Night Sweats

Night sweats may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect sleep may involve several body systems.

Night sweats may accompany other common symptoms including:

• Anxiety

• Cough

• Fatigue

• Fever and chills

• Loss of appetite

• Malaise or lethargy

• Shortness of breath

• Rapid heart rate (tachycardia)

• Unexplained weight loss

In some cases, night sweats may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have night sweats along with other serious symptoms including:

• Coughing up blood (hemoptysis)

• Difficulty breathing or rapid breathing

• Disorientation

• Fever and chills

• Severe headache

• Stiff neck

• Unexplained weight loss

Night sweats can result from a number of different causes. Menopause can lead to profuse night time sweating. In other cases, night sweats may be due to medical conditions. For instance, influenza, HIV/AIDS, hepatitis (liver inflammation), and endocarditis (infection of the heart lining) are all associated with night sweats. In addition, severe illnesses, such as cancer and tuberculosis, can lead to sweating at night.

The precise mechanism that triggers abnormal sweating has not been fully identified. Most researchers point to an increase of chemical mediators in the blood that alter the body’s temperature control. The body doesn’t necessarily get warmer but the brain reacts as if it were.

Night sweats may have common causes including:

• Common cold (viral respiratory infection)

• Consuming hot fluids or spicy foods prior to going to sleep

• Diabetes

• Engaging in physical exercise before bedtime

• Hyperthyroidism

• Influenza (flu)

• Medication side effects

• Menopause

• Nightmares

• Pregnancy

Night sweats can also have other causes including:

• Cancers, such as non-Hodgkin’s lymphoma and Hodgkin’s lymphoma

• Disorders of the thyroid gland, such as hyperthyroidism (overactive thyroid)

• Emotional disorders or problems

• Heart diseases, such as endocarditis

• Hepatitis (inflammation of the liver)

• HIV/AIDS

• Sleep apnea (abnormal breathing pauses during sleep)

• Stroke

• Tuberculosis (serious infection affecting the lungs and other organs)

In some cases, if night sweats are accompanied by a change in your level of consciousness, an extreme headache, a sudden change in vision, or paralysis or numbness on one side of the body or face, they may be a symptom of stroke, a serious or life-threatening condition which should be immediately evaluated in an emergency setting.

Having a night sweat every now and then is not usually a cause for concern. But there are times when seeing your doctor is the safest option in case an underlying condition is to blame. Make an appointment with your doctor if night sweats occur often, interrupt your sleep, or cause other problems such as daytime sleepiness.

See a doctor promptly when:

• Night sweats accompany fever, cough, diarrhea, pain, unexplained weight loss, or other concerning symptoms

• Night sweats occur when you have not had menopause symptoms for several months or years. 

Call 911 or go to your nearest emergency room for night sweats with the following symptoms:

• Chest pain 

• Difficulty breathing or shortness of breath

• Rapid or pounding heartbeat

• Sudden symptoms, such as severe headache, vision problems, disorientation, numbness or paralysis

To diagnose the underlying cause of night sweats, your doctor will take a careful medical history, perform a physical exam, and possibly order some tests.

Questions your doctor may ask related to your night sweats include:

• How often do you have night sweats?

• When did you first notice the night sweats?

• What other symptoms are you having, such as fever, cough, heat intolerance, or weight loss?

• What chronic medical conditions do you have?

• What medications are you taking?

• For women, when was your last period? Are you having other menopausal symptoms, such as hot flashes?

During the physical exam, your doctor will check for signs of infection, cancer, thyroid problems, and other causes. This may include feeling your lymph nodes, abdominal organs, and thyroid gland in your neck. Your doctor may also check your reflexes and nervous system, listen to your heart and lungs, and check your eyes, mouth, throat, hands and feet.

Based on the exam and your medical history, your doctor may order tests including:

• Blood tests, including a CBC (complete blood count), thyroid-stimulating hormone level, and ESR (erythrocyte sedimentation rate). An ESR can check for inflammation in the body.

• PPD (purified protein derivative) skin test for tuberculosis

• Imaging exams, such as a chest X-ray or abdominal CT (computerized tomography) scan

• Biopsy of the bone marrow or lymph nodes to rule out potentially cancerous causes

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

Night sweats are a symptom of multiple diseases and conditions. So, there is no one night sweats treatment. Instead, treatment depends on the underlying cause. This may include treating infections, cancer, or hormonal disorders, including thyroid problems. Night sweats will likely resolve once these causes are treated.

For night sweats due to menopause, hormone replacement therapy (HRT) may be helpful. However, not all women are candidates for HRT or want to take it. Other medications can help relieve hot flashes and night sweats including certain antidepressants, anti-seizure medicines, and blood pressure medicines.

If you are living with night sweats or hot flashes, there are strategies you can use to help manage them when they happen. This includes:

• Avoid triggers, such as alcohol, caffeine and nicotine. Keeping a log can help you track specific triggers that affect you.

• Dress in lightweight, loose-fitting pajamas if you wear them.

• Keep ice water nearby during the night.

• Lose weight if you are overweight or obese.

• Make your bed with light layers you can peel away during an episode.

• Use a fan when you sleep.

Women living with night sweats often look to alternative treatments for relief. While definitive research is lacking, there is some evidence for several mind-body approaches and supplements.

Mind-body techniques that may help manage night sweats include:

• Acupuncture, which may help reduce the frequency and severity of night sweats

• Cognitive behavioral therapy, which may help change your attitude about night sweats and how much they bother you

• Hypnosis, which may help reduce the frequency and severity of night sweats

• Meditation, which may help reduce how much night sweats bother you

Several supplements advertise a potential benefit in dealing with night sweats and hot flashes. This includes plant estrogens, black cohosh, ginseng, and others. Always talk with your doctor before trying any of these supplements. Many of them have estrogen-like effects and are not safe for women who should avoid estrogen. In addition, supplements can have harmful side effects and drug interactions.

Because night sweats can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage.

Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you to reduce the risk of potential complications including:

• Anxiety

• Chronic fatigue

• Difficulty sleeping

• Progression of menopausal symptoms

• Spread of cancer

• Spread of infection