Health Update: Night Sweats
Night sweats, or excessive sweating during sleep, are common symptoms in both women and men. Many medical conditions and diseases can be the culprit. Night sweats refer to any excess sweating transpiring during the nighttime hours. However, be aware that if you keep your bedroom temperature unusually hot or you are sleeping in an excessive amount of clothes, you may sweat during your sleep, which would be considered normal. In order to differentiate night sweats that result from medical causes from those that occur because a person’s surroundings are too warm, healthcare providers generally refer to actual night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, and which are not related to an overheated environment.
In one study consisting of 2267 patients visiting a primary care physician, 41% reported experiencing night sweats during the previous month, so the experience of excessive sweating at night is common. It is important to note that flushing, a warmth and redness of the face or trunk, also may be difficult to discern from true night sweats.
There are a multitude of causes that could result in night sweats. To ascertain what is triggering night sweats in a particular patient, a healthcare provider must obtain a detailed medical history and particular tests to decide if an underlying medical condition is responsible for the night sweats.
Depending upon the underlying cause of the night sweats, other symptoms may occur in connection with the sweating. For example:
- Certain infections or cancers
- Shaking and chills can sometimes occur if the underlying cause is a fever.
- Unexplained weight loss can occur if sweating is due to lymphoma.
- Night sweats due to the menopausal transition are commonly accompanied by other symptoms of menopause such as vaginal dryness, daytime hot flashes, and mood changes.
- Night sweats that occur as a side effect of medications can be accompanied by other medication side effects, depending upon the specific drug.
- Conditions that result in increased sweating in general, versus only night sweats, will result in increased sweating at other times of the day.
Common cause of night sweats may include:
- Perimenopause and Menopause: The hot flashes that accompany the menopausal transition can occur at night and cause sweating. This is a widespread cause of night sweats in perimenopausal women. It is significant to remember that hot flashes and other symptoms of the perimenopause can precede the actual menopause by several years.
- Hypoglycemia: Occasionally, low blood glucose levels or hypoglycemia can cause sweating. People with diabetes who are taking insulin or oral anti-diabetic medications may encounter hypoglycemia at night that is accompanied by sweating.
- Hormone Disorders: Sweating or flushing can be observed with several hormone disorders, including pheochromocytoma , a type of adrenal gland tumor that overproduces hormones known as catecholamines, carcinoid syndrome an overproduction of certain hormones by tumors of the lung or gastrointestinal system, and hyperthyroidism an excessive level of thyroid hormones.
- Idiopathic Hyperhidrosis: Idiopathic hyperhidrosis is a disorder in which the body chronically produces excessive sweat without any detectable medical cause.
- Infections: Typically, tuberculosis is the infection most frequently associated with night sweats. However, bacterial infections such as; endocarditis (inflammation of the heart valves), osteomyelitis (inflammation within the bones due to infection), abscesses (for example, boils, appendix, tonsils, perianal, peritonsillar, diverticulitis), and AIDS virus (HIV) infection can also be associated with night sweats.
- Cancers: Night sweats can be an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, those who have an undiagnosed cancer often have other symptoms as well, such as unexplained weight loss and fever.
- Antidepressants: Taking certain medications can lead to night sweats All types of antidepressants including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and the newer agents, venlafaxine (Effexor) and bupropion (Wellbutrin) can cause night sweats as a side effect, with a span in incidence from 8% to 22% of those taking antidepressant drugs. Other psychiatric drugs have also been linked with night sweats.
- Other Medications: Medicine taken to lower fever (antipyretics) such as aspirin and acetaminophen can sometimes lead to sweating. Other types of drugs can cause flushing, a redness of the skin, typically over the cheeks and neck, which may be misperceived as night sweats. Some of the countless drugs that can cause flushing include: niacin, tamoxifen, hydralazine, nitroglycerine and Viagra. Other drugs, including cortisone, prednisone, and prednisolone, may also be associated with flushing or night sweats.
- Neurologic Conditions: Though uncommon, neurologic conditions may cause intensified sweating and possibly lead to night sweats including; autonomic dysreflexia, post-traumatic syringomyelia, stroke, and autonomic neuropathy.
Keep in mind, night sweats are usually a harmless annoyance; nevertheless, they are occasionally a sign of an underlying medical disorder and those experiencing unexplained night sweats should seek medical care. The treatment for night sweats depends upon the underlying cause.