Clammy hands.
Cold, sweaty feet.
A cold, sopping pillow.
The drip, drip, drip of a faucet keeping you awake is bad enough.
When the dripping is coming from your head, back, and armpits into your sheets, it has to be worse.
Cold night sweats have to be one of the most troubling sleeping problems there are.
Night sweats can defy easy explanation
In extreme cases of night sweats, the person wakes up in the middle of their slumber feeling like someone poured water on them. Their sheets are dripping wet. Their pillow is damp. They have a hard time getting back to sleep if they have to lay in that sopping mess. Their linens smell sour. The moisture makes an excellent place for microscopic organisms to spawn.
In less extreme night sweat cases, their pillow is wet, and, maybe, so are the sheets around their shoulders. To get comfortable, they’ve got to flip the pillow over and move over in bed if they’ve got enough room.
When the sheets dry, they feel pasty. Predictably, their pillows and mattress get stained. If they’re a person who is sensitive to tactile sensations, they’ll want to change the sheets. For a lot of reasons, that’s not always possible. Changing the sheets every night is a real pain.
According to a 2004 study, almost 3 percent of the United States population suffers from excessive sweating. There are surely grades of sweating within these extremes. Other less well-constructed studies put the number at 5 percent worldwide. The study lumps night sweats in with daytime sweating.
There’s even a word in Medical-ese for too much sweating: hyperhidrosis.
Switching on fans and keeping the room cold doesn’t always work. The only thing that will help in finding the cause of the profuse sweating.
A lot of drugs and broad classes of medical conditions cause night sweats. Sometimes it’s not even a medical condition; it’s the way someone is made, their genetics or adaptive response. Heavy sweating can be a familial trait. It’s the quintessential climate adaptation. People who do well in hot climates typically sweat more than others who are more comfortable in cold climates.
Finding the reason for the night sweats can be hard.
Air conditioning can “confuse” our bodies
Air conditioning can be wonderful on a hot summer day.
High temperatures can even be deadly.
However, when someone stays in air conditioning all of the time or when they go between a hot and cold environment frequently, their body doesn’t have time to enact its heat-diminishing strategies. In many cases, it loses its ability to cope. When that happens, night sweats can start.
There are three ways of transferring heat: radiation, conduction, and convection. Your body uses all three strategies. Heat radiates off of your body. If you lay on a cool surface, your body conducts heat away. Then, when you sweat, your body loses heat through convection.
Air conditioning makes the difference between the indoor and outdoor environment drastic.
More people are exposed to these whipsaws in temperature than ever before in history.
In the United States, population growth in scorching areas like southern and central Arizona, the Las Vegas metropolitan area, and California’s desert areas coincide with air conditioning.
This is a massive change from how we lived as humans for thousands of years. While air conditioning keeps a person comfortable and allows places that most people find uninhabitable to be habitable, air conditioning diminishes your body’s ability to adapt to heat. It’s best to use air conditioning in moderation.
Evolutionarily speaking, it’s good to keep in mind how sometimes regular, profuse sweating would be to one’s advantage. It’s best to embrace the ways our body works to keep it functioning well.
In many of the ways our ancestors slept, sweating wasn’t a big deal. Night sweats probably weren’t nearly as common back then, though they likely became more common after the Industrial Revolution. For example, sleeping in a hammock strung out between two trees is probably a lot cooler than sleeping indoors on a bed. Sleeping on a mat or a bed of rushes would be the same.
Few of our ancestors were overweight or obese, too. The extra fat acts like a blanket, making night sweats more common in that demographic. Working a farm, foraging, being a blacksmith, cowboy, all of those more common “hands-on” occupations of yesteryear burned serious calories in the way sitting at a desk doesn’t.
Unfortunately, socially and culturally, excessive sweating can work out the same way as emotional crying in the middle of a fistfight. It’s something you may find embarrassing. Both day and night sweats can be related to anxiety, though that’s not the only cause.
When to be concerned about night sweats
Profuse night sweats are often a symptom or side effect.
Beyond getting used to a climate, profuse sweating during the day or night tends to be related to youth, menopause, fever, anxiety, cramps, numbness, impaired vision and hearing, and being in pain.
Common classes of medical conditions associated with excessive night sweats include:
- Anxiety
- Autoimmune problems (Type 1 diabetes, various forms of arthritis, lupus, multiple sclerosis, inflammatory bowel disease, etc.)
- Autonomic nervous system damage
- Cancers (various forms)
- Drug addiction or withdrawal
- HIV/AIDS
- Infections
- Leukemia
- Osteomyelitis (a bone infection)
- Sleep apnea
- Thyroid and adrenal gland disorders
- Tuberculosis
Some common antidepressants implicated in this are fluoxetine, Lexapro, Paxil, Celexa, Zoloft, and Prozac.
Hormone replacement medicines include estrogen replacements and levothyroxine.
The list of medicines causing night sweats is long and extends far beyond these broad drug classes.
A person’s temperature is regulated in the hypothalamus of the brain. This part of the brain controls the pituitary gland, which is like the leader of the endocrine system. Another name for the endocrine system could be the hormone system. Hormones are chemicals the body makes that involve growth and development, sleep, mood, and sexual function. It makes sense how it’s all interrelated and results in pouring sweat even if we don’t exactly know why it does this in every case.
When to be concerned about night sweats? When it happens regularly.
Self-help for excessive night sweats
Get outside when you’re awake. Go for a walk. Work outside. Acclimatize.
If you’re overweight, use this as an excuse to lose weight. Sleeping more can cause leptin levels to increase, which will make you feel fuller.
Make sure you keep drinking enough water throughout the day. It can be harmful if you don’t.
Consider if a ceiling or tabletop fan would help.
If you’re keeping the indoor temperature a little high at night, turn it down a bit.
A water pillow can help, too.
When do you need to see your doctor for night sweats?
Schedule an appointment if:
- Night sweats happen regularly and interrupt your sleep.
- It’s accompanied by fever, weight loss, pain, diarrhea, or dizziness.
- You’re female, and menopause happened years ago, so you’re sure it’s not that.
- You notice one of the conditions or medications you take on the lists above. Your doctor can help you troubleshoot and maybe suggest a substitute.
If the night sweats are making you miserable, you don’t have to tolerate it. With a little detective work and some help from a doctor, you can turn off the tap!
For further reading:
How to wash Egyptian cotton sheets
5 rules for washing your cotton sheets
Other articles from the blog:
Follow these 5 principles to get the best sleep possible anywhere, anytime
Self-care really means “sleep enough”
Don’t let the perfect be the enemy of the good
Hypnos got a bad rap from Hesiod and society
Melatonin for sleep is not a simple solution
James Cobb RN, MSN, is an emergency department nurse and the founder of the Dream Recovery System. His goal is to provide his readers with simple, actionable ways to improve their health and maximize their quality of life.
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