Night sweats and hot flashes
The body constantly sweats, but night sweats may signal a medical problem.
Night sweats, or nocturnal hidrosis, are when a person sweats excessively while they sleep.
Sweating is the body's way of trying to lower body temperature by letting heat escape through the skin. When the body sweats, water and salt are released from the sweat glands onto the skin.
There are sweat glands all over the body controlled by nerve cells in the dermis, a layer of the skin. It is not always visible, but the body constantly sweats. The amount produced can depend on factors such as:
- What the person is doing
- A person's emotional state
A hot flash is a sudden yet temporary feeling of warmth throughout the body that can lead to sweating. This condition is commonly linked to women in menopause, which is the period when their menstrual period stops. Hot flashes on their own are not normally a health concern.
Night sweats are hot flashes combined with sweating that occur while a person is sleeping. True night sweats due to severe hot flashes can cause some people to drench their clothing as well as their bedsheets. Night sweats often signal a medical problem and doctors will go looking for an underlying cause.
Hot flushing is another symptom that can occur and is often confused with night sweats. A hot flush can occur in men or women and refers to a sudden feeling of warmth marked by redness of the skin. It usually begins in the face and chest and then spreads to the rest of the body.
Hot flushing can be accompanied by:
- Light or heavy sweating
- Racing heart
- Feelings of anxiety or irritability
As a symptom of cancer
Menopause affects women, and it can be in part due to natural, surgical, or chemical causes. Chemical menopause in female cancer patients is often due to chemotherapy, radiation, or hormone therapy.
Men who have cancer can develop low testosterone levels. This development is often due to surgery performed to move one or both testicles, or hormone therapy treatments.
Treatment for cancers such as breast and prostate cancer commonly cause menopause or menopause-like effects, which can include severe hot flashes.
Some treatment drugs can also cause sweating and hot flashes. These medicines include:
- Aromatase inhibitors: Commonly used as hormone therapy in women who have been various breast cancers
- Opioids: A group of very strong pain relievers often given to cancer patients
- Tamoxifen: This drug is used to treat breast cancer in men and women but also to help prevent cancer in some women
- Tricyclic antidepressants
- Steroids: They can be used to help reduce swelling as well as treat some cancers
There are various treatment options for people with cancer who experience night sweats.
Night sweats can affect the quality of sleep for a patient with cancer, so a treatment plan is often devised. The overall treatment plan depends on the exact cause of the night sweats.
The first step of treatment is to identify and treat the primary cause of the night sweats. Sweating due to fever is treated by tackling the cause of the fever. In patients where sweating is due to a tumor, the plan includes treating the underlying tumor.
There are various treatment options to help ease night sweats. It is important to note that many of them also pose their own set of side effects or risks.
Common medicines used to treat patients include:
- Hormone replacement therapy (HRT)
- Clonidine, a blood pressure medicine
Hot flashes can be controlled with estrogen replacement therapy. Some women, including those who have or have had cancer, are unable to take estrogen replacements. Hormone replacement therapy programs that combine estrogen with progestin can even increase the risk of breast cancer or its recurrence and cardiac death.
Men who have been treated for prostate cancer and are undergoing treatment for night sweats may be prescribed estrogens, progestin, antidepressant, and anticonvulsants. Also in men, certain hormones including estrogen can help to speed up the growth of some cancers.
Caregivers at home
At home, caregivers can help by making sure people with cancer do not get dehydrated from the excessive sweating. Extra liquids help to replace the fluid that has been lost.
Caregivers should change wet bedsheets or clothing as soon as possible. They should also make sure that the person they're caring for bathes often to soothe the skin and for good hygiene.
Caregivers should also keep an eye on the person's temperature. The sweats could be due to an elevated temperature, and acetaminophen may be helpful in reducing the fever.
If the fever is higher than 100.5°F for longer than 24 hours or is accompanied by tremors or shaking chills, caregivers should call their cancer doctor immediately.
Treatment side effects
Medicines used to treat night sweats can cause side effects. Though non-estrogen drugs are also used to treat hot flashes, especially in women with a history of breast cancer, they often do not work as well as estrogen replacement. They can also have some unpleasant side effects.
- Antidepressants may lead to nausea, drowsiness, dry mouth, and changes in appetite
- Anticonvulsants can cause drowsiness, dizziness, and trouble concentrating
- Clonidine has been linked to dry mouth, drowsiness, constipation, and insomnia
With such a wide range of symptoms, patients will respond differently to drug therapy treatment programs. Doctors will take into account the patient's medicines, dietary supplements, and any other supplements that they may be taking. It is not uncommon for a patient to have to try many drugs before finding the right ones to help.
Other nonmedical treatment remedies
Night sweats may be caused by a variety of issues such as anxiety and stress.
Simple comfort measures may be recommended to help patients treat night sweats and have more restful sleep. A few common practices include:
- Wearing loose-fitting clothing made of cotton to help to keep cool
- Using absorbent bedclothes to absorb the sweat and help prevent the drenching of bedsheets
- Using fans and opening windows to keep air moving
- Relaxation training and even acupuncture may help some cancer patients
Herbal remedies are also sometimes used to help with night sweats. People should check with a doctor before using any herbal or dietary supplements as they are not recommended for some patients. Some remedies may also lack scientific evidence to prove that they are effective.
Just because a person has night sweats does not mean that they have cancer. Hyperhidrosis is a condition that causes people to sweat excessively during the day or night. It does not pose a big threat usually, and there are treatment options.
A variety of other issues can cause night sweats, including:
- Low blood sugar
- Hormone disorders
- Neurological conditions such as stroke
- Anxiety or stress
- Alcohol or drug withdrawal or abuse
Some medications can also cause night sweats. Even simple aspirin, commonly taken to lower fevers, can lead to sweating and is commonly used to "sweat out a fever."
Although uncomfortable, night sweats alone are typically harmless. It is important to drink plenty of water to make up for the amount lost and to prevent dehydration.
Night sweats can be a sign of additional problems, so it is important to contact a doctor to work out the exact cause as well as a treatment plan. People who experience night sweats and notice other problems such as rapid weight loss or gain, tiredness, or breathing trouble should seek immediate care.