl' Schedule?

The best way to work with a natural night owl tendency is to anchor your circadian rhythm with a consistent schedule and strategic light exposure.

• Get Morning Light: Expose yourself to bright, natural sunlight for 15-30 minutes as soon as possible after waking. This is the most powerful signal to reset your internal clock.

• Maintain a Consistent Wake Time: Even on weekends, try to wake up at roughly the same time. This helps stabilize your circadian rhythm far more than a consistent bedtime.

When Should You See a Doctor About Snoring and Fatigue?

You should see a doctor if your snoring is loud and persistent, and especially if it is accompanied by other key symptoms of sleep apnea. Don't dismiss these signs as normal. Consider speaking with a healthcare professional if you experience:

• Loud, disruptive snoring

• Witnessed pauses in breathing or gasping/choking sounds during sleep

• Excessive daytime sleepiness, despite spending enough time in bed

• Morning headaches

• Difficulty concentrating or memory problems

• Waking up with a dry mouth or sore throat

You can assess your risk of obstructive sleep apnea here. You can also find out more about diagnostic testing for obstructive sleep apnea here.

What Lifestyle Changes Support Men’s Hormonal Health?

Supporting your hormonal health involves a holistic approach where sleep is the foundation.

• Prioritize Sufficient Time For High Quality Sleep: Aim for 7 - 8 hours of sleep opportunity per night. The science is clear that restricting time for sleep directly lowers testosterone.

• Integrate Regular Exercise: Consistent physical activity is known to improve sleep quality and support healthy hormone levels.

• Manage Stress: Chronic stress elevates cortisol, a hormone that can interfere with both sleep and testosterone production. Incorporate stress-management techniques into your daily routine.

If you are concerned about your sleep, we always advocate talking to your primary care health provider in the first instance.

You can also talk to a NZ sleep clinic like The Better Sleep Clinic for sleep help. Whether it’s an Auckland sleep clinic, Wellington sleep clinic, Christchurch sleep clinic, Hamilton sleep clinic or anywhere in NZ, we can help. We specialise in the recommended insomnia treatment - CBT for insomnia as well as treatments for other sleep disorders (Note: we don’t treat breathing-related sleep disorders such as OSA).

Ask for a free chat below or book an assessment (no referral required) and get started addressing your non-breathing related sleep problems today.

Frequently Asked Questions: Men’s Sleep Patterns

Q1: Why are men more likely to be "night owls"?

A1: Men are more likely to be night owls because their internal body clock, or circadian rhythm, naturally runs a bit longer than women's. A study found men's internal clocks average 24 hours and 11 minutes, while women's average 24 hours and 5 minutes (Duffy et al., 2011). This small daily difference adds up over time, making men more likely to prefer later bedtimes and wake times.

Q2: How exactly does a lack of sleep lower testosterone?

A2: Testosterone production is closely tied to your sleep cycle, with levels rising after you fall asleep and peaking in the morning. This process relies on getting consolidated, deep sleep. When sleep is cut short or frequently interrupted, this natural hormonal rhythm is disrupted. One study showed that limiting sleep to just five hours a night for one week lowered young men's daytime testosterone levels by 10-15% (Leproult & Van Cauter, 2011).

Q3: How does sleep change for men as they get older?

A3: The most significant change for men is a sharper decline in deep sleep (also called slow-wave sleep) compared to women as they age (Mong & Cusmano, 2016). This is the most physically restorative stage of sleep, and it is important for tissue repair, hormone regulation, and memory. Research also shows that older men tend to wake up more frequently during the night and have a higher risk for sleep apnea than women of the same age (Boulos et al., 2019).

Q4: What are the classic signs of Obstructive Sleep Apnea (OSA) in men?

A4: The most common signs men should look for are loud and persistent snoring, waking up gasping or choking, and feeling excessively sleepy during the day even after spending a full night in bed. Other key signs include morning headaches, difficulty concentrating, and a partner noticing that you temporarily stop breathing during sleep.

Q5: Are there other sleep disorders besides sleep apnea that are more common in men?

A5: Yes. Besides OSA, men have a much higher prevalence of REM Sleep Behavior Disorder (RBD), a condition where a person physically acts out their dreams. Data suggests men account for nearly 80% of all RBD cases ("Men's Sleep Health," 2025). Additionally, while insomnia is reported more often by women, when men have insomnia combined with objectively short sleep (less than six hours), it is linked to a higher risk of mortality (Vgontzas et al., 2010).

References

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Basner, M., Fomberstein, K. M., Razavi, F. M., Banks, S., Goel, N., & Dinges, D. F. (2007). American time use survey: Sleep time and its relationship to waking activities. Sleep, 30(9), 1085–1095.

Boulos, M. I., Jairam, T., Kendzerska, T., Im, J., Mekhael, A., & Murray, B. J. (2019). Normal polysomnography parameters in healthy adults: A systematic review and meta-analysis. The Lancet Respiratory Medicine, 7(6), 533–543.

Duffy, J. F., Cain, S. W., Chang, A. M., St Hilaire, M. A., Gronfier, C., Klerman, E. B., & Czeisler, C. A. (2011). Sex difference in the near-24-hour intrinsic period of the human circadian timing system. Proceedings of the National Academy of Sciences of the United States of America, 108(Suppl. 3), 15602–15608.

Gambineri, A., Pelusi, C., & Pasquali, R. (2003). Testosterone levels in obese male patients with obstructive sleep apnea syndrome: Relation to oxygen desaturation, body weight, fat distribution and the metabolic parameters. Journal of Endocrinological Investigation, 26(6), 493–498.

George, C. F., Kab, V., Kab, P., & Kryger, M. H. (2003). Sleep and breathing in professional football players. Sleep Medicine, 4(4), 317–325.

Kim, S. D., & Cho, K. S. (2019). Obstructive Sleep Apnea and Testosterone Deficiency. The World Journal of Men's Health, 37(1), 12–18.

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Silber, M. H., St Louis, E. K., & Boeve, B. F. (2021). Rapid eye movement sleep parasomnias. In M. H. Kryger, T. Roth, & C. A. Goldstein (Eds.), Principles and practice of sleep medicine (7th ed., pp. 1093-1101.e7). Elsevier

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Viana, A., Jr., Daffon, A. C., Couto, A., Neves, D., de Araujo-Melo, M. H., & Capasso, R. (2017). Nocturnal hypoxemia is associated with low testosterone levels in overweight males and older men with normal weight. Journal of Clinical Sleep Medicine, 13(12), 1395–1401.

Wright, K. P., Jr., Gronfier, C., Duffy, J. F., & Czeisler, C. A. (2005). Intrinsic period and light intensity determine the phase relationship between melatonin and sleep in humans. Journal of Biological Rhythms, 20(2), 168–177.

Written By The Better Sleep Clinic

Reviewed By Dan Ford, Sleep Psychologist