Night Sweats

Night Sweats

WHEN TO SEE YOUR DOCTOR

* You sweat at night despite a cool room temperature, especially if the episodes come and go with regularity.

* The sweating is accompanied by fever, fatigue, discomfort or pain in the body.

* You are also experiencing a sleep disorder, such as sleepwalking, nightmares, apnea or insomnia.

What Your Symptom Is Telling You

You retire to your bedchamber, eagerly anticipating a cozy night's sleep. But instead of drifting off to a sea of tranquillity, you awake to find yourself in your own little Sea World . . . and you're playing the part of Shamu, the performing killer whale!

If you're suffering from night sweats, you know that this scenario is not exactly an exaggeration. One drenching episode can quickly make your bed look like the set of an Esther Williams movie, leaving you, your clothing and your linens completely soaked.

The good news is that these nocturnal water follies are extremely rare. They're usually one-shot deals with completely harmless origins: a warm room, too many blankets, a bad dream or something you ate. It's also completely natural for women going through menopause to experience night sweats. And if you're an excessive daytime sweater, your propensity for wetness can easily carry over into the night.

"Emotion and stress commonly cause sweating, and you can carry those feelings with you to bed," says Ernest Hartmann, M.D., director of the Sleep Disorders Center at Newton-Wellesley Hospital in Newton, Massachusetts. "Nightmares, sleepwalking and sleep apnea can also cause night sweats," he adds.

"Recurrent night sweats are usually the body's attempt to fight off the effects of a fever," says Hinda Greene, D.O., staff physician of internal medicine with Cleveland Clinic­Florida in Fort Lauderdale. "The best-case scenario is that the fever is brought on by a low-grade infection, a cold, the flu—one of the more common illnesses."

There are also several relatively serious conditions that can trigger night sweats. These include tuberculosis, hepatitis, immune system disorders, thyroid disorders, leukemia, strokes, bowel disease and heart disease.

Symptom Relief

Repetitive night sweats are unusual and are not to be treated lightly. It may take a little detective work on the part of your physician to find the cause. Here's what your doctor might consider as well as a few soak stoppers you may want to try on your own.

Lower the room temperature. "The first and most logical assumption is that you are using too many covers and the room is kept too warm," says Philip R. Westbrook, M.D., director of the Sleep Disorders Center at Cedars-Sinai Medical Center in Los Angeles. "Most sleepers only really need a light blanket and a room temperature of 65°F for a comfortable sleep. If a fan or air conditioner will cool you down, by all means use it."

Get on the stick. "Excessive daytime sweaters may be prone to night sweats and may take the same preventive steps they would use in the daytime," says Dr. Westbrook. "This would include the use of an antiperspirant, rubbing alcohol or body powder before retiring."

Drink more water. "Any time you have sweating, you need to increase your water intake to replenish what is lost," says Dr. Greene. She recommends at least 12 glasses per day (4 more than the average person requires) at room temperature to cool down your core temperature without shocking the system. Drink one glass just before going to bed. Showering or sponging with cool (not cold) water can also lower core temperature to inhibit some sweating.

Ask about estrogen. "Over half of all menopausal women will experience night sweats because of the decline of estrogen," says Lila Wallis, M.D., clinical professor of medicine at Cornell University in Ithaca, New York. "For some relief, your doctor can prescribe estrogen and other hormone supplements and medications." If you're going through menopause, ask your doctor whether hormone replacement therapy is appropriate for you. (For more tips on dealing with hot flashes, see page 264.)

Take aspirin. Check your temperature. If you're harboring a lingering fever, taking aspirin or acetaminophen during the day or before bedtime can break that fever. But, says Dr. Greene, it will do so by causing you to sweat. The good news is that it may be the push that's needed to finally lick the underlying infection.

Forget about nighttime exercise. "Don't take part in heavy physical activity before going to bed," warns Dr. Wallis. "This will only increase your body's core temperature and can serve as a spark to ignite sweating later in the night." Stay away from hot tubs, showers and saunas at night, too.

Avoid midnight snacks. "You shouldn't have a completely full stomach at bedtime," says Dr. Westbrook. "A midnight snack will just lie in your stomach all night, making you uncomfortable and thus producing sweating. Spicy foods and hot beverages can also bring on some severe night sweating."

Say no to nightcaps. That late-night cocktail, coffee or cigarette can raise your pulse, blood pressure, body temperature and adrenaline levels, says Dr. Greene. It's an open invitation for a difficult, if not sweaty, night's sleep.

Keep a sleep log. If you are at a loss to explain what could be causing your night sweats, Dr. Hartmann suggests keeping a record of your sleep activity. Note anything relevant before you went to sleep, such as what you wore or the room temperature. When you wake, jot down anything you can remember during the night, how you feel and the condition of your bed. Also record your daytime activities, food consumption and stresses. Continue logging the information for a few weeks—you may see patterns emerging that can give your doctor a better indication of the cause.