by Elizabeth Burton
date: 03/09/2021
In our article “5 Causes of Night Sweats in Men and 5 Tips for Reducing Them,” we noted that “most of us have woken up in the middle of the night with a start, our sheets drenched and our foreheads clammy.” Nighttime sweating is incredibly common, particularly light sweating related to climate. However, nighttime sweating that results in drenched pajamas or sheets might be a cause for concern. As will be explained below, nighttime sweating in infants, children, teens and adults may be due to any number of factors -- both acute and chronic.
These may include medical conditions like sleep apnea and GERD but might also include behavioral issues like alcohol and drug abuse or mental health issues like anxiety or poorly controlled stress. In his article for The Sleep Foundation, Eric Sunni notes that of 2,000 patients surveyed, "41%...had night sweats in the last month.” Though night sweats are symptomatic of concerning medical issues in some cases, more commonly they are the result of acute illness or mild conditions. Others are a result of hormonal changes common during the teenage years, later in life for both men and women and during menopause for those who experience it.
In fact, a recent brief released by Web MD reported that “for 75% of women...night sweats and hot flashes are a fact of life during perimenopause.” While medication is needed to properly address some causes of night sweats, oftentimes, changing simple elements of one’s bedroom, one’s nighttime routine or one’s general behavior can make all the difference. Follow below to better understand the many causes of night sweats and how to address them safely.
What are the Primary Causes of Night Sweats in Men, Women and Children?
As mentioned above, the causes of night sweats in people of all ages vary widely. They can be acute -- such as those related to viral illnesses like the flu or the common cold -- or chronic -- such as those related to GERD and sleep apnea. However, even night sweats resulting from chronic illness, disorder and disease may be mitigated by simple changes to one's behavior or environment. Below we will discuss the common causes of night sweats -- from health conditions to lifestyle choices -- and how to change one's home and lifestyle to lessen the occurrence of nighttime sweating. In their article “What to know about night sweats” for Medical News Today, Alana Biggers, M.D., MPH and Kathleen Davis, FNP explain the demographic-specific causes of night sweats. In teens and both male and female adults, hormonal changes are a common culprit of nighttime sweating. Similarly, in all demographics, night sweats may occur when an infection, fever, cold or flu is present. Surgery, cardiovascular disease, some neurological disorders and diseases like cancer might also cause night sweats in adults.
Common Causes of Night Sweats in Adults
However, causes of night sweats most common to women and to non-female people possessing such organs include menopause, pregnancy and hormonal changes during the postpartum period. Postpartum night sweats are rarely talked about but do occur in many women after giving birth. In men, write Dr. Biggers and Davis, the most common causes of night sweats are also hormonal -- particularly low levels of testosterone. A mid-life drop in testosterone is incredibly common in men, write Biggers and Davis, with “around 39% of males aged 45 and above [experiencing] this drop in testosterone.” Other causes in both adult men and adult women include reactions to certain medications and substances like alcohol and drugs, hypoglycemia, GERD, “stress and anxiety” and “autoimmune disease.”
Reasons for Night Sweats in Teens and Adolescents
The most common causes of night sweats in teens and adolescents are stress and anxiety and hormonal changes. In his article “Why Am I Waking Up Sweating at Night?” for BedJet.com, Collin Hickey explains that “a change in hormone levels for growing teenagers can be the cause of their night sweats.”
Possible Causes of Night Sweats in Children and Infants
Night sweats are perhaps most common in infants and children up to toddler age. In their article “Why Is My Child Sweating at Night and What Can I Do?” for Healthline, Carissa Stephens, R.N., CCRN, CPN and Dr. Noreen Iftikhar, MD explain why. Referencing a study conducted in 2012, Dr. Iftikhar and Stephens note that of “6,381 children from the ages of 7 to 11 years...almost 12 percent had weekly night sweats.” Infants, babies and young toddlers might be most prone to night sweats because they have not yet learned how to “wiggle out of heavy clothing and bedding,” regulating their body temperature on their own. While genetics and temperament might both play a part, Dr. Iftikhar and Stephens note that “sometimes, night sweats in children happen for no reason at all.” In her article “Is it normal for my preschooler to wake up drenched in sweat?” for Baby Center, health and wellness writer and editor Nancy Montgomery provides a bit more information for concerned parents.
