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The levels of Testosterone in sleep deprived and sluggish drivers

Ghulam NABI1, Muhammad AMIN2, Muhammad SHUAIB1, Rahim ULLAH1, Saleem Ur

RAHMAN3, Ayaz Ali KHAN3

Affiliation:

Department of Animal Sciences, Quaid-i-Azam University Islamabad, Pakistan

Department of Zoology, University of Karachi, Pakistan

Department of biotechnology, University of Malakand Chakdara, Dir (L), Khyber

Pakhtunkhwa, Pakistan

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Correspondence: ghulamnabi751@rocketmail.com

Abstract

Aim: The aim of the present study was to find out the effects of long term sleep

deprivation and exercise on total serum testosterone level.

Materials and Methods: The present study was conducted at Mingora and Timergara in

District Swat and District Dir respectively, Khyber Pakhtunkhwa, Pakistan. Blood samples

were taken from 50 sleeps deprived sluggish drivers and from 50 normal people of the

same locality. A standard format questionnaire was designed regarding their age, marital

status, number of children, mating frequency, duration and timing of sleep, aggression and

habit of exercise. Bio-check (USA) kit was used according to the manufacturer protocol.

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Results: The mean and standard deviation of total serum testosterone in control was 650

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110 ng/dl (P < 0.0001) and in drivers was 410 33 ng/dl (P < 0.0001). The results showed

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a significant difference.

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Conclusion: Total serum testosterone level was significantly lower in sleep deprived and

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sluggish drivers as compared to control group. This difference indicates that sleep

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deprivation and lack of exercise has a negative effect on testosterone level.

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Key words: Sluggish, Exercise, Testosterone, Sleep

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1. Introduction

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In the industrialized countries the duration of sleep has been considerably

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decreased during last decades. Sleep is very crucial for skeletal muscles and other

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physiologies. Chronic sleep deprivation has serious consequences such as producing

muscle atrophy by increasing glucocorticoids and decreasing testosterone, growth hormone

and insulin-like growth factor-I. It is also a risk factor for the chronic diseases such as

cardiovascular diseases, metabolic syndromes, cancer and hormonal imbalance. However

by performing resistance exercises the level of testosterone, growth hormone and insulin-

like growth factor-I can be slightly raised (1). Marcello et al (2) stated that sleep deprived

people are in stress condition and this causes hormonal imbalance by secreting more

cortisol, thyroid and less Testosterone, dehydroepiandrosterone-sulphate and insulin like

growth factor-1 levels. Sleep has a direct modulatory influence on the activity of

Hypothalmo Pituitary Adrenal (HPA) axis and other hormonal axes. Sleep deprivation is

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an example of stressor and has serious consequences depending upon its duration. Kamila

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et al (3) experiment resulted that sleep deprivation affects the pituitarygonadal and

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pituitary- thyroidal axis by lowering the level of testosterone, prolactin and raising the

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level of thyroid stimulating hormone (TSH), free tri-iodothyronine (fT3), and free thyroxin

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(fT4) as compared to control group. Lee et al (4) found that those fathers who sleep with

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their children at night and provide care to their children have low morning testosterone

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level as compared to those fathers who do not sleep at night with their children and do not

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provide care. This difference in morning testosterone occurs because the co-sleeper fathers

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have a disturbed sleep because of their children. According to Xiujun et al (5) different

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types of exercise of moderate-intensity may reduce age-related physiological dysfunction

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associated with inflammation and oxidative stress by increasing expression and activity of

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the nuclear factor erythroid 2-related factor (Nrf2), a transcriptional regulator of the

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cellular anti-oxidant system which ultimately leads to high testosterone level in serum.

Kvorning et al (6) concluded that strength training even in aging men slightly increases

testosterone resulting in increased muscle function. O'Leary et al (7) documented that even

in trained eu-menorrheic women short-term elevations in testosterone can be induced by

prolonged aerobic exercise. This increase may result from either increased androgen

production and/or decreased degradation rates of the hormone, and are not solely the result

of plasma fluid shifts from the exercise. In the present study morning blood samples were

taken from the sleep deprived and exercise deficient professional drivers and from people

who take 8 hours sleep and regular exercise. The objective of the study was to find the

effects of sleep deprivation and lack of exercise on morning testosterone level.

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2. Material and Method

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2.1., Questionnaire

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For the present study a standard format questionnaire was designed for collecting particular

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information from the sleep deprived and exercise deficient drivers and from the control

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people regarding their age, marital status, number of children, aggression, mating

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frequency, duration and timing of sleep and habit of exercise.

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2.2., Data collection

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During sampling, 100 (50 sleep deprived and exercise deficient drivers and 50 controls)

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male individuals were selected. Before taking interviews a written consent was signed from

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all the individuals. The morning blood samples from the drivers and control were collected

in Mingora and Timergara, at district Swat and Dir (Lower), Khyber Pakhtunkhwa, Pakistan,

from 14 August 2013 to 28 August 2013.

