Night Sweats and What They Could Mean

Doctors in primary care fields of medicine often hear their patients complain of night sweats as they are common. Night sweats refer to any excess sweating occurring during the night. However, if your bedroom is unusually hot or you are using too many bedclothes, you may begin to sweat during sleep - and this is normal. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.

What are the causes of night sweats in women, men, and children?

There are many different causes of night sweats. To determine what is causing night sweats in a particular patient, a doctor must obtain a detailed medical history and order tests to decide if an underlying medical condition is responsible for the night sweats.

Although many people associate menopause with night sweats, this is only one cause of night sweats in women. Many other conditions can cause night sweats in men, women, or children.

The following are some of the known conditions that can cause night sweats.

What are the symptoms of night sweats?

Depending upon the underlying cause of the night sweats, other symptoms may occur in association with the sweating. For example:

·       With certain infections and cancers, fever can develop along with night sweats

·       Shaking and chills can sometimes occur

·       With cancers such as lymphoma, unexplained weight loss can occur.

·       Night sweats due to the menopausal transition are typically accompanied by other symptoms of menopause such as vaginal dryness, daytime hot flashes, and mood changes.

·       Night sweats that occur as a side effect of medications can be accompanied by other medication side effects, depending upon the specific drug.

·       Conditions that result in increased sweating in general (as opposed to only night sweats) will result in increased sweating at other hours of the day.

Menopause

The hot flashes that accompany the menopausal transition can occur at night and cause sweating. This is a very common cause of night sweats in perimenopausal women. It is important to remember that hot flashes and other symptoms of the perimenopausal can precede the actual menopause (the cessation of menstrual periods) by several years.

Idiopathic hyperhidrosis

Idiopathic hyperhidrosis is a condition in which the body chronically produces too much sweat without any identifiable medical cause.

Infections

Classically, tuberculosis is the infection most commonly associated with night sweats. However, bacterial infections, such as the following conditions can also be associated with night sweats:

·       Endocarditis (inflammation of the heart valves),

·       Osteomyelitis (inflammation within the bones due to infection),

·       Abscesses (for example, boils, appendix, tonsils, perianal, peritonsillar, diverticulitis), and

·       AIDS virus (HIV) infection.

Cancer

Night sweats are an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, people who have an undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fever.

Medication

Taking certain medications can lead to night sweats. In cases without other physical symptoms or signs of tumor or infection, medications are often determined to be the cause of night sweats.

Antidepressant medications are a common type of medication that can lead to night sweats. All types of antidepressants including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and the newer agents, venlafaxine (Effexor) and bupropion (Wellbutrin) can cause night sweats as a side effect, with a range in incidence from 8% to 22% of persons taking antidepressant drugs. Other psychiatric drugs have also been associated with night sweats.

Medicine taken to lower fever (antipyretics) such as aspirin and acetaminophen can sometimes lead to sweating.

Other types of drugs can cause flushing (redness of the skin, typically over the cheeks and neck), which, as mentioned above, may be confused with night sweats. Some of the many drugs that can cause flushing include:

·       Niacin (Niacor, Niaspan, Slo-Niacin - taken in the higher doses used for lipid disorders)],

·       Tamoxifen (Nolvadex)

·       Hydralazine,

·       Nitroglycerine, and

·       Sildenafil (Viagra).

Many other drugs not mentioned above, including cortisone, prednisone, and prednisolone, may also be associated with flushing or night sweats.

Hypoglycemia

Sometimes low blood glucose(hypoglycemia) levels can cause sweating. People who are taking insulin or oral anti-diabetic medications may experience hypoglycemia at night that is accompanied by sweating.

Hormone disorders

Sweating or flushing can be seen with several hormone disorders, including pheochromocytoma (a type of adrenal gland tumor that overproduces hormones known as catecholamines), carcinoid syndrome (overproduction of certain hormones by tumors of the lung or gastrointestinal system), and hyperthyroidism (excessive levels of thyroid hormones).

Neurologic conditions

Uncommonly, neurologic conditions may cause increased sweating and possibly lead to night sweats including:

·       Autonomic dysreflexia,

·       Post-traumatic syringomyelia,

·       Stroke, and

·       Autonomic neuropathy.

Night sweats treatment

The treatment for night sweats depends upon the underlying cause.

In summary, night sweats are usually a harmless annoyance; however, they are sometimes a sign of an underlying medical condition. Persons with unexplained night sweats should seek medical care.