Extreme nighttime sweating, NOT due to an overheated room, too many blankets, or hyper-insulating pajamas, is fairly common. In one study of 2,267 people visiting primary care physicians, 41% said they experience night sweats.
Sometimes we call excess nighttime sweating “night sweats” or severe nighttime “hot flashes.” These episodes are described as drenching sleepwear and sheets and disrupting sleep; NOT due to an overheated sleep environment. While not a type of primary focal hyperhidrosis, night sweats are something the experts at the International Hyperhidrosis Society often receive questions about. To help us get to the bottom of night sweats, we talked to the International Hyperhidrosis Society Board of Directors President and founding member, Dr. Dee Anna Glaser. Dr. Glaser is also Professor of Dermatology for the Saint Louis University School of Medicine, St. Louis, Missouri. (She is also registered in our hyperhidrosis Clinician Finder.)
"This is an important category," says Dr. Glaser. "Experiencing night sweats could be significant. Don't disregard it. Drenching night sweats or a change in your pattern of sweating has to be evaluated." Many different medical conditions can cause night sweats, she adds. To figure out what’s going on, visit your medical provider for a complete physical. Your clinician will likely obtain a detailed medical history (including travel history) and order tests to figure out whether there is an underlying medical issue at work.
Medical conditions that may cause night sweats include:
- Hormonal shifts such as with menopause and perimenopause (a woman reaches menopause when she has not had her period for 12 consecutive months.) Symptoms of menopause may begin years before the actual cessation of a woman’s menstrual cycle. Other hormonal changes in women (such as those that occur in adolescence and pregnancy) can also cause night sweats. Drops in testosterone in men can also lead to night sweating.
- Infections. Such as tuberculosis; endocarditis (inflammation of the heart valves); osteomyelitis (infection within the bones); abscesses (such as in boils, the appendix, tonsils, and diverticulitis); and HIV infection.
- Cancer. Night sweats can be an early symptom of some cancers, especially lymphoma. With cancer, however, night sweats are not usually the only symptom. Other associated symptoms frequently include fever and unexplained weight loss.
- Hypoglycemia (low blood sugar).
- Hormone disorders including pheochromocytoma, carcinoid syndrome, and hyperthyroidism.
- Neurologic conditions. Although neurologic causes of night sweats are not common, they may include stroke, autonomic dysreflexia, and autonomic neuropathy.
- Acid reflux.
- Idiopathic night sweating. When all other potential root causes or conditions have been ruled out, your medical provider may determine that you have "idiopathic" (meaning of no known cause) night sweats.
- Some other conditions can be linked to night sweating, too. See a more complete list from the Mayo Clinic here.
Medications are also a common cause of night sweats. Frequent culprits are antidepressants (WebMD says 8%-22% of people taking antidepressants experience night sweats), other psychiatric medicines, hormone therapy, and medications taken to decrease the level of sugar (glucose) in your blood. Even medicine taken to lower fever (aspirin, acetaminophen) can lead to sweating. So can cortisone, prednisone, and prednisolone.
We should mention here that flushing is different from night sweats. Flushing is redness of the skin, typically of the neck and cheeks that is sometimes confused with night sweats. There are a number of drugs that can cause flushing, including: niacin, nizagara 100, tamoxifen, hydralazine, nitroglycerine, and sildenafil (Viagra).
If you suffer from night sweats, it is important to talk to a healthcare professional about it. Especially if the night sweats are accompanied by a fever or other symptoms such as unexplained weight loss. "Most night sweating is not idiopathic [from an unknown cause]," says Dr. Glaser. "There is usually an underlying medical condition that needs to be addressed." Tell your clinician about any medications you take, including over-the-counter and herbal or “natural” supplements or vitamins.
While you and your clinician figure out if there is an underlying medical cause for your nighttime sweating (a critical step!), there are things you can do to make bedtime more comfortable.
- Keep your bedroom at a moderate temperature. Use fans for air circulation and/or open windows.
- Wear moisture-wicking/quick-drying pajamas like those listed on our Fan Faves page. Wear layers that can be removed as needed. Long underwear used for camping or comfortable exercise garments made of moisture-wicking fabrics may be good choices. Avoid non-breathable synthetics. Visit our Fan Faves page for discounts.
- Upgrade to quick-drying, high-tech bedding and stash your usual cotton sheets. Again, use layers so that you can adjust your bedding as needed in the night. Some sheets are now are made of the same material that athletes wear to wick moisture away from their bodies as they exercise and are specifically for night sweats. SweatHelp.org readers can save when ordering using codes found here.
- Sip ice water throughout the night.
- Keep a cool pack under your pillow and during the night flip your pillow occasionally so you are sleeping on the chilled side. You may also consider keeping a bucket of ice by your bed and some wash cloths so you can apply cool compresses as needed.
- Avoid nighttime sweat triggers such as spicy foods, cigarettes/nicotine, alcohol, and spicy food.
- Try to lower your stress through calming, breathing, or meditation exercises. Or try gentle bedtime yoga. Some people try to focus their minds on feeling relaxed and cool.
- Exercise daily, but not too close to bedtime.
Another option may be to consider a climate-controlling, airflow bed cover. According to a research poster presented at the Annual Meeting of the North American Menopause Society, a climate-controlling bed cover equipped with airflow can help women experiencing night sweats to achieve improvement in sleep quality and daytime functioning. In a study involving 36 women, average age 49.8 years, those using an airflow bed cover experienced reductions in anxiety, irritability, muscle and joint pain, hot flashes, and night sweats. They also experienced improvements in mood, energy levels, the ability to fall asleep and stay asleep, and waking times (were able to sleep longer.) Additional improvements were seen in the effects of sleepiness on relationships with family, friends, and work colleagues. Sleep quality was improved in 83%-94% of subjects (depending on the scale of measurement used.)
For more information on night sweats, read our blog on the topic, and please remember to also talk to your medical provider about any nocturnal sweat problems you are experiencing. This is a common problem with a lot of potential causes and some are serious. A discussion with a healthcare professional is key to getting appropriate care. Depending upon the source of your nighttime sweating, there are some treatment options that might be recommended, including oral medications.
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