While TRT generally improves sleep in men with low testosterone, some patients may experience temporary sleep issues during treatment. This can include difficulty falling asleep, waking in the night, or waking earlier than usual.
We start with low doses and small, frequent injections to maintain stable hormone levels and reduce side effects. Despite this, insomnia can still occur in some patients, especially early in treatment.
Common Causes of Insomnia on TRT
Increased Energy Levels: TRT can boost daytime energy. If you're sedentary, your body may not be physically tired at night.
Hormonal Adjustment Period: Your body is adapting to new hormone levels, which may disrupt sleep for a few weeks.
Anxiety or Overstimulation: Anxiety (even if subtle), overstimulation in the evenings, or overthinking can interfere with sleep onset or quality.
Management Tips
Increase Daily Physical Activity: Exercise reduces excess energy and supports sleep. Aim for 30+ minutes daily.
Evening Wind-Down Routine: Avoid screens late at night, and try meditation, breathing exercises, or journaling before bed.
Consistent Sleep Schedule: Wake up and go to bed at the same time daily—even on weekends.
Limit Stimulants: Avoid caffeine, nicotine, and pre-workout supplements at least 10 hours before bed.
Avoid Long Daytime Naps: Short naps are fine, but sleeping more than 30–60 minutes in the day can worsen nighttime insomnia.
When to Take Action
If sleep issues persist beyond 2–3 months:
Get Updated Blood Work: Check testosterone, estrogen, hematocrit, and other levels.
Consult with Your Doctor: You may need a dose adjustment or further support strategies.
Assess for Other Sleep Disorders: If snoring, gasping, or daytime fatigue is present, rule out sleep apnea.
Insomnia during TRT is usually temporary and manageable. Our doctors are here to help if symptoms persist.