Night Sweats

What are night sweats?

Night sweats are drenching sweats that are intense enough to soak through your clothes and bedding and disturb your sleep. Typically, sweating is a healthy cool-down response that keeps your body temperature at a safe and comfortable level.

Night sweats, on the other hand, don’t feel comfortable at all. Instead, you may feel a sudden wave of heat that spreads throughout your body, followed by sweating, reddening skin and a rapid heartbeat. You may wake in a cold sweat, wondering what’s causing your body to behave in this way.

Night sweats often accompany menopause. When night sweats happen alongside other symptoms, they may signal a condition that requires medical attention.

What causes night sweats in women?

Night sweats can affect anyone, but they’re most commonly associated with women. Hormone changes related to reproductive hormones, like estrogen and progesterone, can cause unpleasant changes in your body temperature that make you feel too hot. Your body may respond with a flash (hot flash) to cool down, or you may sweat excessively (night sweat).

Perimenopause and menopause

Night sweats are common during perimenopause and menopause. Menopause officially begins when you haven’t had a period for 12 consecutive months. The average age of onset is 51. Perimenopause is the period that precedes menopause. During perimenopause, your ovaries produce less estrogen, progesterone and testosterone, and your periods become irregular. Perimenopause usually happens between the ages of 40 and 50.

Changing hormone levels during perimenopause and menopause likely cause your hypothalamus (the part of the brain that controls your body heat) to have trouble regulating your body temperature. Think of it as a glitch in your body’s internal thermostat. You may feel sudden warmth or a flush in your face, neck and chest. In response, your body tries to cool itself by sweating too much.

People with primary ovarian insufficiency (POI) may experience night sweats for reasons similar to people going through perimenopause and menopause. With POI, your ovaries stop producing estrogen before age 40.

Premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)

Hormone fluctuations during your menstrual cycle can also cause night sweats. Your estrogen levels decrease before your period, in the time most commonly associated with PMS and PMDD. While symptoms like irritability and cramps are more commonly associated with PMS and PMDD, night sweats can occur, too.

Pregnancy

Fluctuating hormone levels during pregnancy may also cause you to experience night sweats. Pregnancy-related night sweats are more common during the first trimester (weeks 1 to 14) and the third trimester (weeks 27 to childbirth). The sweating may continue a few weeks after your baby is born as your hormones adjust to their pre-pregnancy levels.

Are menopause, perimenopause, PMS/PMDD and pregnancy the only causes of night sweats?

No. Night sweats are both a symptom of multiple conditions and a side effect of various medications. Night sweats can occur for many reasons that affect people regardless of sex. Other causes include:

• Infectious diseases: Including tuberculosis and human immunodeficiency virus (HIV).
• Bacterial infections: Including endocarditis (inflammation of the inner lining of the heart), osteomyelitis (inflammation of bone/bone marrow) and pyogenic abscess (pus in the liver).
• Viral infections: Including colds, the flu and COVID-19.
• Hormonal diseases: Including overactive thyroid, endocrine tumors and diabetes.
• Substance abuse: Including alcohol, heroin and cocaine.
• Neurologic disorders: Including autonomic dysreflexia, autonomic neuropathy (damage to autonomic nerves), syringomyelia (cyst in the spinal cord) and stroke.
• Cancer: Including leukemia (blood and bone marrow cancer) and lymphoma (blood cell cancer).
• Behavioral health conditions: Including panic disorder and anxiety.
• Sleep disorders: Including obstructive sleep apnea.
• Digestive diseases: including gastroesophageal reflux disease (GERD).
• Side effects of cancer treatments: Including aromatase inhibitors, tamoxifen, opioids and steroids.
• Side effects of other medications: Including some antidepressants and diabetes medications, steroids, acetaminophen, aspirin and high blood pressure drugs.

Night sweats may also be related to hyperhidrosis, a condition that involves excessive sweating for no apparent reason.

How are menopause-related night sweats treated?

Treatment depends on what’s causing your night sweats. For menopause-related night sweats, hormone therapy — estrogen alone or with progestin — may be an option. Hormone therapy can also help with other symptoms of menopause, including bone loss and vaginal dryness. You shouldn’t receive estrogen replacement therapy if you have a history of breast cancer. All hormone therapies carry some risks, including blood clots and gallbladder inflammation.

Non-estrogen medications used to treat night sweats include:

• Anticonvulsants (gabapentin, pregabalin): Also used to control/prevent seizures.
• Antidepressants: A low dose of Brisdelle®, a form of paroxetine, is FDA- approved to treat hot flashes.
• Clonidine: Also used to treat high blood pressure, attention deficit hyperactivity disorder, anxiety, and other conditions.
• Megestrol: Also used to treat breast and uterine cancers, increase appetite and reverse weight loss.
• Oxybutynin: Also used to treat urinary conditions.

What can I do at home to treat night sweats?

Regardless of what’s causing your night sweats, you can take preventative steps to improve your sleep quality. To keep cooler during bedtime:

• Sip cool water throughout the night.
• Use pillows and mattress covers that contain cooling gels.
• Wear loose-fitting, lightweight, cotton or linen pajamas to bed.
• Exercise daily by walking, swimming, dancing, bicycling, etc.
• Use lightweight, layered bedding that you can remove as needed at night.
• Unwind before bedtime using deep breathing, relaxation and meditation techniques.
• Use a bedroom fan, sleep with your windows open, or crank up the air conditioning.
• Keep a cold pack under your pillow, then flip your pillow to rest your head on a cool surface.
• Avoid common night sweat triggers such as alcohol, spicy foods, caffeine and cigarettes or exercising immediately before bed.

When should I be worried about night sweats?

Schedule a visit with your healthcare provider if you’re regularly experiencing night sweats that disrupt your sleep or if you’re experiencing night sweats alongside other symptoms. If you’re close to age 50 and you’re waking with cold sweats — menopause is likely the cause. Experiencing night sweats in addition to other concerning symptoms may be a sign of something more serious.

Still, only your provider can make a definitive diagnosis. Once your provider determines the cause, they can prescribe treatments to help.

Do menopause-related night sweats ever end?

Night sweats go away for most people a few years after menopause starts. Sometimes, though, they don’t go away. Night sweats that linger well into postmenopause (the period after menopause) usually become less severe over time.

Can stress cause night sweats?

Yes. Stress, panic and anxiety can elevate your heart rate and cause you to become overheated and sweaty both day and night.

What cancers cause night sweats?

Night sweats are a common symptom of both leukemia and lymphoma. Other symptoms are usually present when cancer causes night sweats, like fever and fatigue.

What infections cause night sweats?

Night sweats are a common symptom of tuberculosis. Night sweats are also associated with colds, the flu, COVID-19, HIV, and some bacterial infections (endocarditis, osteomyelitis and pyogenic abscess).