From the Guidelines
Night sweats can be caused by various factors, including hormonal changes, infections, certain medications, anxiety or stress, and certain cancers, with menopause being a common cause in women, affecting up to 85% of women during this transition, as noted in studies such as 1 and 1. The causes of night sweats are diverse and can be attributed to several factors. Some of the key causes include:
- Hormonal changes, such as those experienced during menopause or thyroid disorders
- Infections, like tuberculosis or HIV
- Certain medications, including antidepressants, hormone treatments, or fever reducers
- Anxiety or stress
- Certain cancers, particularly lymphoma
- Sleep disorders
- Hypoglycemia
- Neurological conditions It is essential to note that menopause is a common cause of night sweats in women, with hot flashes and night sweats affecting a significant percentage of women during this transition, as discussed in 1 and 1. Some medications that commonly cause night sweats include:
- Antidepressants like venlafaxine (Effexor) and sertraline (Zoloft)
- Hormone therapies
- Drugs like acetaminophen and aspirin when they're reducing a fever Excessive alcohol consumption and substance withdrawal can also trigger night sweats, as mentioned in 1. If night sweats are disrupting sleep or accompanied by other symptoms like unexplained weight loss, fever, or pain, it is crucial to consult a healthcare provider for proper evaluation, as emphasized in 1 and 1. Managing night sweats often involves addressing the underlying cause, and some strategies include:
- Keeping the bedroom cool
- Using moisture-wicking bedding
- Avoiding spicy foods and alcohol before bed
- Maintaining a healthy weight It is vital to assess the frequency and severity of menopausal symptoms, including night sweats, and their impact on quality of life, as discussed in 1.
From the Research
Causes of Sweating at Night
- Night sweats can be caused by various factors, including menopause, malignancies, autoimmune diseases, and infections 2
- Other conditions commonly associated with night sweats include mood disorders, gastroesophageal reflux disease, hyperthyroidism, and obesity 3
- Hormonal changes, such as those experienced during menopause, can also lead to night sweats 4
- In some cases, night sweats can be a side effect of certain medications, such as serotonin reuptake inhibitors 2
Clinical Evaluation
- A systematic and cost-conscious approach to evaluation is recommended, using readily available laboratory and imaging studies 3
- Tests that may be considered include a complete blood count, tuberculosis testing, thyroid-stimulating hormone levels, HIV testing, C-reactive protein level, and chest radiography 3
- Additional tests, such as computed tomography of the chest and/or abdomen, bone marrow biopsy, and polysomnography, may be considered selectively 3
Treatment and Management
- Hormone replacement therapy (HRT) is the most effective treatment for managing menopausal hot flushes and night sweats 4
- Alpha adrenergic blockers may reduce night sweats in patients taking serotonin reuptake inhibitors 2
- Thalidomide and thioridazine may benefit some terminal cancer patients with night sweats 2
- Reassurance and continued monitoring are recommended if no underlying cause is found and test results are normal 3