Quoting pediatrician Dr. Jennifer Shu, Montgomery writes that "’it's very common for children to sweat while they're in a deep stage of sleep,’” and most of the time it is not an issue at all. In fact, “children are more likely than adults to sweat at night because they spend more time in deep sleep, their temperature regulation systems aren't as mature, and they have a higher proportion of sweat glands compared to their body size.” Parents should only be concerned if additional symptoms occur. They should keep an eye on their children and inform their doctor if a fever or other symptoms arise or if the child appears uncomfortable or excessively tired after sleep. Montgomery and Dr. Shu recommend watching for “‘fever, snoring, gasping, pauses in breathing, and any symptoms of illness’" in addition to pain or fatigue.
Common Medical Conditions that Can Cause Nighttime Sweating
Infections, the Flu and the Common Cold
The flu and the common cold are two acute causes of night sweats. Both the flu and the common cold may evoke temporary night sweats in infants, children, teens and adults of all ages. According to the Cleveland Clinic’s Health Essentials article “Frustrated By Night Sweats While You’re Sleeping?,” “viral illnesses such as colds and the flu cause night sweats, but they resolve on their own.” Night sweats related to the flu or common cold are frequently associated with the resultant fever. Viral illnesses like the flu and the common cold cause fevers purposefully, explains Aaron Kandola in his article “Can you have the flu without a fever?” for Medical News Today. Kandola writes that “when fighting an influenza infection, the body may raise its temperature to make it difficult for the virus to replicate.” As such -- notes the Cleveland Clinic article -- both the fever itself “and sweating typically respond to anti-fever medications, such as acetaminophen (TYLENOL®) or ibuprofen (Advil®).”
GERD or Gastroesophageal Reflux Disease
What is GERD?
Some studies have noted a surprising connection between the very common reflux issue GERD and night sweats. The Mayo Clinic brief “Gastroesophageal reflux disease (GERD)” notes discomfort due to GERD occurs “when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus).” When acid moves backward through the body, “it can irritate the lining of your esophagus,” causing “a burning sensation in your chest,” “chest pain,” “difficulty swallowing,” “regurgitation” and the “sensation of a lump in your throat.” While GERD is often self-diagnosable, the Mayo Clinic brief recommends consulting with a doctor when the issue persists, when severe symptoms are experienced and when over-the-counter medications seem not to help. While those suffering from GERD might have noticed difficulty falling or staying asleep due to pain from acid backflow when lying down, the connection between GERD and night sweats might be more of a surprise.
Why Does GERD Cause Night Sweats?
In their paper “Gastroesophageal reflux as a cause of night sweating” for Anales de Medicina Interna, P Young, B C Finn, J E Bruetman and H Trimarchi explain that many of those dealing with night sweats have also been shown to suffer from GERD. Young, et al. reference an earlier study conducted in 1989. During this study, the researchers examined “200 patients with night sweats.” They found that of these 200 participants in the study, “44% had gastroesophageal reflux (GER).” Young, et al. explain that the presence of night sweats in both acid reflux and alkaline GERD sufferers suggests that the “trigger for sweating is not the PH, but the reflux itself.”
In her Healthline article “Is GERD Causing Your Night Sweats?,” Kristeen Cherney explains the relationship in layman’s terms. Cherney writes that “if you have GERD, you may experience night sweats along with more classic symptoms of the disease.” They often occur together and are related to each other. For instance, Cherney notes, “you might wake up in the middle of the night with both heartburn and excessive sweating,” evidence that “you may have GERD that isn’t well controlled.”
How to Treat GERD-Caused Night Sweats
Kristeen Cherney recommends speaking with one’s doctor if frequently subjected to uncontrollable night sweats in conjunction with GERD. A doctor may be able to prescribe medications to better control GERD symptoms and to limit night sweats. For example, writes Cherney, a medical professional may prescribe “H₂ blockers [which work] by decreasing your stomach acid production.” This type of medication may also “help reduce your night sweats, as well as other symptoms of GERD.” If after trying H₂ blockers or other GERD treatments without success in reducing frequency or intensity of night sweats, one should once again visit their doctor as the night sweats might be caused by another issue.
