Night sweats are an unpleasant part of life for many people. Although sweating is a normal part of the body’s temperature regulation system, night sweats are not caused by external factors such as your bedroom temperature or choice of bedding. Instead, the term refers to excessive nighttime sweating caused by physiological processes or underlying health conditions. Night sweats can vary in severity but are often described as severe enough to soak through bedding.
Both men and women may experience night sweats for many of the same reasons, such as infection and stress, but some causes differ between the sexes. Men do not experience night sweats as often as women do, possibly because menopause is a leading cause of night sweats in women. However, hormones can also play a role in night sweats among men, as low testosterone levels have been identified as a potential cause. A person’s sex also affects other aspects of health, including how they sleep, so men are sometimes more likely to have other conditions that cause night sweats.
Our bodies want to stay at approximately the same temperature, a safe range called the thermoneutral zone. Temperatures lower than this zone cause us to shiver and raise our internal temperature, while higher temperatures provoke sweating to cool us down. Men usually have a lower tolerance for heat than women do, but your sex is only part of how your body determines your thermoneutral zone.
Many conditions and physiological factors can trigger night sweats via changes to the thermoneutral zone, either by narrowing the range of acceptable temperatures or temporarily raising the thermoneutral zone range, which first causes shivering and chills that are followed by sweating when the thermoneutral zone returns to normal. Some of these triggers are harmless or even related to positive lifestyle changes, while others involve health conditions that may require treatment.
Your doctor is your best resource if you are concerned about night sweats. They are able to diagnose any underlying medical conditions and help you find ways to alleviate your symptoms.
Low Testosterone Levels
Men can experience night sweats due to low testosterone levels, also called male hypogonadism. Around 38% of men 45 years or older have low testosterone levels for a variety of reasons, and even otherwise healthy men have a 20% likelihood of having low testosterone levels if they are over 60 years old. The causes of male hypogonadism vary dramatically but can be categorized into primary, which refers to a problem with the testicles, and secondary, which refers to a problem with the part of the brain that controls hormone production.
Other symptoms of low testosterone levels include:
- Low libido and erectile dysfunction
- Loss of body and facial hair
- Weakness and fatigue
- Lower muscle mass and increased body fat
Night sweats caused by low testosterone levels can be treated with testosterone replacement therapy or by treating the underlying cause of the low hormone levels.
Stress and Anxiety
Anxiety makes sweat glands more responsive, and people with high stress or anxiety levels are more likely to experience night sweats. These effects are true for both short-term and chronic anxiety, with some research showing that even the stress of trying to solve a math problem can affect sweat gland responsiveness.
While women are nearly twice as likely to be diagnosed with an anxiety disorder, men are also significantly less likely to report or seek help for mental health symptoms. The symptoms of stress can also differ between men and women, with women having more emotional responses, like sadness, and men experiencing more physical symptoms, such as changes in diastolic blood pressure. However, there are more similarities than differences between male and female responses to stress.
Obstructive sleep apnea (OSA) is a sleep disorder that causes people to stop breathing for multiple short periods during sleep. These pauses, or apneas, are often followed by gasping or choking sounds, and severe snoring is a common symptom of OSA. An estimated 3% to 7% of Americans have OSA, but it is three to five times more common in men than in women due to differences in airway shape, obesity rates, hormones, and other factors.
Nearly a third of men with OSA report experiencing night sweats, rates which are three times higher than those seen in the general population. Successful treatment of sleep apnea appears to help resolve any related night sweats.
Some medications are known to cause excessive sweating, including night sweats. These include:
- Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants
- Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Hypoglycemic agents used for diabetes treatment
- Corticosteroids such as cortisone
If you believe a medication could be causing your night sweats, see your doctor. It is important to always speak to your doctor before stopping or lowering the dose of a medication you have been prescribed.
Infection can cause both night sweats and unusual daytime sweating. When your body is fighting off an infection, it releases inflammatory mediators that temporarily raise your thermoneutral zone. This process begins with chills and shivering that increase your core body temperature, and it is followed by excessive sweating to decrease your temperature once your thermoneutral zone returns to normal. This cycle can occur many times throughout the course of an infection.