2.3., Blood sampling from sleep deprived and exercise deficient drivers

5 ml of the blood was taken from 50 sleep deprived and exercise deficient professional

drivers and transferred into glass Vacutainer tubes (Becton Dickinson) without

anticoagulant or preservative. Serum was obtained after centrifugation at 3200 rpm at 4C.

Samples were transferred on dry ice to various participating laboratories for immediate

analysis. The remaining samples were stored at 20 C. Serum level of total serum

testosterone was measured using testosterone enzyme immunoassay test kit, Bio-check

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(USA) according to the manufacturer protocol.

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2.4., Blood sampling from control

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The people living around the bus stations in the same area were taken as control. A total of

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50 people were randomly selected from the given areas. For the collection and analysis of

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blood samples same procedure was adopted as for drivers. The individuals selected were

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physically normal, have no history of chronic diseases, addiction and were not using any

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medications.

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2.5., Statistical analysis

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The results obtained were statistically analyzed by using Graphpad Prism, Demo version

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05 (www.graphpad.com). The results were represented through mean and standard

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deviation and the comparison between two groups was performed by using student T-test.

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P value < 0.05 was considered to be statistically significant.

3. Results

3.1., History of drivers and control

Two groups were made; control and drivers. Each group was then divided into 3 age

groups ranging from 25 to 55 years. Specific information from both control and drivers

were collected via a standard questionnaire from various age groups and are summarized in

Table 1.

3.2., Comparative analysis of Serum Total Testosterone in Control and Drivers

The total serum testosterone level in drivers was 410 33 (ng/dl) and in control the level

was 650 110 (ng/dl), while the P value was < 0.0001. There was a significant difference

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in the result of both groups. The results of total serum testosterone level of both groups are

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listed in table 2.

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Discussion

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In the present study we analyzed the ill effects of sleep deprivation and lack of exercise on

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the sleep deprived and sluggish drivers. Sleep deprivation and sluggishness is a common

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phenomenon in both industrialized and developing countries and produces ill effects on

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general health. In the developing countries like Pakistan, particularly in Khyber

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Pakhtunkhwa the awareness about this problem is lacking.

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Chronic sleep deprivation produces serous health effects by increasing the level of

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glucocorticoids, cortisol, Thyroid Stimulating Hormone (TSH), free tri-iodothyronine

(fT3), free thyroxin (fT4) and decreasing the level of testosterone, prolactin,

dehydroepiandrosterone-sulphate, growth hormone and insulin like growth factor-1 (1-4).

Sleep is a very active, dynamic, complex behavior and occupies one-third of human life

span. Sleep modulates cardiovascular, endocrine and metabolic system. Over the last

several decades the average sleep duration has decreased. Long term sleep deprivation is a

risk factor for several outcomes such as; disturb testosterone level, sexual dysfunction,

Type-2 diabetes, insulin resistance and weight gain. In young men testosterone level rises

during daytime sleep just as in night time sleep, but the levels fall upon waking thus

confirming that sleep, rather than a circadian rhythm is critical for testosterone regulation.

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The level of testosterone begins to rise with the onset of sleep and reaches to a peak at

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REM (Rapid Eye Movement) sleep onset approximately 90 min later. It has also been

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found that testosterone levels were highest during the first REM sleep episode and lowest

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when the subjects were awake. Sleep disturbance can cause both lower and higher

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circulating testosterone level. Men who sleep less than 4 hours and those who sleep 4-6

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hours daily had significantly lower androgen concentrations than those who slept over 8

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hours (8).

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In a series of experiments in normal young adult men the interrelations of plasma LH

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(Luteinizing Hormone), FSH (Follicle Stimulating Hormone), prolactin (PRL), and

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testosterone during sleep were measured. It was found that during night baseline LH and

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FSH concentrations did not change, whereas PRL and testosterone over the course of night

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did show similar patterns of increasing concentration. In summer season due to shorter

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sleep duration, testosterone concentration was reported to be lowered. But in Ramadan

sleep onset is later, sleep duration is reduced and it did not change the 24-h mean

concentration of testosterone, but did delay the onset of the increase. After 4 days of sleep

deprivation in male rats, decreased testosterone levels and increased levels of progesterone,

PRL, corticosterone, and catecholamines were observed. During military operations there

is prolong psychological and physical stress, sleep deprivation lasts for several days and

androgen levels fall by 70-90% (9).

Children with better sleep quality were associated with better control over aggressive

behaviors, while sleep deprived display aggression. Researchers had found that REM

deprived rats engaged in more aggressive behavior (10).

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Exercise, competitions

and resistance training transiently increase

testosterone

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concentration in men and women. Testosterone levels vary before and after competition.

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Moderate intensity exercise raises the level of serum testosterone even in aging men and

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eu-menorrheic women (5-7, 11).