Sleep Apnea
What is Sleep Apnea?
According to a Mayo Clinic brief outlining the disorder, obstructive sleep apnea is a “potentially serious sleep disorder…[that] causes breathing to repeatedly stop and start during sleep” due to a blockage in the person’s airway. Signs and symptoms of sleep apnea include “excessive daytime sleepiness, loud snoring, observed episodes of stopped breathing during sleep” and “abrupt awakenings accompanied by gasping or choking.” Other symptoms may include “awakening with a dry mouth or sore throat or a morning headache.” The Mayo Clinic also lists “mood changes,” “high blood pressure” and “nighttime sweating” as other possible signs of obstructive sleep apnea.
The Cleveland Clinic notes that “sleep apnea occurs in about 25% of men and nearly 10% of women,” but can “affect people of all ages, including babies and children and particularly people over the age of 50 and those who are overweight.” Some physical characteristics might make a person more prone to developing sleep apnea, particularly when they relate to the face, neck, nasal passages or throat. The Cleveland Clinic article notes that night sweats are common in people suffering from sleep apnea because the disorder the “heart rate tends to accelerate quickly and your blood pressure rises,” similarly to the effects of exercise.
Why Do Night Sweats Arise from Sleep Apnea?
A post published by Sleep Better Chicagoland explains the relationship between sleep apnea and nighttime sweating. The post notes that “night sweats and sleep apnea both happen during sleep, so it’s no shock that they can be connected.” Those with sleep apnea struggle significantly to “breathe at night” as they fight the blockage in their airway. According to the post, because breathing requires extreme effort, the body reacts “almost as if you’re exercising while you’re trying to sleep.” Night sweats may also result from an increase in the concentration of cortisol released during sleep when one suffers from sleep apnea. In his article “Why We Get Sweaty in Our Sleep” for VeryWellHealth, Dr. Brandon Peters, MD explains that “each episode of apnea can also provoke a burst of cortisol, the body’s natural stress hormone, to prompt normal breathing.”
Sweat due to an increase in cortisol is often referred to as “stress sweat,” as it typically occurs in response to a threat to the body. In her article “Stress Sweat Is Real, Here’s How to Manage It” for Healthline, Adrienne Santos-Longhurst writes that “when you feel stress, your body temperature rises, prompting your sweat glands to kick in.” Because bodies suffering from sleep apnea are experiencing extreme stress due to struggling to breathe, “excessive sweating” may occur throughout the night.
Treating Sleep Apnea
Effectively treating sleep apnea effectively will likely limit or stop frequent nighttime sweating. The Cedars Sinai brief about sleep apnea notes that the disorder can be treated in a number of ways, but the right treatment plan “will depend on your symptoms, age, and general health” as well as “how severe the condition is.” Because “medicines generally don't work to treat sleep apnea,” mechanical treatments are often required. These may include receiving oxygen, making changes to one’s behavior and beginning physical therapy to strengthen muscles prone to collapse over the airway. Lifestyle changes that may reduce the occurrence of sleep apnea include limiting the use of alcohol and sleeping pills. They may also include losing weight if recommended and repositioning oneself into a side sleeping position. A mask or other inserted device may also be required to push air into the airway and prevent obstructions during sleep. In rare cases, surgery is required for a permanent fix.
The Influence of Hormonal Changes and Imbalances on Nighttime Sweating
Night sweats can occur in men, women, teens and children when a fluctuation in hormones occurs. It is particularly common amongst teenagers and adolescents transitioning into or through puberty as well as in women experiencing a fluctuation in estrogen or men experiencing a drop in testosterone. While these fluctuations might most commonly occur in specific periods of one’s life -- e.g. mid-life, perimenopause, menopause or adolescence -- some can occur unexpectedly, at certain intervals or after particular events. For instance, surgeries that affect hormonal imbalance, stress events and different points throughout one’s menstrual cycle might all spur night sweats.
