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Why do I sweat so much in my sleep?

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There are many possible reasons people might wake up in a pool of perspiration. Here is how to tell when it should be cause for concern. (Photos: NYTimes)
Night sweats are “a weird symptom, because mostly they’re harmless, but every once in a while, they’re not, so it’s certainly something that we always take seriously,” said Dr Kate Rowland, an associate professor of family medicine at Rush University in Aurora, Illinois.اضافة اعلان

There are many potential causes of night sweats, so when patients tell Rowland that they are waking up soaked, she will want to know more.

“One of the first things we ask is ‘How warm is it in your room?’” she said.

The National Sleep Foundation recommends a bedroom temperature between 16°C and 20°C for comfortable sleep. If you are not able to keep your bedroom that cool, you can try adding a strategically placed fan, Rowland said. Switching to lighter bedding or sleepwear might also help.

If you are sweating at night even after taking these steps to cool your sleep setup, see a health care provider to consider possible medical causes. He or she will likely ask how long and how frequently you have been having night sweats, whether they’re mild or they drench your pajamas, and if you have additional symptoms such as fever, weight loss, fatigue, cough, shortness of breath, or pain.

Any infection that causes a fever might result in sweating during the day or night, but a few serious illnesses, including tuberculosis, HIV infection, endocarditis (inflammation of the lining of your heart valves and chambers), malaria, and mononucleosis, have been specifically associated with night sweats. And rarely, severe night sweats may be a symptom of a cancer such as lymphoma, Rowland said.

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

Matsumura said she often sees patients in the menopausal transition whose sleep is fragmented by night sweats; along with hot flashes, these often begin several years before the final menstrual cycle and can persist for years afterward. If menopausal night sweats are interfering with a good night’s sleep, talk with your health care provider about treatment options, she said.

Among her patients, excessive nighttime sweating occurs “typically because they’re having some sort of abnormal breathing in their sleep, and that’s a sign of sleep apnea,” Matsumura said. Studies have found that night sweats can also be associated with insomnia, restless legs syndrome, and narcolepsy.

Finally, many medications can cause night sweats. Among the most common culprits are antidepressants, diabetes medications, and certain hormonal therapies. If a medication seems to be a cause, Rowland will talk with her patients about the risks and benefits of stopping or changing the medication, depending on how bothersome the night sweats are.

Otherwise, sweating in sleep may just be a part of how your body regulates its temperature at night, Rowland said. Our usual circadian rhythm includes a small, steady decline in core body temperature throughout the night, and sweating is a “normal, physiologic response” that may help you reach or maintain that lower temperature, she added. And “some people sweat more than other people do.”

Normal or not, night sweats can be uncomfortable and disruptive to sleep. In addition to regulating the temperature of your sleep setup, Matsumura recommended avoiding exercise, drinking alcohol or hot beverages, and eating a heavy meal too close to bedtime, all of which she said can cause sweating during the night.

If you normally sleep with a partner, you might also try sleeping separately for a few nights to see if that helps, Rowland said.

Very often, coping with night sweats means performing a series of individual experiments in pursuit of a more comfortable snooze. “There’s nothing magic,” Rowland said. “Different things work for different people.”


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