Reasons for Night Sweats: Experts explain why you sweat in your sleep

Q: Why do I sweat in my sleep?

You go to sleep at a comfortable temperature – not too hot, not too cold – only to wake up hours later drenched in sweat. Sometimes your pajamas get soaked, and you may even need to change your sheets before bed. You’re wet, uncomfortable and maybe a little anxious. What’s happening?

“Night sweats are a strange symptom because they’re usually harmless, but occasionally they aren’t, so it’s definitely something we should always take seriously,” said Dr. Kate Rowland, associate professor of family medicine at Rush University in Aurora, IL.

Sweating during sleep is a relatively common complaint that affects people across the age and gender spectrum, Dr. Rowland said. Surveys of adults who visit primary care physicians for unrelated reasons show that 10 to 40 percent of them experience night sweats, at least occasionally.

There are many potential causes of night sweats, so when the patient tells the doctor. Rowland wakes up soaking wet in the middle of the night, and he wants to know more.

“One of the first things we ask is how warm is your room?” he said. “When you wake up and say, ‘Oh, this room is hot,’ we say, ‘Well, adjust the temperature accordingly.'”

The National Sleep Foundation recommends bedroom temperatures between 60 and 67 degrees for a comfortable night’s sleep. If you can’t keep your bedroom that cool, try adding a strategically placed fan, Dr. Rowland said. Changing to lighter bedding or sleepwear may also help.

“It’s tricky because the temperature that makes you feel most comfortable sleeping may not be the most comfortable temperature for falling asleep,” he said.

In fact, being cozy and warm can help you fall asleep, said William Wisden, professor of life sciences and sleep researcher at Imperial College London. Just as other mammals nest before bed, we put on our pajamas and curl up under the covers before bed, and research shows that people fall asleep faster after a warm bath, shower or foot soak, he said. “However, if you get too hot during the night and you put on a very thick blanket, your body will try to regulate its temperature.” And sweating is one of your body’s cooling tools, he said.

If you’re still sweating at night even after lowering the temperature in your room or taking other steps to cool down your sleep, see your healthcare provider to rule out possible medical causes. They may ask how long and how often you sweat at night, whether they are soft or seeping into your pajamas, and whether you have a fever, weight loss, fatigue, cough, shortness of breath, or other symptoms. pain – “or other symptoms that are completely inappropriate for that patient,” Dr. Rowland said.

Any infection that causes a fever can be accompanied by sweating during the day or at night, but several serious diseases, including tuberculosis, HIV infection, endocarditis (inflammation of the lining of the heart valves and chambers), malaria mononucleosis, are associated with the night. sweats. But rarely, severe night sweats can be a sign of cancer, such as lymphoma, Dr. Rowland said.

“You can quickly narrow things down with a few lab tests and a few detective-like questions,” said Dr. Andrea Matsumura, a sleep medicine physician at the Oregon Clinic in Portland, and a spokesperson for the American Academy of Sleep Medicine.

Dr. Matsumura said he often sees patients in the menopausal transition whose sleep is disrupted by night sweats; Along with hot flashes, this often starts a few years before your last period and can last for years afterward. If menopausal night sweats are preventing you from getting a good night’s sleep, talk to your doctor about treatment options, she said.

Among his sleep medicine patients, excessive night sweats “are usually caused by some abnormal breathing while they sleep, and that’s a symptom of sleep apnea,” says Dr. Matsumura said. Studies have shown that night sweats can also be linked to insomnia, restless legs syndrome and narcolepsy.

Finally, many medications can cause night sweats. Common culprits include antidepressants, diabetes medications, and certain hormone therapies. If medication may be the cause, Dr. Rowland talks with her patients about the risks and benefits of stopping or switching medications, depending on how troublesome the night sweats are.

But often Dr. Rowland said he can’t pinpoint the cause of night sweats in his patients, “and it’s always frustrating.” In such cases, he stressed, patients should report if the night sweats worsen or if any new symptoms appear.

Otherwise, sleep sweating may be part of how your body regulates its temperature at night, Dr. Rowland said. Our normal circadian rhythm involves a slight, steady drop in core body temperature throughout the night, and sweating is a “normal, physiological response” that helps you reach or maintain a lower temperature, he added. And “some people sweat more than others.”

Regular or not, night sweats can be uncomfortable and interfere with sleep. In addition to lowering your bedroom temperature and adjusting your sleepwear and bedding, Dr. Matsumura recommends avoiding exercise, drinking alcohol or hot drinks, and eating too heavy before bed, all of which can lead to night sweats.

If you usually sleep with your partner, you can try sleeping separately for a few nights to see if that helps. Rowland said. “Sometimes another person is like a 180- or 200-pound 98-degree oven next to you and can also affect your temperature regulation at night.”

Often, dealing with night sweats means doing a series of personal experiments in pursuit of a more comfortable night’s sleep. “Nothing Magical” Dr. Rowland said. “Different things work for different people.”

Alice Callahan is an Oregon-based health and science journalist and frequent contributor to The New York Times.

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