Sweating is normal and a core part of how the body regulates its temperature. In a sauna or working out in the gym, sweating profusely is expected. Waking up sweating in the middle of the night is another matter altogether. Night sweats can be defined as sweating in excess of that required by the body to regulate body temperature.
Night sweats can occur during sleep and without physical exertion. They aren’t caused by a heavy blanket or warm bedroom. Instead, other underlying health issues may be responsible for these episodes of considerable sweating in your sleep.
Night sweats can reduce sleep quality, concern a bed partner, and provoke serious discomfort. As a result, it’s natural to want to know more about the causes of night sweats and how they can be resolved.
What Are Night Sweats?
As the name indicates, night sweats are episodes of excessive perspiration that happen during sleep. They are often described as soaking or drenching and may require a change of sheets or even clothes.
Night sweats are distinct from simple overheating, which occurs because of something in a person’s environment, such as a heavy blanket or high bedroom temperature.
How Are Night Sweats Different From Hot Flashes?
Hot flashes are sudden feelings of warmth. Hot flashes can occur at any time during the day, and when they occur at night and provoke heavy perspiration, they are classified as night sweats.
In some resources, night sweats are also called hot flushes, but they are distinct from flushing. Flushing1 is a reddening of the skin from increased blood flow. While night sweats can occur with flushing, flushing itself does not provoke intense sweating.
How Common Are Night Sweats?
Exact estimates of how many people have night sweats are limited. One study of over 2,000 patients in primary care offices found that 41% of people reported2 having had night sweats in the last month. In that study, night sweats were most common in people aged 41 to 55.
Four Common Causes of Night Sweats
The body’s system for temperature regulation is complex and influenced by multiple factors, which can make it hard in some cases to know exactly why a person experiences night sweats.
That said, four common causes identified in research about night sweats include menopause, medications, infections, and hormone problems.
Menopause3 is when women permanently stop having their period. During this time, significant changes in the body’s production of the hormones estrogen and progesterone are believed to be an important driver of hot flashes4.
Hot flashes are considered to be a hallmark of menopause5, affecting up to 85% of women6. In most cases, hot flashes actually begin in the transition time before menopause, known as perimenopause, and can continue once a woman is postmenopausal.
Menopausal hot flashes normally last for a few minutes and can occur multiple times per day4, including at night, when they can cause night sweats. It’s common for hot flashes to continue occurring for several years, and some women experience them for more than two decades.
Perhaps not surprisingly, many women — up to 64%5 — report sleeping problems and higher rates of insomnia7 during perimenopause and menopause. While night sweats are not the only cause of these sleeping difficulties, they can contribute to poor sleep6, especially when they are severe.
Certain medications8 are known to be associated with night sweats. These include some antidepressants known as selective serotonin reuptake inhibitors (SSRIs), steroids, and medicines taken to lower fevers, such as aspirin or acetaminophen, that may paradoxically cause sweating.
Caffeine intake can be a cause of generalized sweating. Alcohol and drug use9 can also increase the risk of night sweats.
Many infections are associated with night sweats10. Most often, this is because infections may trigger a fever and overheating. Tuberculosis, bacterial and fungal infections, and human immunodeficiency virus (HIV) are a few examples of infections for which night sweats are a significant symptom.
Changes in the endocrine system11, which controls hormone levels in the body, can be related to night sweats. Examples of hormone problems with links to night sweats include overactivity of the thyroid (hyperthyroidism12), diabetes and elevated blood sugar, and abnormal levels of sex hormones.
The part of the brain that regulates body temperature is known as the hypothalamus, and it is also involved in the endocrine system. Hypothalamic dysfunction13 may be an underlying issue related to hormone imbalances and night sweats.
Other conditions affecting the endocrine system such as pheochromocytoma14 (a tumor of the adrenal gland) and carcinoid syndrome15 (caused by slow-growing tumors that produce hormones) can also be associated with night sweats.
Other Causes of Night Sweats
Beyond these four common causes, other conditions may give rise to night sweats. Hot flashes may be more common during pregnancy and the post-partum period16. Anxiety and panic attacks have been correlated with night sweats2.
Hyperhidrosis18, a condition of excessive sweating, may affect people during both day and night. Some research has pointed to Gastroesophageal Reflux Disease (GERD)19 as a potential cause of night sweats20.