Nighttime Sweating Before and After Periods
In their article “Why Do I Get Night Sweats During My Period?” for Healthline, Dr. Valinda Riggins Nwadike, MD, MPH and writer Crystal Raypole explain why menstruating individuals might wake up in a cold sweat. According to Dr. Nwadike and Raypole, “night sweats often happen with premenstrual syndrome (PMS), though they can also occur after your period starts.” When one’s hormones fluctuate throughout the menstrual cycle -- which is a natural and expected occurrence -- they can cause PMS symptoms like “hot flashes and night sweats.” The primary hormones responsible for these symptoms are progesterone and estrogen. Raypole and Dr. Nwadike write that “as progesterone levels increase, estrogen levels decrease,” which “can affect your hypothalamus, the part of your brain that controls internal temperature.” These changes can occur throughout one’s cycle -- before, during and after one’s period. When they do occur, “your brain may respond more readily to even slight temperature changes and send signals telling your body to cool you off by sweating, even if it isn’t necessary.”
Night Sweats During Menopause
As one might expect, night sweats occur during perimenopause and during menopause for similar reasons as when they occur throughout the menstrual period. In their article “Coping with menopausal hot flashes and night sweats” for Medical News Today, Holly Ernst, P.A. and Joana Cavaco Silva explain. They write that “hot flashes and night sweats occur before and during menopause because of changing hormone levels, including estrogen and progesterone, affecting the body’s temperature control.” According to Silva and Ernst, “changes in these hormone levels affect the action of other hormones that are responsible for regulating the body’s temperature.” This lack of ability to regulate the body’s temperature “causes the characteristic feelings of sudden warmth, flushing, and excessive sweating” -- both during the day and at night. Ernst and Silva write that “if someone experiences severe hot flashes or night sweats that interrupt their daily lives or cause high levels of distress, a doctor may recommend medications” and treatments like hormone replacement therapy or antidepressants.
Common Medications that Can Cause Night Sweats
Unfortunately, many commonly prescribed medications can -- and do -- lead to night sweats. In her article “Is Your Medication Making You Sweat? 10 Drugs That Cause Excessive Sweating as a Side Effect” for GoodRx, Dr. Sharon Orrange, MD, MPH lists a few. The Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC writes that antidepressants, migraine medications and OTC pain medications are common culprits. Dr. Orrange writes that “all classes of antidepressants may cause excessive sweating,” with types like Wellbutrin causing “excess sweating in approximately 1 in 5 people taking it.” The artificial release of serotonin is likely the cause, notes Dr. Orrange, as “serotonin affects both the hypothalamus, which sets our core temperature at which sweating occurs, and the spinal cord, which may lead to excessive sweating.”
Migraine medications can cause night sweats for the same reason as they also increase serotonin production. OTC pain medication can cause night sweats because “these medications work to lower fever by causing blood vessels to dilate so heat is lost through the skin, and this same mechanism may lead to sweating.” Steroids like those from asthma inhalers, diabetes medications, “heartburn and reflux medications,” “Sildenafil,” “Ropinirole” and “breast cancer medications” might also cause night sweats.
Six FAQs About Night Sweats
#1 Can Anxiety Cause Night Sweats?
The short answer to “can anxiety cause night sweats?” is yes. The American Osteopathic Association article “Excessive sweating keeping you up at night? Know when it's time to see your doctor” notes that “stress and emotional problems that cause sweating during the day can often have the same effect at night.” In fact, nighttime sweating due to anxiety is incredibly common, explains the article “Night Sweats From Anxiety - Causes and Treatment” from CalmClinic.com -- a health information resource reviewed by mental health experts and specialists across the country. The article notes that “night sweats are a common symptom of anxiety, especially chronic anxiety and panic attacks.” Those who suffer from anxiety should approach a medical professional if they continue to experience night sweats regularly and intensely, as “night sweats themselves can also cause further anxiety, fueling a cycle.” In short, “it's not uncommon for anxiety to cause night sweats, and it's also not uncommon for night sweats to lead to even greater levels of anxiety.”
