There’s nothing worse than waking up in a pile of your own sweat when you have to dream. Yet this is the reality for 80 percent of women during menopause. Furthermore, American Family Physicians reports that 41% of primary care patients have night sweats for any reason.
According to Dr. Francesco Calipari, medical director of the Caroline Rowan Center for Women’s Health and Wellness and medical director of the OB/GYN faculty practice at Mount Sinai Hospital in New York, night sweats are heavy sweating while you’re sleeping, which can also cause you to soak clothes or bedding. Here’s what causes night sweats and how to stop it before it takes away too much of your sleep.
What causes night sweats?
While menopause is the most common time for night sweats, there are other less common causes. These include medications for depression and opioid use disorder, as well as medications used to lower blood sugar for people with diabetes. Additionally, the Mayo Clinic reports, a variety of conditions can cause night sweats, ranging from sleep disorders to cancer and autoimmune diseases.
What are night sweats?
Here’s how to know how much to sweat at night: “A hot room or lots of blankets make you uncomfortable, but you adjust the thermostat or remove the covers and you’re OK,” says Calipari. “Really night sweats are different – they come in waves regardless of room temperature, often preceded by a sudden intensity of heat, and they get you really wet, sometimes requiring you to change your nightclothes or sheets.” So, if you’re in a cool room and wake up still drenched, that’s a “distinctive feature” of night sweats, he says.
He says patients often present with persistent sleep disruption rather than worrying much about hot flashes and sweats, as some menopausal night sweats last for 7-10 years or more. “The disruption is real and often underestimated: Frequent waking up leads to daytime fatigue, irritability, brain fog, and mood swings,” says Calipari. He wants more women to bring up the issue with their doctors sooner.
What’s actually happening in the body during night sweats in menopause?
A person who has always slept well may wonder what exactly is causing them to have night sweats during menopause. Calipari says we can blame the ups and downs in estrogen levels, which cause the brain’s “thermostat,” which is in the hypothalamus, to go out of whack.
“Even a small increase in core temperature that you would normally never notice triggers a full vasomotor response,” he says. “Blood vessels dilate, you turn red, you sweat to get relief from the heat and then often you feel cold after that. At night, these fragments disrupt sleep, which affects everything else.”
What experts recommend to stop sweating at night
If menopause is behind your night sweats, there are lifestyle changes as well as traditional and holistic treatment options, including:
- Menopausal hormone therapy: The most effective treatment for vasomotor symptoms in suitable candidates, Calipari says.
- Non-hormonal treatment options: Calipari also says that night sweats can be treated with medications like Vioza and Linquet, as well as some SSRIs and gabapentin.
- Good sleep hygiene and environment: “Keep the bedroom cool, keep bedding layered so you can discard it, limit alcohol and spicy foods in the evening, keep caffeine moderate, maintain a healthy weight, and eliminate stress,” he says. Also try a fast breathing and wind-down routine.
- Supplements: You can try them, he shares, but keep expectations moderate. “I am candid to patients that the supplement evidence is mixed; black cohosh and soy isoflavones help some women modestly, but not all.”
- Cooling sheets and pajamas: He noted they won’t prevent night flashes, but they can make it easier to tell how wet you are. “When shopping, look for moisture-wicking, breathable fabrics – merino wool (surprisingly good at temperature regulation), bamboo/Tencel or technical performance fabrics that are designed to draw moisture away from the skin, rather than traditional cotton, which absorbs moisture and stays wet. For bedding, the same principle applies, as well as phase-change materials to absorb body heat. A medium-firm, breathable A removable mattress topper helps too.”
He further said that, although night sweats are common, it is still treatable. “You don’t have to do it ‘hard,'” he says. “It’s an old message. We can do better.”