What Are Night Sweats—And Why Do They Happen?

Night sweats, characterized by excessive sweating during sleep, can be a disruptive and uncomfortable phenomenon. This condition can drench your clothes and bed sheets, often leading to interrupted sleep and a sense of discomfort. Night sweats can affect individuals of any age and are a common occurrence. According to a 2020 review published in American Family Physician, the prevalence of night sweats in the general population varies between 10% to 41%, with the highest rates occurring in adults between the ages of 41 and 55. Night sweats can be indicative of an underlying health condition or a side effect of medication, and understanding their causes, symptoms, and available treatments is crucial for improving your quality of life.

The Nature of Night Sweats

Night sweats are typically an outcome of an underlying medical condition or medication that affects the body’s ability to regulate sweating. Sweating is governed by the sympathetic nervous system, a component of the nervous system responsible for triggering the body’s fight-or-flight response and regulating functions such as heart rate, perspiration, and digestion. Consequently, medications or conditions that activate this system can lead to increased frequency and intensity of sweating.

Common Causes of Night Sweats

Numerous factors can contribute to night sweats, including:

1. Menopause: Menopause, which occurs when the ovaries reduce or halt estrogen production, leads to hormonal fluctuations and hot flashes. More than 80% of women experience hot flashes during menopause, often accompanied by night sweats.

2. Cancer and Cancer Treatments: Night sweats frequently occur in individuals with cancer and can be a sign of disease progression. Additionally, cancer treatments such as chemotherapy, hormone therapy, radiation therapy, and certain medications like opioids, antidepressants, or steroids can induce night sweats.

3. Surgical Procedures: Surgeries that involve the removal of ovaries (hysterectomy) or testes (orchiectomy) can disrupt hormone production, resulting in night sweats.

4. Hormonal Conditions: Hormonal imbalances caused by conditions like hyperthyroidism and diabetes can lead to night sweats.

5. Infections: Bacterial and viral infections can trigger immune responses characterized by fever, chills, and night sweats. Conditions such as HIV, malaria, mononucleosis, pneumonia, and endocarditis can induce night sweats.

6. Hyperhidrosis: This chronic condition involves excessive sweating, particularly in areas like the palms, feet, head, and armpits. While the precise cause of hyperhidrosis remains under study, it affects approximately 3% of Americans.

7. Other Underlying Conditions: Night sweats may also manifest in conjunction with conditions such as sleep disorders (insomnia or sleep apnea), autoimmune disorders (psoriasis or lupus), cardiopulmonary disorders (heart disease or COPD), gastroesophageal reflux disease (GERD), and mental health disorders (anxiety).

Symptoms of Night Sweats

The symptoms accompanying night sweats can vary based on the underlying condition but often include:

• Excessive sweating
• Fever
• Chills
• Pale skin
• Skin infections
• Fatigue
• Sleep disturbances
• Muscle cramps
• Chronic pain
• Mood changes

When to Seek Medical Attention

It is advisable to consult a healthcare provider if you experience regular night sweats coupled with symptoms like fever or unexplained weight loss. There are no specific tests for diagnosing night sweats; instead, healthcare providers rely on comprehensive medical histories and physical examinations to identify potential underlying causes. During your appointment, your provider may inquire about accompanying symptoms, family medical history, onset and frequency of excessive sweating, potential triggers, and other relevant details. Based on their assessment, additional tests may be ordered to investigate underlying conditions such as cancer or hormonal disorders.

Treatment Options for Night Sweats

Treatment for night sweats depends on their severity and the presence of underlying conditions. Common treatment options include:

1. Antiperspirants: Over-the-counter antiperspirants and clinical-strength products can be applied to sweat-prone areas, such as the underarms, hands, scalp, or feet, to reduce sweating.

2. Menopause Treatments: Hormonal and non-hormonal medications like estrogen, progesterone pills, or selective serotonin receptor inhibitors can alleviate hot flashes and sweating during menopause.

3. Botox Injections: FDA-approved for treating underarm sweating and hyperhidrosis in the palms and soles, botox injections block sweat gland stimulation.

4. Anticholinergics: Prescription wipes and topical gels limit acetylcholine production, controlling sweat gland activation.

5. Surgery: Minimally invasive surgical procedures, including sweat gland removal, liposuction, and laser surgery, may be considered in some cases.

6. Sympathectomy: In severe cases, sympathectomy involves surgically cutting nerves of the sympathetic nervous system to control sweating.

7. Lifestyle Strategies: Lifestyle changes can complement medical treatment and include wearing loose-fitted clothing, using moisture-wicking fabrics, consuming cold water before bedtime, practicing relaxation techniques, and avoiding triggers like spicy foods, alcohol, caffeine, and smoking.

Conclusion

Night sweats, also known as nocturnal hyperhidrosis, can be a distressing and disruptive experience. These episodes involve excessive sweating during sleep, which can drench bedding and disturb restful sleep patterns. While menopause is a common cause of night sweats in women due to hormonal fluctuations, it’s essential to recognize that they can result from various underlying factors in both men and women.

Potential causes of night sweats extend beyond menopause and can include infections, such as tuberculosis or HIV, certain medications, hormonal disorders like hyperthyroidism, anxiety, and even certain cancers, like lymphoma. In some cases, lifestyle factors such as consuming spicy foods, excessive alcohol, or sleeping in a hot room can trigger night sweats.

The symptoms of night sweats can be debilitating, leading to fatigue, irritability, and a decreased overall quality of life. Therefore, if you experience frequent night sweats, especially when accompanied by other concerning symptoms like unexplained weight loss or fever, it’s crucial to consult a healthcare provider. They will conduct a thorough evaluation, which may involve blood tests, imaging, or other diagnostic procedures, to determine the underlying cause of your night sweats.

Once the cause is identified, your healthcare provider can develop a personalized treatment plan. Treatment options may range from addressing the underlying condition (e.g., treating an infection or adjusting medications) to lifestyle modifications and medications to manage the night sweats directly. By seeking medical attention and understanding the potential causes, individuals can take proactive steps to alleviate night sweats and improve their overall well-being, ensuring restful and comfortable nights of sleep.