Introduction

Sweating is a bodily function that helps regulate your body temperature. sweating is the release of a salt-based fluid from your sweat glands. Sweating during warm weather is very common but if a person wakes up from bed soaked in sweat (even in a winter season) it is not a pleasant feeling. The most common areas of sweating on the body include:

• armpits

• face

• palms of the hands

• soles of the feet

It does not allow for a sound sleep and may not always be related to warm weather. There is no serious underlying medical issue but it is always advisable to see a doctor. Sweating in normal amounts is an essential bodily process. Not enough sweating or too much sweating can both cause problems. The absence of sweat can be dangerous because your risk of overheating increases. Excessive sweating may be more psychologically damaging than physically damaging. Your body is equipped with an average of three million sweat glands. Sweating is normal and occurs regularly in your daily living. The following are some common reasons that could lead to night sweats:

Menopause: The hot flashes that are so popularly associated with menopause is one of the main reasons for night sweats. Hormonal levels can be checked to confirm if required. Even puberty and pregnancy can cause night sweats due to hormonal level alterations. About 75–85% of women in perimenopause and menopause notice increased sweating and recurrent feeling of internal heat throughout the body.

Infections: Most infections present with fever and night sweats are very common. Tuberculosis, osteomyelitis, endocarditis, influenza and even HIV can cause night sweats and hamper a person’s sleep. Most infections cause an increase in temperature which is worse at night.

Obstructive sleep apnea: The walls of the windpipe get narrowed and the person might have short periods where the breathing just stops. These people are three times more likely to develop night sweats. Sleep apnea and night sweats are a common symptom but in women they may be mistaken for a symptom of menopause only and not treated as sleep apnea. In fact, for both men and women, night-time sweating is a common symptom of obstructive sleep apnea, affecting just over 30% of men and just under 35% of women.

Hypoglycemia: One of the most common symptoms of low blood sugar is night sweat. For some people who take beta-blockers, a type of blood pressure medicine, sweating may be the only early symptom of hypoglycemia because beta-blockers can prevent the body from shaking or having other hypoglycemia symptoms such as a fast heartbeat. When the sugar drop happens during the time the person is sleeping, it is very common for the person to wake up soaked in sweat.

Cancer: For some cancers, night sweats are one of the first warning signs. These cancers include lymphoma and presence of symptoms like unexplained weight loss, fatigue etc. should be addressed to rule out the possibility of cancer. In people with cancer, certain conditions and medications can cause sweating, hot flashes or night sweats. They happen when your body tries to lower its temperature. They can happen even when the area around you or the room you're in is cool.

Side effect of medications: Antidepressants, psychiatric drugs, anti-pyretic drugs, anti-virals, steroids, anti-diabetic medications, hormones etc. can lead to night sweats. Suspected cases of night sweats should have their medications reviewed to see if any drug is causing the night sweats.

Gastro-Esophageal Reflux Disease (GERD): As it is popularly known can cause night sweats in addition to heartburn. They would also have other symptoms of indigestion which will help in identifying the problem.

Neurologic disorders: Stroke, neuropathy and anxiety disorders can cause night sweats and would require psychotherapy in addition to medications. Gastroesophageal reflux disease (GERD) is a common condition in which gastric contents flow retrograde past the lower esophageal sphincter causing irritation and damage to the esophagus. Common symptoms associated with this disease include heartburn, chest pain, vomiting and a hoarse voice. In most cases some permutation of these symptoms is enough to make the diagnosis and resolution of symptoms with acid suppression therapy strengthens the diagnostic probability. Currently, there is very little evidence to support GERD as a cause of night sweats with previous associations between GERD and night sweats based mostly on informal observations.

Idiopathic: Despite all these possible reasons, if there is no identifiable reason, it is known as idiopathic hyperhidrosis, in simple words increased sweating. The person produces too much sweat without any known underlying cause and can even wake up at night soaked in sweat.

Management: Identifying the underlying cause is the first step in treatment. It may require hormonal corrections, changing or withdrawing the causal or relevant medications, treating associated conditions, etc., as the case may be.

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