Sounding as if he was fighting back tears, the track star began his testimony by apologizing to the Steenkamp family,
"I would like to take this opportunity to apologize -- to Mr. and Mrs. Steenkamp, to Reeva's family -- to those who are here today who knew her," Pistorius said.
"I can't imagine the pain and the sorrow and the emptiness that I have caused you and your family. ... I can promise you that when she went to bed that night, she felt loved," he said.
As Pistorius' defense team on Monday began its fight against the prosecution case that he murdered Steenkamp, he told the Pretoria court that he is afraid to sleep and has terrible nightmares, and "if I hear noise, I wake up just in a complete state of terror." He said he is on medication, including an antidepressant and sleeping aids.
Steenkamp: 'Sometimes you scare me' Pistorius witness: I heard screaming
Earlier, in front of a courtroom including Steenkamp's mother, June, the first defense witness, pathologist Jan Botha, talked about the wounds Steenkamp suffered when Pistorius shot her and about when she last ate.
The South African amputee sprinter put his head in his hands as Botha said that the shot that hit Steenkamp's arm was "akin to a traumatic amputation" and that she died "fairly quickly after sustaining the head wound."
Childhood remembered
Pistorius, 27, is accused of intentionally murdering Steenkamp, 29.
The defense team will call 14 to 17 witnesses, Barry Roux, who is Pistorius' lead lawyer, said as he opened his case.
Botha went first because of "family health reasons," Roux said, breaking with the South African legal custom of the defendant testifying first. He said Botha was the only defense witness who will go "out of order."
The prosecution rested its case on March 25 after 15 days and 21 witnesses.
Oscar Pistorius on trial: Explore each side's case
Talking about his childhood, Pistorius said his mother kept a firearm in a padded bag under her pillow. His father was often not around, and Pistorius said his mother would sometimes wake her children up, thinking they were being burgled.
He said she was very supportive of him and "never made me feel any different from the rest of the kids."
He also spoke of her passing. Pistorius said he and his brother didn't even know she was sick when she went into the hospital; he was at boarding school at the time. When he found out, he and his brother went to visit her regularly.
"Everything I learned in life, I learned from her," he said.
Trial to last until mid-May
Pistorius admits that he killed Steenkamp, firing four shots through a closed door in his house in the early hours of February 14, 2013. Three hit her, with the last one probably killing her almost instantly, according to the pathologist who performed the autopsy.
But Pistorius says he thought she was a nighttime intruder in his pitch-black house and believed he was firing in self-defense. He pleaded not guilty to murder.
The trial, which began March 3, is scheduled to continue until the middle of May.
Pistorius first achieved global fame as an outstanding double-amputee sprinter who ran with special prostheses that earned him the nickname "Blade Runner."
Judge Thokozile Matilda Masipa will decide the verdict in collaboration with two experts called assessors. South Africa does not have jury trials.
In South Africa, premeditated murder carries a mandatory life sentence with a minimum of 25 years in prison. Pistorius also could get five years for each of two unrelated gun indictments and 15 years for a firearms charge he also faces.
If he isn't convicted of premeditated murder, the sprinter could face a lesser charge of culpable homicide, a crime based on negligence.
The sentence for culpable homicide is at the judge's discretion.
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