How Might T and E2 Affect Sleep and Sleep Apnea?


  • I’ve been using an APAP machine since June for mild/moderate sleep apnea.
  • I’ve also been on TRT for 6 years.
  • For the first few months, my sleep was noticeably better and my numbers according to the machine were optimal in terms of treating the apnea.
  • In mid-August, I had to stop my TRT temporarily related to some other medical issues.
  • Within about a week of coming off TRT, my sleep started to suffer and my numbers started to tick upward on the sleep report (that’s bad). It meant my apnea was more prevalent.
  • As my numbers continued to fall due to no exogenous T, my sleep got worse and the apnea plateaued higher than the optimal numbers I had been getting every night previously.

So here’s what I’m wondering: what do we know about the relationship between T, E2, sleep, and sleep apnea? I had bloodwork after 3 full half-lives off testosterone, and my T and E2 were both extremely low. However, there was about a 10:1 ratio between T and E2 I had lots of symptoms of low T, but I’m also wondering how much of this was due to out of whack E2 numbers. From everything I’ve seen, that actually seems like too much E2 for the bottomed-out T levels I was showing. To ask this differently, how might high or low T or E2 affect sleep and sleep apnea?


Estrogen is the sleep hormone, so hormonal changes will affect sleep. When a woman enters menopause estrogen plumits and so to does sleep quality.

You have to get your T and E2 back up, the body wasn’t designed to function without sufficient hormones.

I’m back on shots as of 2 days ago, so I’m doing everything I can do get those numbers back up! Would your recommendation be to taper back up slowly or do a big shot to try to jump my numbers quickly?

If your previous protocol was what you would consider a successful one I see no need to take it slow unless you have a lot of anxiety the first time around.

What was your previous protocol and where did your SHBG sit?

Previous protocol was 45-50mg EOD for a total of 155-175 / week averaged out over two weeks (7 shots in a 2 week period). SHBG was 23.3 nmol/L (16.5-55.9 ref range). Was using a little Aromasin when that was taken.