Anxiety causes night sweats much in the same way that physical disorders like sleep apnea cause night sweats -- by triggering stress responses in the body and brain. The CalmClinic.com article explains that the body overheats as a result of anxiety. This is because “anxiety symptoms result from the activation of your brain’s fight or flight system” and when this reaction is triggered, “blood rushes to the parts of your body where energy is needed to fight or flee in the face of a threat.” It is during this process that the body experiences “vasoconstriction, or the constricting of the blood vessels,” which causes the body “to heat up as a result.” When the body heats up in a way that is perceived as harmful, sweating occurs as your body’s attempt to prevent you from overheating.
#2 How Can I Control Stress-Induced Night Sweats?
The CalmClinic.com article “Night Sweats From Anxiety - Causes and Treatment” notes that “managing anxiety overall, including healthy coping strategies, decreases the frequency of night sweats and how much they affect a person’s life.” The first step in managing one’s anxiety is reaching out to one’s doctor or mental health professional for advice. However, if one must wait before meeting with a healthcare provider, there are a few ways in which one may mitigate uncomfortable and anxiety-provoking night sweats in the interim. The CalmClinic.com article suggests “adjust[ing] your clothes or sheets so that you don't overheat” when you begin to feel anxious or uncomfortable. The article also suggests avoiding attempts to force sleep when nervous, stressed or uncomfortable. Instead, one should “get up and walk around so that you're more comfortable” before settling into bed.
#3 How Can I Change My Environment to Lessen the Frequency of Night Sweats?
Though some will require medical intervention in order to adequately reduce the frequency of disruptive nighttime sweating, many suffering from night sweats will be able to return to a comfortable night of sleep purely through lifestyle and environmental alterations. In his article “Why Am I Experiencing Night Sweats?” for Healthline, David Heitz outlines a few ways to change one’s environment at home in order to limit the likelihood of nighttime sweating. Lifestyle changes suggested by Heitz include “limit[ing] your consumption of alcohol and caffeine [and] avoiding using tobacco and illegal drugs.” Avoiding exercise, eating spicy foods and “consuming warm drinks too close to bedtime” might also help. As for one’s environment, keeping “your bedroom at a comfortable temperature, cooler at night than during the day,” can decrease the likelihood one might overheat during sleep.
The SweatHelp.org article “Night Sweats” adds a few more at-home remediative options to the list. These include using “fans for air circulation and/or open[ing] windows” when possible. Avoiding any materials -- whether bedding or pajamas -- made from “non-breathable synthetics” may also help. The ideal bedding and pajamas are made from natural fibers that can easily thermoregulate and wick away moisture from the body as it is released. Keeping cool water by the bed and storing a “cool pack under your pillow” can also help reduce the frequency of nighttime sweating as it can calm the body throughout the night if one is woken up unexpectedly.
#4 Can the Right Bedding Really Limit Nighttime Sweating?
Choosing cooling materials for bedding can also make a huge difference, particularly due to their temperature-regulating and moisture-wicking capabilities. For instance -- as we explained in our recent article “What is Tencel? The Natural Eucalyptus Fiber Has Roots in Fashion“ we explained that materials like “tencel tend to be light, moisture-wicking and cool to the touch when compared to other natural fibers.” While swapping out oppressive bedsheets, duvets and quilts for moisture-wicking options is a great place to start, one’s entire bedroom might need to be overhauled. Anything that comes into contact with the skin -- whether direct contact like clothing or ambient contact like relative humidity -- can affect the body’s ability to cool down properly. For example, pillowcases, mattresses, mattress toppers and pajamas can also limit the body’s ability to thermoregulate and prevent excessive nighttime sweating.
#5 Which Pajama and Bedding Materials Are Best for Preventing Night Sweats?
Kazue Okamoto-Mizuno and Koh Mizuno explained this in their study “Effects of thermal environment on sleep and circadian rhythm” for the Journal of Physiological Anthropology. They noted that “the use of beddings and clothing during sleep is critical in supporting thermoregulation and sleep in cold exposure,” making your choice of materials incredibly important to securing reparative sleep. In our recent article “A Seasonal Guide to the Best Fabrics for Pajamas,” we outlined the best ways in which to keep the body cool and comfortable during hot and humid months.
