Night Sweats

Doctors often hear patients complain of night sweats because they are common. Night sweats refer to excess sweating during the night. However, if your bedroom temperature is hot or you are wearing too many clothes, you may sweat during sleep, which is normal.

To distinguish medical night sweats from those caused by a warm environment, doctors consider true night sweats as severe hot flashes at night that drench sleepwear and sheets and are unrelated to overheating.

In a study of 2267 patients, 41% reported night sweats in the previous month, so excessive sweating at night is common. Note that flushing (redness of face or trunk) can be hard to differentiate from true night sweats.

Night sweats vs. hot flashes vs. night terrors

Hot flashes

Although both make you feel hot, night sweats and hot flashes are not exactly the same. Hot flashes give you sudden, intense feelings of warmth. They can occur day or night and are considered night sweats if they happen overnight and cause heavy sweating.

Night terrors

Night terrors, or sleep terrors, are often confused with night sweats. Night terrors occur when you abruptly wake up feeling scared. Sweating can accompany night terrors, but they are primarily defined by the emotional terror and anxiety they cause.

Causes of night sweats in men, women, and children?

Many medical conditions and diseases can cause night sweats, such as perimenopause or menopause, medications, infections, blood cancers, and hormone problems (e.g., low testosterone or hyperthyroidism), low blood sugar, and neurological problems.

Perimenopause and Menopause

The menopausal transition can cause hot flashes, including nighttime sweating. This is a common cause of night sweats in perimenopausal individuals. Hot flashes and other perimenopausal symptoms can occur years before actual menopause (cessation of menstrual periods).

Hormone disorders

Sweating or flushing can be associated with hormone disorders such as pheochromocytoma, carcinoid syndrome, and hyperthyroidism.

Idiopathic hyperhidrosis

Idiopathic hyperhidrosis is a condition where the body produces too much sweat without any identifiable medical cause.

Infections

Tuberculosis is classically associated with night sweats. Bacterial infections such as endocarditis, osteomyelitis, abscesses, malaria, Covid-19, mycoplasma pneumonia, AIDS, and HIV infection can also cause night sweats.

Cancers

Night sweats can be an early symptom of certain cancers, lymphoma being the most common. Undiagnosed cancer often presents with additional symptoms like unexplained weight loss and fever.

Antidepressants

Certain medications, including antidepressants, can cause night sweats. Tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), venlafaxine (Effexor), and bupropion (Wellbutrin), can all lead to night sweats as a side effect.

Other medications

Medications like aspirin, acetaminophen, niacin, tamoxifen, hydralazine, nitroglycerine, and sildenafil can cause sweating or flushing, which may be mistaken for night sweats.

Neurologic conditions

Neurologic conditions like autonomic dysreflexia, post-traumatic syringomyelia, stroke, and autonomic neuropathy can cause increased sweating and potentially lead to night sweats.

QUESTION

What are other symptoms of night sweats?

Depending on the underlying cause, night sweats may be accompanied by other symptoms such as shaking, chills (if fever is present), unexplained weight loss (lymphoma).

Additionally, night sweats due to the menopausal transition are typically accompanied by other menopausal symptoms, and night sweats caused by medications can have other side effects depending on the specific drug.

Conditions that result in increased sweating in general will lead to increased sweating throughout the day, not just at night.

Which types of doctors diagnose and treat night sweats?

Night sweats are commonly treated by internists, family practice specialists, or gynecologists. Depending on specific medical conditions, other specialists like endocrinologists, neurologists, infectious disease specialists, or oncologists may be involved in the care of patients with night sweats.

What are the treatments for night sweats?

Treatment for night sweats depends on the underlying cause and varies for each patient. It should always be overseen by a healthcare professional. Treatment methods may include modifications to environment and behavior, cognitive-behavioral therapy (CBT), and medications.

• Lifestyle modifications: Avoiding caffeine, alcohol, and spicy foods; drinking water; maintaining a healthy weight; using relaxation techniques; and wearing breathable clothing before sleep can help relieve night sweats.
• CBT: This type of talk therapy is used for health problems like depression, anxiety, and insomnia. CBT for hot flashes and night sweats can reduce frequency and improve mood and quality of life. It can be combined with other approaches.
• Medications: Some medications may cause night sweats. Switching to different diabetes or thyroid medications, adjusting drug doses and timing, or changing prescriptions can help manage night sweats.

Summary: Night sweats are usually a harmless annoyance but can be a sign of an underlying medical condition. If you experience unexplained night sweats, seek medical care.

What is the outcome of patients with night sweats?

Night sweats affect many people, and while they can be harmless, they can disrupt sleep and reduce quality of life. In some cases, night sweats indicate a health issue that requires attention. Sleeping in a cool room with light, natural fabric bedding and clothing may help. If not, a doctor can recommend other approaches, including medications and therapies.

When should I be worried about night sweats?

Night sweats are common and usually don’t require treatment. However, if you experience other alarming symptoms or have underlying conditions, it’s essential to see a healthcare provider. If you regularly have night sweats that disrupt your sleep, accompanied by a fever, or experience unexplained weight loss, it may be a cause for concern.

Night sweats should be a concern if they:

• Occur regularly
• Disrupt sleep
• Are accompanied by:

• Fever
• Chills
• Unintended weight loss
• Other concerning symptoms

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Mold, JW, Mathew, MK, Belgore, S, DeHaven, M. Prevalence of night sweats in primary care patients: an OKPRN and TAFP-Net collaborative study. J Fam Pract; 51:452.

Cleveland Clinic. Night Sweats and Women’s Health. https://my.clevelandclinic.org/health/symptoms/16562-night-sweats-and-womens-health

Suni E. Common Causes of Night Sweats and How to Fix Them. Sleep Foundation. https://www.sleepfoundation.org/night-sweats

American Osteopathic Association: “Excessive sweating keeping you up at night? Know when it’s time to see your doctor.”

Cleveland Clinic: “Frustrated By Night Sweats While You’re Sleeping?”

National Health Service: “Night sweats.”

Sleep Foundation: “Common Causes of Night Sweats and How to Fix Them.”