From the Guidelines
Nocturnal diaphoresis and cold extremities are most likely caused by nocturnal hypoglycemia, which is a common condition that can occur in individuals with diabetes, particularly those with type 1 diabetes, as reported in a study published in Diabetes Care in 2005 1. This condition can be asymptomatic, but it may also cause a range of symptoms, including night sweats, cold extremities, and other systemic symptoms.
Possible Causes
Other possible causes of nocturnal diaphoresis and cold extremities include:
- Hormonal changes, such as menopause or thyroid disorders
- Infections, such as tuberculosis or HIV
- Certain medications, such as antidepressants, hormone treatments, or fever reducers
- Anxiety or stress
- Sleep disorders, such as insomnia, obstructive sleep apnea, or restless legs syndrome, as suggested by the PLANET study published in European Urology in 2022 1
Diagnosis and Treatment
To diagnose the underlying cause of nocturnal diaphoresis and cold extremities, a healthcare provider may perform a physical examination, take a medical history, and order laboratory tests, such as blood glucose monitoring or sleep studies. Treatment for nocturnal hypoglycemia typically involves adjusting insulin dosing or other diabetes medications, as well as making lifestyle changes, such as eating a bedtime snack or adjusting exercise routines. For other underlying causes, treatment may involve addressing the specific condition, such as hormone replacement therapy for menopause or cognitive behavioral therapy for anxiety or stress.
Key Takeaways
- Nocturnal diaphoresis and cold extremities can be caused by a range of underlying conditions, including nocturnal hypoglycemia, hormonal changes, infections, medications, anxiety or stress, and sleep disorders
- Diagnosis and treatment involve identifying the underlying cause and addressing it with lifestyle changes, medications, or other therapies
- It is essential to consult a healthcare provider for proper diagnosis and treatment if symptoms are severe, persistent, or accompanied by other systemic symptoms.
From the FDA Drug Label
Thyroid hormones increase heart rate, ventricular contractility and cardiac output, as well as decrease total systemic vascular resistance. They also increase the rate and depth of respiration, motility of the gastrointestinal tract, rapidity of cerebration, and vasodilatation The clinical features of myxedema coma include depression of the cardiovascular, respiratory, gastrointestinal and central nervous systems, impaired diuresis, and hypothermia. Thyroid hormones correct hypothermia by markedly increasing the basal metabolic rate, as well as the number and activity of mitochondria in almost all cells of the body.
The cause of nocturnal diaphoresis and cold extremities is not directly addressed in the provided drug label. However, hypothyroidism can cause decreased basal metabolic rate, which may lead to hypothermia and potentially cold extremities. On the other hand, hyperthyroidism can cause increased basal metabolic rate, leading to heat intolerance and potentially diaphoresis. Since the label does not directly address the question, no conclusion can be drawn about the specific causes of nocturnal diaphoresis and cold extremities 2.
From the Research
Nocturnal Diaphoresis and Cold Extremities
- Nocturnal diaphoresis, or night sweats, can be caused by various factors, including sleep disorders and medical conditions 3
- Cold extremities can be related to poor sleep quality, which can be affected by environmental factors such as cold indoor temperatures 4 or noise pollution 5
- Certain medical conditions, such as neuroendocrine tumors, mast cell disorders, and hyperbasophila, can cause flushing disorders associated with gastrointestinal symptoms, which may include diaphoresis 6
- Cold intolerance, characterized by symptoms such as pain, tingling, and numbness in response to cold, can also contribute to cold extremities and may be associated with various factors, including comorbidities and decreased quality of life 7
Associated Factors
- Sleep quality and environmental factors, such as temperature and noise, can play a role in nocturnal diaphoresis and cold extremities 4, 5
- Medical conditions, such as chronic renal disease, fibromyalgia, and cancer, can disrupt sleep and contribute to nocturnal diaphoresis and cold extremities 3
- Hormonal and neurological factors, such as those involved in flushing disorders, can also contribute to diaphoresis and cold extremities 6
- Cold intolerance can be a significant factor in cold extremities and may be associated with decreased quality of life and job performance 7