HEAT WAVES
There are a handful of reasons why somebody can suffer from night sweats. Dr. Trisha Pasricha explains.
Q Why do I sweat in my sleep? Is there something wrong with me?
A Night sweats are common, and a solution may be straightforward. But there are a few more concerning causes to keep in mind.
We often think of normal human body temperature to be 98.6 F (37 C), but that temperature varies over a 24-hour cycle with our circadian rhythm. Just before we go to sleep, our body temperature starts to fall and ultimately reaches a nadir of about 97.7 F around three hours before we wake up.
This is a minimal drop, but to keep the body at that temperature, many people commonly compensate by sweating at night — especially if the external temperature is too hot.
Solutions include lowering the bedroom temperature to
15.5 to 19 C at night, the ideal ambient room temperature for sleep, according to the National Sleep Foundation, and swapping heat-trapping bedding for lightweight coverings and cooling sheets made from breathable materials such as linen or bamboo.
Evening alcohol intake can aggravate night sweating by causing our blood vessels to dilate (also why some people experience “flushing” while imbibing). This makes our skin feel warmer, triggering sweating. Smoking, too, leads to sweating through the effects of nicotine on the nerves responsible for activating our sweat glands. Cutting back or stopping these behaviours can improve symptoms.
Night sweats are common, with one study showing as many as 41 per cent of adults experiencing them within the prior month. While night sweats are typically not associated with worse health outcomes, if you wake up each morning completely drenched, it's time to talk with your physician as there may be something else important going on.
Here are some examples of what your night sweats could mean:
FLUCTUATIONS IN HORMONES
One of the most important causes of night sweats is menopause.
Menopause is a normal part of female aging when the menstrual cycle ends, usually between the ages of 45 to 55. That transition involves a fluctuation of hormones and changes to the body, which can last several years.
Among the most classic symptoms are hot flashes with night sweats, which can affect half of all women. In general, hot flashes can occur at any time and refer to a sudden feeling of heat and flushing throughout the body, thought to be caused by sudden changes to the part of the brain responsible for managing body temperature.
They're also associated with sweating — again, it's a way our bodies compensate for that sensation of warmth. When hot flashes happen at night, they can manifest as sweating during sleep, the kind that may leave you soaked.
If your night sweats regularly keep you from getting adequate rest, hormone therapy may decrease the frequency of these symptoms by as much as 75 per cent, but treatment is associated with increased risk of certain complications such as strokes, and so it is important to discuss the pros and cons with a physician who knows your medical history.
MEDICATION SIDE-EFFECT
Did you start a new medication recently? That could be the reason for your night sweats.
The most common medications associated with night sweats are antidepressants. Increased sweating occurs in approximately 10 to 15 per cent of people taking these medications, and if the night sweats are intolerable, switching to a different class may be a good idea.
A more dangerous scenario is if you have diabetes and take insulin before bedtime or other anti-hyperglycemic medications. In these cases, night sweats may be a sign of low blood sugar. If that happens, check your levels at the time of symptoms, and if low, discuss possibly adjusting your medication with your physician as soon as possible.
INFECTION AND CANCER
Many types of infection and cancer are associated with night sweats.
Tuberculosis or malaria: In North America, we don't immediately think about tuberculosis or malaria when someone has night sweats, but globally, infections such as these are important causes of night sweats.
Bacterial infections: Especially if present in the bloodstream, these can produce night sweats and may be accompanied by fevers and other signs such as back pain or a new heart murmur depending on the source of the infection.
Human immunodeficiency virus:
A typical infection-related cause of night sweats, this often also occurring with fever, whether from acute HIV infection or because of later complications such as opportunistic infections.
Ehrlichiosis or Lyme disease:
These can lead to night sweats, which is why I tend to ask my patients with night sweats whether they live near wooded areas or have had recent tick bites. Certain cancers: Some, such as Hodgkin lymphoma, are classically associated with night sweats.
This is among the most alarming reason for the symptom — and happens more frequently among younger adults, from late teens to the 30s, or in older people.