Do you wake up at night with damp hair or your T-shirt stuck to your skin? Have you noticed that it happens to you more often during certain times of the month? The truth is, it's not uncommon to sweat at night from time to time, especially if you ate something spicy before going to bed, you're wearing thicker pajamas, or the temperature in your bedroom is high.

Night sweats become a problem when they occur regularly, interrupt your sleep, and force you to change your sleepwear or even your bedding. If this is a scenario you face frequently, then the causes may be medical in nature and it is time to talk to a doctor.

In this article we talk about everything you need to know about night sweats.

What are night sweats?

When it's very hot in the room, you sleep in thick clothes or wrapped in a warm duvet, sweating at night is a normal process by which the body regulates its temperature. Your body releases water and electrolytes that evaporate through the skin and create a feeling of coolness. This process describes what we call normal sweating, which is nothing more than a physiological response occasionally caused by heat or exertion.

Excessive sleep sweats, on the other hand, tend to be more intense, more repetitive, and can occur even in normal temperature conditions. They are characterized by discomfort and are often associated with reduced sleep quality and nocturnal anxiety, precisely because the subsequent feeling of cold and damp underwear causes you to wake up frequently to change your clothes and bedding. Such night sweats are often correlated with hormonal imbalances or other conditions.

When night sweats become worrisome

The frequency and intensity of your sweating are signs you should watch for. If you only occasionally sweat at night and wake up with damp clothes, there's probably nothing to worry about.

Suspicions about possible health problems arise if night sweats occur daily or very frequently and you have to change your clothes or underwear, or if other alarm signs appear such as fever, fatigue, cough, aches, chills, or weight loss.

A visit to the doctor is recommended if:

• Symptoms persist for periods longer than two weeks.
• Night sweat episodes occur suddenly and are intense.
• Excessive sweating disturbs your sleep.
• You notice symptoms such as fever, diarrhea, cough, or other worrying signs.
• Night sweats begin several months or years after menopause symptoms have disappeared.

Possible causes of night sweats

It's not always possible to pinpoint the exact cause of night sweats, but most often it's environmental factors, certain health conditions, hormonal factors, or a combination of these. If you're also experiencing other symptoms, these can help narrow down the possible causes and rule out other conditions.

Environmental and lifestyle factors

The environment in which you sleep, from the high room temperature and lack of ventilation to the mattress, bedding, and thick clothing, can increase your body temperature during the night and cause you to sweat.

Daily habits, especially your bedtime routine, can also be associated with night sweats. If you experience anxiety, are going through a stressful period, consume alcohol, caffeine, or spicy foods before bed, or exercise heavily in the evening, these could explain why you wake up sweating at night.

Hormonal causes of night sweats

Hormonal imbalances and disorders can also be responsible for excessive sweating, including at night. Common hormonal causes of night sweats include:

• Menopause and perimenopause (in women)
• Andropause (in men)
• Task
• Thyroid disorders (for example, hypothyroidism)
• Increased cortisol levels (associated with periods of intense stress)

These imbalances are also often associated with symptoms such as unexplained fluctuations in weight and energy levels, headaches, sexual dysfunction, and changes in the menstrual cycle.

Medical causes of night sweats

There are cases where night sweats are associated with medical conditions such as infections and chronic diseases, which is why it is important to monitor the associated symptoms and the overall context. Medical causes of night sweats in women include:

• Infections such as tuberculosis, HIV, or endocarditis (infection of the heart valves)
• Diabetes
• Nocturnal hypoglycemia (common in patients with type 1 or 2 diabetes)
• Sleep apnea (according to 2018 research, women who experience night sweats during menopause are at an 80% higher risk of developing sleep apnea)
• Autoimmune diseases such as sarcoidosis, Graves' disease, rheumatoid arthritis
• Certain forms of cancer, such as Hodgkin lymphoma
• Neurological disorders (in rare cases)

Adverse effects of medications that cause night sweats

Certain medications are known to have the potential to cause night sweats. If you have recently started treatment and your night sweats have started shortly after, it is possible that these are the cause and it is recommended that you discuss them with your prescribing doctor:

• Pain relievers such as aspirin and paracetamol
• Antidepressants
• Steroids (including prednisone and cortisone)
• Hormonal treatments
• Diabetes medications
• Antipyretics
• Beta-blockers

Diagnosis and recommended tests for night sweats

If your night sweats are worrying you and you need to see a doctor to determine their exact cause, your doctor will usually start with a physical examination. You will have a detailed discussion about your symptoms, medical history, and lifestyle, followed by a clinical consultation.

Depending on the context and associated symptoms, additional investigations such as blood tests, infectious tests, ultrasound or sleep studies may be necessary.

In general, blood tests are recommended to identify possible hormonal or metabolic imbalances. Blood sugar, thyroid hormones, cortisol levels are measured, and a complete blood count may be performed to detect possible infections or inflammation in the body. Your doctor may also recommend imaging tests such as thyroid or abdominal ultrasound, depending on your symptoms.

To confirm the presence of serious infections such as tuberculosis, HIV, or viral hepatitis, specific infectious tests may be performed. And if disorders such as sleep apnea are suspected, sleep studies may be performed to confirm them.

Treatment and remedies for night sweats

When night sweats occur frequently and disrupt your sleep, your doctor will recommend a personalized treatment based on the identified cause. This treatment usually involves a combination of medical approaches and adjustments to environmental or lifestyle factors.

