Night Sweat: When is There a Reason for Concern?

Sweating is usually a natural necessary way for the body to cool itself when overheated. But excessive sweating at the wrong time can be pestering or even a cause for concern. Have you ever woken up in the middle of the night, or in the early morning, dripping in sweat as if you’ve just run a marathon?
If so, you’re not alone. Night sweats, or sleep hyperhidrosis, is quite common and usually doesn’t have to do with the temperature in the room. There is a variety of factors that might prompt night sweating, some more concerning than others. This is what you need to know about night sweats, the common causes, and when you need to consult a doctor. 

1. Gastroesophageal reflux disease (GERD)

7 Causes of Night Sweat and When to be Concerned acid reflux
GERD is a digestive disorder that makes patients experience recurring acid reflux -  acidic stomach juices or food and fluids that travel back up from the stomach into the esophagus. If GERD is the reason you wake up sweaty, it will usually be accompanied by more classic symptoms of GERD, primarily heartburn. If you suspect that you suffer from this condition it is strongly recommended to see a doctor. Early treatment will minimize the risk of complications.
Your physician may prescribe antacids or histamine H2 blockers. The latter also referred to simply as H2 blockers, work by decreasing your stomach acid production. Other recommended steps are to eat smaller meals, have dinner at least 2 hours before bedtime, and avoid trigger foods like those that are fatty, fried, or tomato-based.

2. Hormonal Disorders

7 Causes of Night Sweat and When to be Concerned woman having hot flashes

The body’s temperature is controlled by an area of the brain called the hypothalamus which is also responsible for the production of certain hormones. When your hormones are out of balance, it may prevent the hypothalamus from regulating your body temperature properly. Two conditions that are caused by hormonal imbalances and are often the reason for night sweats are hyperthyroidism and menopause. 

  • Hyperthyroidism - the thyroid gland controls the metabolism, so when it produces too much thyroid hormones, your body goes into overdrive, and its temperature rises. You may feel hungrier or thirstier than usual, experience racing pulse or shaking hands, feel tired, and suffer night sweats.
  • Menopause -  This might be the most common hormonal fluctuation to cause night sweats. Perimenopause, also called menopause transition, occurs 7 to 14 years before menopause itself. It’s the time when the ovaries gradually start to produce less estrogen, and it usually lasts up until menopause itself, the point when the ovaries stop releasing eggs. 

    More than 80% of women in perimenopause and menopause experience hot flashes — sudden, intense feelings of warmth. The sharp drop in the estrogen affects the body’s temperature regulation and often leads to night sweats. Menopausal night sweats are very common and not a cause for concern, although they can be uncomfortable. You may talk to your doctor about treating this symptom with medications that help replace estrogen.

3. Anxiety and Stress

7 Causes of Night Sweat and When to be Concerned anxiety
Anxiety, worry, depression, or feeling overwhelmed do not magically disappear when you go to sleep. When you are not conscious you can’t actively think about the things that bother you during the day, but when you experience stress your brain produces an excess of the hormone cortisol. High levels of this hormone can cause disruptions in your sleep, including night sweats.  
Managing mental health is crucial for your physical wellbeing. Seek help from a counselor, therapist, or doctor if you feel that stress is causing ongoing disturbances in your daily life.

4. Certain Medications7 Causes of Night Sweat and When to be Concerned medicaation

Night sweats can be a side effect of certain medications. For example, it's very common among people who regularly take antidepressants. A study conducted in 2018 found that up to 14% of people on Selective Serotonin Reuptake Inhibitors (SSRIs) — the most common form of antidepressants — experience excessive sweating and night sweats. According to the study’s authors, the reason for that is that this kind of medication affects the areas of the brain which produce hormones and help control temperature and sweating. 

Other medications that might cause night sweats include triptan migraine medication, diabetes medication like Metformin or insulin, hormone-blocking medication, and even aspirin. If simple solutions like sleeping in lighter clothes or keeping the room cooler are insufficient, talk to your doctor about your concern.

5. Infection

7 Causes of Night Sweat and When to be Concerned infection
When you get sick with a viral or bacterial infection, the level of inflammation in your body will increase in order to fight off the intruder, and one of the ways it does that is by raising the body temperature. This can cause fever and night sweats. If you experience a combination of both of these symptoms, you may want to check with your doctor about the type of infection you have.
Tuberculosis is one of the most common infections to cause night sweat, but there are also more serious conditions that are common culprits - like HIV and bacterial endocarditis (an infection of the inner lining of your heart and heart valves). “These conditions can produce chemicals called cytokines which combat infection. Cytokines can induce fever and night sweats,” explains Soma Mandal, MD, board-certified internist at Summit Medical Group, in Berkeley Heights, New Jersey. Your doctor will check for them based on your risk factors, additional symptoms, exposure, and travel history.

6. Sleep Apnea

7 Causes of Night Sweat and When to be Concerned sleep apnea
Sleep Apnea is a condition that causes you to briefly stop breathing during sleep, usually several times at night. Obstructive sleep apnea can generally occur when something, like a throat tissue, is blocking your airway, while central sleep apnea can develop as a result of other health conditions affecting the function in your central nervous system.
Because your body isn’t getting enough oxygen it may slip into ‘fight or flight’ mode, which triggers sweating. Moreover, each time your muscles need to kick-start breathing again, it requires a burst of work from them. This effort causes sweating. A 2013 study found that excessive sweating at night happens three times as often in people with untreated sleep apnea. If you suspect you’re suffering from this condition it is extremely important to seek medical help! Click here to read the rest of the symptoms.

7. Cancer

7 Causes of Night Sweat and When to be Concerned cancer

The types of cancer most associated with night sweat are lymphoma and leukemia. These can start in different areas of the immune system like the spleen, bone marrow, lymph nodes, and the thymus. About a quarter of people with Hodgkin's lymphoma report getting night sweats. Other symptoms may include feeling tired, itchy, and experiencing pain where the tumor is after drinking alcohol. People with aggressive or advanced non-Hodgkin's lymphoma can get drenching night sweats, too.

According to Healthline, most types of cancer will have other noticeable symptoms too, so there is probably no need to panic at the first sight of night sweat. It’s recommended to seek medical help if you experience night sweats, fatigue, and generally feel unwell for more than 2 weeks. Other signs to look out for are a persistent fever and unexplained weight loss. 

When Do Night Sweats Become a Cause for Concern?

Generally speaking, experts claim that night sweats by themselves are not always a cause for worry. That's especially true if they're happening for a common reason — like if you're going through menopause or taking SSRIs. Take note of any additional symptoms you experience, alongside night sweats, like fever, weight loss, general malaise, or change in appetite. This is usually an indication of a bigger underlying problem. 

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