Night Sweats – Causes and Treatment

Night sweats, also known as nocturnal hyperhidrosis, is the occurrence of excessive sweating during sleep.  It is also called sleep hyperhydrosis.

The condition is not related to day-time perspiration. The person may or may not also perspire excessively while awake.

There are repeated episodes of extreme perspiration that may soak the nightclothes or bedding.

An occasional sweaty awakening particularly if you are sleeping under too many blankets or if your bedroom is too warm is not labeled as night sweats.

The night sweats occur irrespective of temperature of the room and are often associated with medical conditions like fever, weight loss, localized pain, cough, diarrhea.

One of the most common causes of in women over 40 is the hormonal changes related to menopause and perimenopause.

This is a very common occurrence during the menopausal transition years. Often often, but not always, they are associated with hot flashes that women may experience during the menopausal transition.

These are often  relatively harmless but can be a sign of a serious underlying disease.

Night sweats affect approximately 3 percent of the population.

Night sweat is a symptom and not disease and often occur in conjunction with other symptoms such as flushing,fever, or chills.

Why does sweating Occur?

Sweating is the body’s natural cooling system to prevent overheating. Body temperature is regulated by hypothalamus. There are over 2 million sweat glands to help keep us cool.

The sweat as evaporates produces the cooling effect.

Causes

There are many conditions that cause night sweats to occur. Certain drugs can also lead to night sweating.

Infections

• HIV/AIDS
• Tuberculosis [Traditionally most common]
• Infectious mononucleosis
• Fungal infections
• Lung abscess
• Infective endocarditis
• Brucellosis

Endocrine disorders

• Menopause
• Premature ovarian failure
• Hyperthyroidism
• Diabetes mellitus (nocturnal hypoglycemia)
• Endocrine tumors (pheochromocytoma, carcinoid)
• Orchiectomy

Rheumatic disorders

• Takayasu’s arteritis
• Temporal arteritis
•  Cancers
  • Lymphoma
  • LeukemiaDrugs
    • Antipyretics(salicylates, acetaminophen)
    • Antihypertensives
    • Dinitrophenol- a common side effect
    • Phenothiazines
    • Drug withdrawal: ethanol, benzodiazepines, heroin(and other opiates)

Drugs

• Acyclovir
• Albuterol
• Amlodipine
• Atorvastatin
• Bupropion
• Buspirone
• Citalopram
• Ciprofloxacin
• Esomeprazole
• Glipizide
• Hydrocodone
• Insulin
• Levothyroxine
• Lisinopril
• Loratadine
• Naproxen sodium
• Nicotine replacement
• Omeprazole
• Paroxetine
• Prednisolone
• Sertraline
• Sumatriptan
• Tadalafil
• Trazodone
• Zolpidem

Other

• Obstructive sleep apnea
• Gastroesophageal reflux disease
• Chronic fatigue syndrome
• Fibromyalgia
• Granulomatous disease
• Chronic eosinophilic pneumonia
• Lymphoid hyperplasia
• Diabetes insipidus
• Anxiety
• Pregnancy
• Inflammatory bowel disease) – Crohn’s disease/ulcerative colitis
• Obesity
• Substance abuse – heroin
• Cardiovascular disorders
• Hypoglycemia, or low blood sugar
• Parkinson’s disease

Treatment of Night Sweats

As the night sweats are symptom of an underlying problem, the underlying problem needs to be treated, if it could be.

The treatment therefore is directed at the underlying cause.

For examples, hormonal disorders, cancers, and infections are among the causes in which treatment is directed at the underlying condition.

Night sweats in perimenopausal women treated with hormone therapy, if appropriate.

At present estrogen therapy (ET) and combined estrogen and progestin therapy have been used.

If a drug is causing the night sweats, changing the drug would cause night sweats to stop.

If there is no specific cause of night sweats, treatment focuses on preventive measures along with symptomatic treatment

Prevention

Night sweats are not preventable when there is underlying conditions. Following measures may help in reduction of frequency and severity

• Better sleeping environment
• Cool environment
• Light, breathable, non-synthetic night-clothes and sheets.
• Avoiding alcohol, caffeine, spicy foods
• Using antiperspirant to the parts of the body that are most susceptible, such as the underarms, hands, feet, hairline, back, chest, or groin.
• Not eating within 2 to 3 hours before going to bed
• Low fat and low sugar diet
• Relaxation breathing exercises before bed. Repeat them if woken up by night sweat.
• Daily exercise
• Maintain a normal weight
• Take anticholinergic agents [under the advice of a doctor.]