Quoting Breathe Right’s article “How Humid Weather Affects Sleep,” we explained that warm weather and “high humidity ‘prevents moisture from evaporating off your body, which can make you hot and sweaty,’ causing you to toss and turn throughout the night, interrupting your sleep and upsetting your partner’s.” Fabrics like cotton and other light, natural plant fibers are best for preventing the stickiness and sweating caused by hot and humid environments.Eucalyptus-derived Tencel, which has captured the attention of countless media including The Huffington Post, are the most consistently endorsed fibers for hot, humid weather. Try a moisture-wicking, cooling pillow case made from Tencel or a set of eucalyptus sheets derived from the fiber.
#6 Does Nighttime Sweating Affect Sleep Quality?
Nighttime sweating affects sleep quality in a number of ways, as it may disrupt sleep by waking those that suffer from night sweats and because thermoregulation is important to preserving sleep quality. Anna Gotter explains the former in her article “Is Waking Up in the Middle of the Night Making You Tired?” for Healthline. Gotter writes that “getting a full night’s sleep is important for rapid eye movement (REM) sleep cycles.” Unfortunately, she notes “when sleep is disturbed” -- whether due to nighttime sweating, anxiety, night terrors or other reasons -- “it takes your body a while to get back into REM sleep.” This disruption “can make you groggy the next day” and over time can affect one’s overall health. The latter -- i.e. the effect of thermoregulation on sleep quality -- may be even more impactful than the former.
Kazue Okamoto-Mizuno and Koh Mizuno explain in their paper “Effects of thermal environment on sleep and circadian rhythm,” published by the Journal of Physiological Anthropology. The two note that “the thermal environment is a key determinant of sleep because thermoregulation is strongly linked to the mechanism regulating sleep.” As one might imagine, “excessively high or low ambient temperature (Ta) may affect sleep even in healthy humans without insomnia” or other health issues. Because “disturbed nocturnal sleep affects not only daytime activities, but is also related to various adverse health effects, such as obesity, quality of life, and even mortality,” preventing one’s body from overheating is vital to both sleep quality and overall health. Okamoto-Mizuno and Mizuno impress upon readers that “maintaining a comfortable thermal sleep environment is important for sleep maintenance as well as daytime activities and health status.”
Tips and Takeaways for Managing Night Sweating
Those suffering from night sweats not due to medical conditions that could be solely addressed through the help of a medical professional or medical treatment can and may choose to make a series of lifestyle and behavioral changes to limit the disruptive occurrence of nighttime sweating. These include the following:
#1 Exercising during the day instead of in the evening.
#2 Eating several hours before laying down or going to sleep.
#3 Sleeping with a pillow propping up the neck, head and torso if one suffers from GERD or reflux.
#4 Reducing the consumption of alcohol, acidic foods, fatty foods and drugs -- including OTC pain medication when possible.
#5 Regulating the relative humidity and ambient temperature of one’s bedroom.
#6 Swapping out restrictive clothing for comfortable, lightweight pajamas made from natural fibers like eucalyptus and Tencel.
#7 Replacing heavy bedding and insulating pillowcases for those made from breathable, moisture-wicking materials.
#8 Keeping cool water or ice packs near the bedside.
#9 Relaxing before bed in order to calm the mind through meditation, reading and other practices.
#10 Acknowledging the causes of night sweats and acting accordingly -- particularly in limiting stress or recognizing and mitigating acute causes when they arise.
#11 Layering clothing and bedding rather than relying on a single heavy set.
#12 Breathing calmly and deeply before falling asleep.
#13 Trying not to force sleep when anxious, uncomfortable or simply not tired.
#14 Adopting a circadian sleep cycle if possible.
#15 Opening windows and increasing circulation throughout the sleep space.
#16 Keeping one’s hair off one’s face while sleeping.
#17 Taking medications as prescribed.