Night sweats can be a symptom of certain types of cancer or a side effect of cancer treatments21. Hot flushes may occur in people with lymphoma22. They frequently arise as a result of hormone therapy for women with breast cancer23 and men with prostate cancer24. Surgery, radiation therapy, and chemotherapy for cancer may provoke night sweats.
How to Stop Night Sweats and Get Better Sleep
Night sweats can be worrying and bothersome, and they frequently are tied to serious sleep disruptions. As a result, it’s natural for anyone dealing with night sweats to want to know how to avoid them and sleep more soundly.
Because there are multiple potential causes of night sweats, there’s no single solution for stopping them. Several steps may be involved and can be tailored to fit a person’s specific situation.
Talk to Your Doctor About Night Sweats
You should talk to your doctor if you have night sweats that are
- Persistent over time
- Interfering with your sleep
- Affecting other aspects of your daily life
- Occurring along with other health changes
It’s important to consult with a doctor in these situations, but unfortunately, one study of over 900 people who experienced night sweats found that the majority had not raised the issue with a doctor.
Meeting with a doctor is important because they can help determine the most likely cause and order tests to get to the bottom of the situation. Based on that information, a doctor can work with you to create a treatment plan that takes your symptoms and overall health into account.
It’s also important to let the doctor know about any sleeping problems that you have. Sleep disorders, like obstructive sleep apnea (OSA), may be causing daytime sleepiness and, according to some research, may also be a factor promoting night sweats25.
Treatments for Night Sweats
The most effective treatment for night sweats will vary for any individual patient and should always be overseen by a health professional. Some potential treatment methods include modifications to environment and behavior, cognitive behavioral therapy (CBT), and medication.
Changes to Your Environment and Lifestyle
A standard approach to night sweats, especially those related to menopause, is to start by trying straightforward changes26 that can minimize the frequency and severity of night sweats while improving overall health and sleep.
- Sleeping in a Cooler Bedroom: While a warmer bedroom isn’t the central cause of night sweats, it may facilitate or trigger them. Keeping the thermostat at a lower temperature and using lighter bedding can keep heat from building up around the body during the night.
- Wearing Breathable Clothing: Tight-fitting clothes trap heat, so it’s best to wear lightweight, loose-fitting clothes made with materials that are breathable and airy. Dressing in layers makes it easier to make adjustments to maintain a comfortable temperature.
- Avoiding Caffeine, Alcohol, and Spicy Foods: All of these things can cause spikes in body temperature and induce sweating. Avoiding them, especially in the evening, may cut down on night sweats.
- Drinking Cold Water: Having a small amount of cool water before going to bed helps some people with night sweats achieve a more pleasant temperature.
- Maintaining a Healthy Weight: Some research has identified a correlation between higher body weight and night sweats. Being overweight or obese can contribute to other health problems, including those that affect sleep, such as sleep apnea.
- Utilizing Relaxation Techniques: Finding ways to put yourself at-ease can make it easier to fall asleep. Studies also suggest that techniques like controlled breathing may help to meaningfully reduce hot flashes27 in menopausal women.
Many of these tips overlap with broader healthy sleep tips that can be gradually implemented to make your sleep-related habits work in your favor for more consistent and high-quality sleep.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a type of talk therapy that is commonly used for health problems like depression, anxiety, and insomnia. It is normally conducted in-person by a psychiatrist or counselor, but a number of self-directed programs have been developed.
CBT is based predominantly on reframing negative thoughts in order to promote healthier actions. CBT for insomnia (CBT-I) has a strong track record of success, including in menopausal women7.
Studies have found that CBT for hot flashes and night sweats28 can reduce their frequency and improve mood and quality of life in menopausal women. CBT is compatible with other approaches, such as behavior modifications, and likely has the greatest effect on night sweats29 when combined with other approaches.
If existing medications are causing night sweats, then changing the prescription, the dosage, or when the drug is taken may resolve night sweats. If the night sweats are caused by an underlying infection or hormone problem, medication may help address them.
For menopausal women, medications may be considered if behavioral treatments don’t work. Several types of drugs, notably hormone therapies, can reduce night sweats, but these drugs can have significant side effects. A doctor is in the best position to discuss the benefits and downsides of any specific medication.
Alternative therapy with estrogen-containing products like black cohosh, red clover, or soy have not been proven to be effective26 in addressing hot flashes caused by menopause. Even though these may be available as supplements without a prescription, patients should always talk with their doctor before taking them in order to help prevent potential adverse reactions.
This content was created by the National Sleep Foundation