While many minor infections can cause night sweats, they are also a symptom of serious infections like human immunodeficiency virus (HIV), tuberculosis, endocarditis, and brucellosis.
Hyperhidrosis describes excessive sweating that occurs without ordinary triggers like exercise, heat, or stress. The sweating can be excessive enough to soak through clothing and can even cause skin problems due to the constant moisture it causes. Some people develop primary hyperhidrosis that is not caused by underlying issues, but hyperhidrosis can also be caused by a number of health conditions and medications.
The rates of hyperhidrosis are similar for both men and women. Treatments for hyperhidrosis differ depending on the underlying cause and can include oral or topical medications, using botulinum to block neurotransmitters, and surgery.
There is some evidence that regular exercise can lower the thermoneutral zone, causing people to start sweating at lower temperatures than usual. For example, eight to 14 days spent exercising in a hot environment can cause changes in your thermoneutral zone that may contribute to night sweats. While exercise is healthy, night sweats are also considered a symptom of sports overtraining, and it is important to discuss any new or concerning symptoms with your doctor.
Night sweats are a common symptom with many potential causes. Although no relationship has been found between night sweats and the risk of death, night sweats can be a symptom of some serious conditions. These include:
- Cancer: People who have cancer sometimes experience night sweats as a side effect of either cancer itself or the treatment they are receiving. Cancer survivors may also have night sweats even once they are in remission. Treatment usually involves treating the cancer while using lifestyle changes or medication to ease discomfort associated with night sweats.
- Neurological Conditions: Some neurological conditions can cause either night sweats or hyperhidrosis during both the day and night. These include neuropathy, autonomic dysreflexia, syringomyelia, and stroke.
- Hyperthyroidism: In addition to low testosterone levels, men can also develop night sweats due to hormonal conditions like hyperthyroidism. Also known as having an overactive thyroid, hyperthyroidism can cause excessive sweating during the day and at night. Other symptoms include fatigue, weight loss, heart palpitations, tremors, anxiety, and disturbed sleep. Treatment involves antithyroid drugs, radioactive iodine ablation, or surgery.
When to Talk to Your Doctor
Night sweats are a common condition and may not be cause for concern. However, since night sweats can be a symptom of health conditions that require treatment, you should speak to your doctor if they happen regularly or are unaffected by lifestyle changes.
Other signs that you should talk to your doctor include:
- Sleep disturbances
- Fatigue, weakness, or excessive daytime sleepiness
- Weight loss unrelated to lifestyle or diet changes
- Mood changes
Even if you do not have an underlying condition causing your night sweats, you may want to speak to your doctor about treatment options if night sweats interfere with your ability to sleep comfortably.
Tips to Reduce Night Sweats
If night sweats are due to an underlying health condition, treating the condition will usually help reduce the night sweats. You can take additional measures to sleep more comfortably, including:
- Keep Cool: Although night sweats occur regardless of ambient temperature, turning on your air conditioning, buying a mattress that sleeps cool, or using breathable bedding can be more comfortable and help reduce sweating. It is also easier to get a good night’s sleep if your room is set to a comfortable temperature.
- Wear Comfortable Clothing: Loose pajamas made of a breathable, moisture-wicking fabric, like cotton, can help keep you cool while allowing sweat to evaporate more quickly.
- Use Relaxation Techniques: Since stress and anxiety can worsen night sweats, relaxation techniques may be helpful for both coping with and reducing night sweats. Meditation, mindfulness, guided imagery, and breathing exercises are all popular techniques. Working with a professional for cognitive behavioral therapy or hypnosis may also be helpful.
- Avoid Dietary Triggers: Alcohol, caffeine, and spicy foods can all affect sweating and your internal temperature. Avoiding them, particularly at night, may help reduce your night sweats.
- Maintain a Healthy Weight: Excess weight may cause night sweats in some people. Obesity is also a risk factor for other conditions that may cause night sweats, such as sleep apnea, and weight loss is sometimes recommended to treat these conditions.
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