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Testosterone concentration increases significantly after exercise. Therefore coaches may

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consider low-intensity resistance exercise as a potential training method for athletes who

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need to maintain muscle mass and strength during the long in-season (12).

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In conclusion it was observed that in professional drivers due to work load there is lack of

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sleep and proper exercise which produce a stress condition in their bodies. This stress may

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be then responsible for low serum total testosterone level. Low testosterone has ill effects

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on the body. Therefore these peoples should take enough qualitative and quantitative sleep

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and exercise to maintain normal serum testosterone concentration. They are also advised to

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take a resistance exercise that raises testosterone level.

Limitations

Due to limited facilities the correlation with other hormones was not studied.

4. References

1. Mnico MN, Antunes HK, Dattilo M, Medeiros A, Souza HS, Lee KS, Melo CM,

Tufik S, Mello MT. Resistance exercise: A non-pharmacological strategy to

minimize or reverse sleep deprivation-induced muscle atrophy. Med. Hypotheses

2013; 80: 701-705.

2. Maggio M, Colizzi E, Fisichella A, Valenti G, Ceresini G, Dall'Aglio E, Ruffini

L, Lauretani F, Parrino L, Ceda GP. Stress hormone, Sleep deprivation and

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cognition in older adults. Maturitas 2013; 76: 22-44.

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3. Jauch-Chara K, Schmid SM, Hallschmid M, Oltmanns KM, Schultes B. Pituitary-

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Gonadal and PituitaryThyroid Axis Hormone Concentrations before and during a

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Hypoglycemic Clamp after Sleep Deprivation in Healthy Men. PLoS ONE 2013; 8:

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54209.

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4. Gettler LT, McKenna JJ, McDade TW, Agustin SS, Kuzawa CW. Does Cosleeping

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Contribute to Lower Testosterone Levels in Fathers? Evidence from the

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Philippines. PLoS ONE 2012; 7: 41559.

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5. Zhao X, Bian Y, Sun Y, Li L, Wang L, Zhao C, Shen Y, Song Q, Qu Y, Niu S et al.

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Effects of moderate exercise over different phases on age- related physiological

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dysfunctions in testes of SAMP8 mice. EXP GERONTOL 2013; 48: 869-80.

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6. Kvorning T, Christensen LL, Madsen K, Nielsen JL, Gejl KD, Brixen K, Andersen

M. Mechanical muscle function and lean body mass during supervised strength

training and testosterone therapy in aging men with low-normal testosterone levels.

J Am Geriatr Soc 2013; 61: 957-62.

7. O'Leary CB, Lehman C, Koltun K, Smith-Ryan A, Hackney AC. Response

of testosterone to prolonged aerobic exercise during different phases of the

menstrual cycle. Eur J Appl Physiol 2013; 9: 2419-24.

8. Monica A, Tathiana A, Renata M, Helena H, Sergio T. The association of

testosterone, sleep, and sexual function in men and women. Brain Res. 2011; 1416:

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80-104.

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9. Monica La, Sergio T. The effects of testosterone on sleep and sleep- disordered

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breathing in men: Its bidirectional interaction with erectile function. SLEEP MED

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REV 2008; 12: 365-379.

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10. Kimberly A, Cheryl MM, Shawn NG, Ryan PR, Stacey DM. Sleep deprivation

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lowers reactive aggression and testosterone in men. Biopsycho 2013; 92: 249-

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256.

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11. Ruth IW, Steven JS. Testosterone and sport: Current perspectives. Yhbeh 2012;61:
147-155.

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12. Con M, Ikeda T, Homma T, Suzuki Y. Effects of Low-Intensity Resistance

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Exercise under Acute Systemic Hypoxia on Hormonal Responses. J Strength Cond

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Res 2012; 26: 611-617.

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Table 1. History of Drivers and Controls

Age
Group
(Years)

Years
No. of
Mating
after
children frequency
marriage (average) (average/ week)

Aggression Sleep
duration

3
4
5
6
7
8
9
10
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Exercise

(hours)

(years)

Sleep
timing

Drivers
25-34

10-15

02

03

Moderate

3-4

Not
specific

Absent

35-44

15-20

03

02

Moderate

2-3

Not
specific

Absent

45-55

20-25

03

01

High

2-3

Not
specific

Absent

Control
25-34

10-15

04

05

Nill

7-8

Specific

02 hrs.
(average)

35-44

15-20

05

03

Low

6-7

Specific

02 hrs.
(average)

45-55

20-25

06

02

Specific

01 hrs.
(average)

Low

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Table 2. Total Serum Testosterone Level in Control and driver

Parameters

Total Serum
Testosterone
Level
2
3
4
5
6
7
8
9
10
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13
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15
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Control

Drivers

Mean SD

Mean SD

650 110
(ng/dl)

410 33
(ng/dl)

95% CI

P value

-260 to 200

< 0.0001

SD: Standard Deviation; CI: Confidence Interval

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