Reducing or eliminating sleep apnea leads to significant increases in testosterone in males and improved testosterone to estrogen ratios in females.

“but what's really interesting is that there are very clear ways in which patterns of breathing, especially patterns of breathing in sleep, can modulate hormones in ways that are immediately actionable and can serve to optimize both estrogen and testosterone regardless of whether or not you have ovaries or testes.”

“when apnea is reduced in sleep, or eliminated, there are significant increases in testosterone in males and in proper estrogen to testosterone ratios in females”

“it works by reductions in cortisol, now, cortisol is a stress hormone that is released early in the day as we wake up and serves healthy roles in protecting us against infection, reducing inflammation, et cetera, but you don't want cortisol to be too high, and you certainly don't want it elevated too long throughout the day and night, and so we all know, because now we've been told a lot in the last decade or so, that getting proper sleep is important for all these aspects of health, getting proper sleep can really offset all the reductions in testosterone and estrogen and reductions in fertility that occur if we don't get enough sleep, but seldom is it discussed how sleep actually adjusts things like testosterone and estrogen, and it does it by modifying cortisol”

“the effects of apnea on these hormones are dramatic and terrible, and the positive effects of getting breathing right on these hormones, testosterone and estrogen, are dramatic and wonderful”

“This means we have to be breathing properly, it almost sounds kind of like, kind of new-agey, like, oh, you have to breathe properly to get your hormones right, but no, you have to breathe properly to get your breathing and sleep right so that your sleep can actually be deep enough and you're not entering apnea states, and then that will support gonad function”