September 24, 2010
Dear Mayo Clinic:
I'm a man, and I have been experiencing night sweats several times a week. And they are more severe in the early morning. Can you offer a possible cause and treatment?
Most people who have night sweats are worried that they indicate some serious underlying disease. But night sweats are quite common and, for the vast majority of people, don't represent a medical concern.
We often ask patients how much they are sweating. Light sweat on the brow or on the pillow is not uncommon during the night when our brain resets our body's temperature, which normally varies from higher in the evening to lowest in the morning. For many people, a solution to night sweats may be adjusting the room temperature or removing some extra coverings from the bed.
If you are sweating enough that you have to get up and change your nightclothes or the sheets because they are wet, that is more significant. It may indicate a side effect of a medication, such as antidepressants or hormone therapy, or the existence of an underlying illness.
Night sweats can be related to infection. For example, if you've recently been ill with a minor respiratory infection, a slight fever can cause you to sweat more at night, as your body's normal day/night temperature reset may be exaggerated.
More serious infections that can cause night sweats include tuberculosis or other bacterial infections, fungal diseases and conditions that are unusual and more chronic, such as disorders of the nervous system or in the body's hormone-producing glands (endocrine system). Occasionally, diseases such as cancer cause temperature elevations and night sweats. So if the night sweats are a new symptom, particularly if they are associated with red flags such as fever, change in appetite — particularly decrease in appetite — weight loss, lymph node swelling or rash, you should see a physician for evaluation.
Even without these red flag symptoms, if the night sweats are new and worrisome, or if they're occurring on a regular basis and interrupting your sleep, a visit with your doctor is not a bad idea.
If you have no underlying medical condition, and adjusting room temperatures and bedcovers has not resolved the problem, you may consider asking your doctor about treatment for acid reflux. Acid reflux is the backward flow of stomach acid into the esophagus — the tube that connects the throat and stomach. Information in the medical literature suggests that night sweats can be associated with acid reflux, which is a relatively common nighttime condition in adults. I have not seen a lot of evidence to substantiate this in my practice, but a simple trial of a medicine to reduce acid production at night for a few weeks shouldn't be harmful and might provide a solution.
— J. Taylor Hays, M.D., General Internal Medicine, Mayo Clinic, Rochester, Minn.