Medical approach to night sweats

If the underlying cause of your night sweats is an infection, metabolic condition, or hormonal disorder, treating that cause is a priority. Your doctor may recommend:

• Specific treatments or therapies for infections and hormonal imbalances.
• Adjusting doses or changing treatment if sweating occurs as an adverse effect of certain medications.
• Psychological therapy for stress in cases of anxiety and chronic stress.

Natural and Lifestyle Solutions for Night Sweats

In parallel with medical treatment, a few seemingly minor changes to your sleeping environment and lifestyle can help you significantly reduce the frequency of night sweats.

The optimal temperature in the bedroom is between 18 and 20°C for a more comfortable sleep. It is also recommended to use bed linen and sleepwear made from natural materials such as cotton, which allows the skin to breathe, to reduce alcohol and caffeine consumption especially in the evening, and to avoid spicy meals before bed.

Last but not least, you can improve your sleep quality by avoiding intense physical exertion at least 1-2 hours before bedtime and replacing it with relaxation exercises and conscious breathing or with an evening routine designed to reduce stress.

Hormonal treatments for night sweats

If hormonal fluctuations are the source of night sweats, such as those during menopause in women or andropause in men, your doctor may recommend hormone replacement therapy or natural alternatives with phytoestrogens, isoflavones, or supplements.

The effectiveness of alternatives may be lower compared to drug treatment, so it is important to evaluate all options with a specialist and choose the most suitable one for you.

Night sweats in the luteal phase

Hormonal changes associated with night sweats do not occur exclusively during menopause, but can even include the normal fluctuations in estrogen and progesterone that occur throughout the menstrual cycle, especially in the luteal phase .

In some women, night sweats may occur more frequently before menstruation, when estrogen and progesterone levels increase. These fluctuations can increase body temperature and sweat gland activity, leading to heavy sweating at night.

The phenomenon is more common in women in perimenopause, those experiencing premenstrual syndrome, or those using hormonal contraceptives, and is most often temporary and reduces at the end of the luteal phase.

With the onset of menstruation , however, it is equally important to use menstrual products with 100% organic cotton to let your skin breathe and enjoy a peaceful sleep, without synthetic ingredients that promote sweating.

How to prevent night sweats

To prevent night sweats, proper sleep hygiene is necessary, first and foremost. Regulate the temperature in the room, ventilate the room regularly, and choose appropriate underwear to create a restful environment and reduce nighttime discomfort.

Avoid heavy meals and intense physical exertion in the evening, hydrate yourself properly throughout the day, and limit caffeine and alcohol consumption to reduce the risk of excessive sweating at night.

Regular medical check-ups, including endocrinological and psychological evaluation when necessary, can help you identify and manage early the factors that may favor night sweats.

Frequently Asked Questions About Night Sweats (FAQ)

Night sweats do not always have an obvious explanation, especially since episodes can recur at different stages of life, but have different causes. Don't know what investigations are necessary? Still not sure if you should worry or not? We hope you will find the answers you are looking for below.

Can night sweats be caused by stress?

Yes, chronic stress and anxiety can increase cortisol levels, a hormone involved in regulating body temperature. This mechanism can become a cause of night sweats, especially if you are experiencing tense periods, insomnia, and restless sleep.

What tests are done for night sweats?

Depending on the associated symptoms, your doctor may recommend blood tests that measure blood sugar, TSH, thyroid hormones, cortisol levels, inflammatory markers, or a complete blood count. In some cases, additional tests for infections (TB, HIV, hepatitis), imaging studies, or sleep studies to rule out apnea may be indicated.

Can night sweats be linked to anxiety or depression?

Yes, anxiety and depression can influence body temperature regulation and sleep quality, and some medications used to treat these conditions can have night sweats as an adverse effect.

Are night sweats dangerous if they occur occasionally?

Isolated episodes of night sweats that occur, for example, when the room is too hot, when you are stressed, or when you have had a spicy meal before bed, are usually not a cause for concern. It becomes important to consult a doctor if the sweats are frequent, intense, or accompanied by other alarming symptoms.

What serious illnesses can cause night sweats?

Persistent night sweats, associated with fever, unexplained weight loss, or extreme fatigue may be associated with severe infections, autoimmune diseases, or certain types of cancer such as lymphomas and require medical evaluation.

How can I differentiate hormonal and pathological sweating?

Hormonal hot flashes often occur cyclically or in specific contexts, such as menopause, perimenopause, or the luteal phase of the menstrual cycle. Pathological hot flashes tend to be constant, severe, and associated with more worrisome symptoms such as fever, aches, or a persistent cough.

Can night sweats be caused by diabetes or hypoglycemia?

Yes, in people with diabetes, nocturnal hypoglycemia can trigger profuse sweating during sleep. In these cases, blood sugar monitoring and treatment adjustment by a doctor is recommended.

Why do night sweats occur in men after 40?

In men, night sweats can be associated with a decline in testosterone levels, known as andropause. Hormonal changes can affect thermoregulation and can be accompanied by fatigue, decreased libido, and sleep disturbances.

What natural remedies can reduce night sweats?

Simple measures such as airing out your bedroom, maintaining an optimal temperature, wearing underwear made from natural materials, and practicing relaxation techniques can reduce the frequency and intensity of night sweats. Some people may see improvements with herbal supplements, but always consult a specialist before using them.

What role does room temperature play in the occurrence of night sweats?

High bedroom temperatures are among the most common causes of night sweats, as they make it difficult to regulate body temperature and promote sweating. Experts recommend maintaining a temperature between 18 and 20°C for a restful sleep.

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