Mouth Breathing, Sleep Apnea, and Low Testosterone

I was watching this Andrew Huberman video this morning and he was talking about testosterone levels in men and estrogen levels in women and what causes them to fall significantly.

I would recommed watching all of this video, but if you want to just see the part relasted to sleep apnea and mouth breathing, skip to 10:00.

As someone who has severe sleep apnea and wears a full face mask, I was shocked when said the number one culprit was sleep apnea. So I dug in and did the research.

Mouth breathing is often dismissed as a minor inconvenience, but emerging research suggests it can have far-reaching consequences on health—particularly for men.

One of the most concerning effects is its potential link to low testosterone levels. Testosterone plays a crucial role in muscle growth, metabolism, mood regulation, and sexual health.

Yet, many men experience a decline in this vital hormone due to factors they may not even be aware of, such as poor sleep quality and chronic mouth breathing.

If you’ve been diagnosed with sleep apnea, struggle with nasal congestion, or wake up with a dry mouth, it’s time to take a closer look at how mouth breathing could be silently sabotaging your testosterone levels.

In this article, we’ll explore the science behind this connection and provide actionable solutions to help improve both your breathing and hormonal health.

The Science of Mouth Breathing: Why It Matters

Mouth breathing occurs when an individual primarily breathes through their mouth instead of their nose. This can happen during the day, but it’s most concerning when it occurs at night. Several factors contribute to chronic mouth breathing, including:

Nasal congestion from allergies or sinus issues
Structural abnormalities like a deviated septum
Enlarged tonsils or adenoids
Habitual mouth breathing due to poor nasal breathing patterns

Mouth breathing isn’t just a minor nuisance; it disrupts the body’s natural respiratory processes.

Unlike nasal breathing, which filters and humidifies air, mouth breathing leads to dry airways, reduced oxygen intake, and increased likelihood of sleep-disordered breathing. Over time, these issues can take a toll on sleep quality and, in turn, hormonal balance.

The Link Between Sleep and Testosterone Production

Testosterone production follows a diurnal rhythm, meaning its levels fluctuate throughout the day.

The highest levels of testosterone are typically produced during sleep, particularly during the deep non-REM and REM sleep cycles. When sleep is disrupted—whether by sleep apnea, mouth breathing, or other disturbances—testosterone production takes a hit.

Research shows that just one week of restricted sleep (5 hours per night) can reduce testosterone levels in young, healthy men by up to 15%. Sleep deprivation not only lowers testosterone but also increases cortisol, the stress hormone that further suppresses testosterone production.

This is why addressing sleep-disordered breathing, including mouth breathing and sleep apnea, is crucial for maintaining healthy hormone levels.

Sleep Apnea, Mouth Breathing, and Testosterone: A Vicious Cycle

Obstructive Sleep Apnea (OSA) is a condition where the airway becomes partially or fully blocked during sleep, leading to repeated breathing interruptions. Many people with OSA unknowingly switch to mouth breathing due to the body’s attempt to compensate for airway obstruction.

How Sleep Apnea and Mouth Breathing Reduce Testosterone

Frequent Oxygen Drops (Hypoxia)
- When the airway is blocked, oxygen levels drop. This triggers a stress response in the body, leading to increased cortisol levels.
- Chronic hypoxia is associated with decreased testosterone production and reduced sperm quality in men.
Sleep Fragmentation
- Sleep apnea and mouth breathing cause frequent awakenings, even if you don’t remember them.
- Since testosterone is mainly produced during deep sleep, interruptions in these cycles lead to lower hormone production.
Increased Inflammation
- Sleep apnea is associated with higher levels of systemic inflammation, which has been linked to lower testosterone.
- Mouth breathing can contribute to chronic inflammation in the throat and nasal passages, further exacerbating the problem.
Weight Gain and Insulin Resistance
- Sleep apnea and poor sleep quality are directly linked to weight gain, which contributes to low testosterone.
- Excess fat, particularly around the abdomen, converts testosterone into estrogen, leading to hormonal imbalances.

These factors create a vicious cycle where poor sleep leads to lower testosterone, which in turn contributes to increased fatigue, weight gain, and further sleep disturbances.

Research Findings: The Testosterone-Mouth Breathing Connection

Several studies have examined the link between sleep-disordered breathing and testosterone levels:

A 2014 study published in the Journal of Clinical Endocrinology & Metabolism found that men with untreated OSA had significantly lower testosterone levels than those without the condition.
Research from PLOS ONE found that men with severe sleep apnea experienced a 30% reduction in testosterone levels compared to men without apnea.
Another study in The Journal of Sexual Medicine highlighted that treating sleep apnea with CPAP therapy led to improvements in testosterone levels over time.

These findings underscore the importance of addressing sleep apnea and mouth breathing to maintain optimal hormonal health.

Solutions: How to Stop Mouth Breathing and Improve Testosterone Levels

If you suspect that mouth breathing and poor sleep are affecting your testosterone levels, there are several strategies you can implement to improve both your breathing and hormonal health.

1. Use a CPAP Machine (If You Have Sleep Apnea)

Continuous Positive Airway Pressure (CPAP) therapy helps keep your airway open during sleep, preventing apnea episodes.
Studies show that CPAP users experience significant improvements in testosterone levels after consistent use.
If you struggle with mouth breathing while using CPAP, a full-face mask may be a better option.

2. Encourage Nasal Breathing

Nasal breathing is superior to mouth breathing because it increases nitric oxide production, which enhances oxygen absorption.
Try mouth taping at night (using a safe medical tape) to encourage nasal breathing.
Consider nasal dilators or nasal sprays if congestion is an issue.

3. Optimize Sleep Hygiene

Aim for 7-9 hours of uninterrupted sleep.
Keep your room cool, dark, and quiet.
Avoid blue light exposure before bed, as it can disrupt melatonin production.

4. Treat Nasal Congestion

If you have chronic nasal congestion, address it with:
- Saline nasal rinses or neti pots
- Antihistamines (if allergies are the cause)
- Nasal corticosteroid sprays
- A consultation with an ENT specialist for structural issues

5. Improve Your Diet and Exercise Routine

A balanced diet rich in healthy fats, protein, and micronutrients supports testosterone production.
Engage in strength training and high-intensity interval training (HIIT), which have been shown to naturally boost testosterone.
Maintain a healthy weight to reduce excess estrogen conversion.

6. Manage Stress and Cortisol Levels

Chronic stress elevates cortisol, which suppresses testosterone production.
Meditation, yoga, and breathwork can help lower stress and improve sleep quality.

7. Consider Supplements (With Caution)

Vitamin D: Linked to higher testosterone levels.
Zinc & Magnesium: Essential for testosterone production.
Ashwagandha: May help reduce cortisol and increase testosterone.

Always consult with a healthcare provider before adding supplements to your routine.

Final Thoughts: Take Charge of Your Breathing and Hormonal Health

Mouth breathing during sleep is more than just a bad habit—it can have profound effects on sleep quality, testosterone production, and overall health. If you wake up with a dry mouth, experience excessive fatigue, or suspect you have sleep apnea, taking action now can help prevent long-term hormonal imbalances.

Addressing the root causes of mouth breathing through nasal breathing techniques, CPAP therapy, and lifestyle changes can help restore normal testosterone levels and improve your overall well-being.

Don’t let poor sleep rob you of your vitality—take control of your breathing and reclaim your health today.