Night Sweats

What are night sweats?

Night sweats are heavy sweating episodes that happen while you sleep. They’re much more intense than normal sweating. They can soak through your clothes and bedding and wake you up at night.

During a night sweat, you may feel a sudden wave of heat, especially in your neck, chest and upper body. You might notice sweat dripping from your skin and feel your heart beating faster. When the sweating stops, you may feel cold.

Night sweats often happen with menopause. When night sweats happen with other symptoms, they could be a sign of an underlying health issue. There are several possible treatment options to help you with night sweats.

What causes night sweats?

Night sweats happen more often in women because of changes in hormones like estrogen and progesterone. These hormones help your body control its temperature. When hormone levels rise or fall, your body may have trouble staying at a comfortable temperature. It responds by sweating to cool down. Here are some examples:

• Menopause and perimenopause: Night sweats are common during perimenopause and menopause, when hormone levels change more often. You may feel a sudden wave of heat followed by heavy sweating as your body tries to cool itself.
• Pregnancy and after childbirth: Hormone levels change a lot during pregnancy, which can cause night sweats. Sweating may continue for a few weeks after your baby is born while your hormones return to normal levels.
• Hormone changes during your menstrual cycle: Hormone levels naturally change during your menstrual cycle. Estrogen drops before your period, which is when PMS symptoms happen. Night sweats are a less common symptom, but they can occur.

Causes of night sweats not related to hormones

Some examples of other health conditions that can cause sweats are:

• Infections: Both bacterial and viral infections, like the flu or COVID-19, can cause night sweats when your body responds to the illness.
• Hormonal and metabolic conditions: Conditions like an overactive thyroid, endocrine tumors and diabetes can interfere with how your body controls its temperature.
• Neurological and sleep disorders: Problems affecting your nervous system or sleep, like sleep apnea, may lead to night sweats.
• Cancer and cancer treatments: Cancers like leukemia and lymphoma can cause night sweats. Certain cancer treatments, like hormone therapy or radiation therapy, can also cause them.
• Mental health conditions and substances: Anxiety, panic disorders, alcohol and other substances can trigger sweating in your sleep. Even constant stress can lead to sweating.
• Medications: Sweating can be a side effect of many medications, like blood pressure medications, antidepressants, some migraine medication, pain relievers, like ibuprofen, narcotic pain medication, breast cancer treatments or steroids. Your provider may need to change or adjust your dose if medication is to blame.

Night sweats can also happen with hyperhidrosis, a condition that involves excessive sweating for unknown reasons.

What deficiency causes night sweats?

There is some evidence that Vitamin B12 deficiency can lead to night sweats. A nutritional deficiency alone rarely causes night sweats. But low levels of estrogen are a well-known cause of night sweats.

How are menopause-related night sweats treated?

Treatment depends on what’s causing your night sweats and how severe they are.

Mild cases may get better on their own or improve by making simple changes to your sleep environment. This may include turning on the air conditioning or sleeping in less clothing.

If menopause causes your night sweats, hormone replacement therapy (HRT) may be an option. This treatment replaces hormones you lose during menopause. All hormone therapies carry some risks. Your healthcare provider can help you weigh the benefits and risks.

If hormone therapy isn’t safe for you, there are medications that don’t contain estrogen that may help. These medications work by affecting how your body controls its temperature. Options include:

• Antiseizure medications
• Antidepressants
• Oxybutynin or clonidine
• Fezolinetant or paroxetine

Your healthcare provider can help you choose the treatment option that’s safest and most effective for you.

What can I do at home to stop night sweats?

You can take these steps to help with night sweats:

• Keep a cup of cold water next to your bed to sip on.
• Use pillows and mattress covers that contain cooling gels.
• Wear loose-fitting, lightweight, cotton or linen pajamas.
• Use a bedroom fan, sleep with your windows open or crank up the air conditioning.
• Use lightweight, layered bedding that you can remove as needed at night.
• Avoid foods and beverages that make you sweat (like spicy foods and caffeine).

When should I be worried about night sweats?

Schedule a visit with a healthcare provider if you have night sweats that disrupt your sleep. If you’re close to 50 and waking up drenched in sweat, menopause is likely the cause. Still, only a provider can make a diagnosis. Once they determine the cause, they can prescribe treatments to help.