From the Guidelines
Night sweats are most commonly caused by hormonal disorders, such as menopause, which affects up to 80% of women, as well as other conditions like infections, certain cancers, medications, and neurological conditions. The causes of night sweats can be diverse and include:
- Infections (tuberculosis, HIV, endocarditis) 1
- Hormonal disorders (menopause, hyperthyroidism, carcinoid syndrome) 1
- Certain cancers (lymphoma, leukemia) 1
- Medications (antidepressants, hormone treatments, fever reducers) 1
- Neurological conditions 1
- Anxiety disorders, sleep apnea, hypoglycemia, and alcohol or drug use 1
- Idiopathic hyperhidrosis, where excessive sweating occurs without an identifiable cause 1
The mechanism typically involves disruption of the body's temperature regulation system, whether from hormonal fluctuations, inflammatory responses to infection, or medication side effects. If night sweats are severe, persistent, or accompanied by other symptoms like unexplained weight loss, fever, or pain, medical evaluation is recommended to identify the underlying cause 1.
Some key indicators for underlying medical conditions can be identified in clinics, working in partnership with the primary care provider, and therapy of the medical condition in some circumstances lessens the severity of night sweats 1. However, in many cases, there is a conflict between the two, in which case the medical condition generally takes priority on safety grounds. It is essential to provide patients with a realistic expectation of therapy and awareness of limitations of current therapeutic options for night sweats.
Given the most recent and highest quality study available, the evaluation and treatment of night sweats should consider the possibility of one or more medical conditions, and therapy should focus on established specialist priorities, relating to the condition and its prognosis 1.
From the Research
Night Sweats Causes
- Night sweats can be caused by various factors, including tuberculosis and lymphoma, although these are infrequently found to be the cause in modern practice 2
- Other potential causes of night sweats include:
- Human immunodeficiency virus
- Gastroesophageal reflux disease
- Obstructive sleep apnea
- Hyperthyroidism
- Hypoglycemia
- Certain medications, such as antihypertensives and antipyretics
- Drugs of abuse, such as alcohol and heroin 2
- Menopause is also a common cause of night sweats, resulting from the decline in estrogen levels 3
- Night sweats can also be a symptom of malignancies, autoimmune diseases, and infections 4
Evaluation and Diagnosis
- A thorough history, physical examination, and directed laboratory and radiographic studies can help exclude serious causes of night sweats 2
- Tests that may be considered include:
- Purified protein derivative
- Complete blood count
- Human immunodeficiency virus test
- Thyroid-stimulating hormone test
- Erythrocyte sedimentation rate evaluation
- Chest radiograph
- Chest and abdominal computed tomographic scans
- Bone marrow biopsy 2
Treatment and Management
- Treatment of night sweats depends on the underlying cause 4
- Alpha adrenergic blockers may reduce night sweats in patients taking serotonin reuptake inhibitors 4
- Thalidomide and thioridazine may benefit some terminal cancer patients with night sweats 4
- Hormone replacement therapy may be considered for menopausal women with night sweats 3