Night Sweats

Night sweats mean soaking sweats that wake you and dampen bedding, rather than feeling warm in an overheated room. The most common explanations are benign: menopause and perimenopause, an over-warm bedroom, alcohol in the evening, and medications such as SSRIs and some diabetes drugs. Anxiety, low blood sugar overnight and obstructive sleep apnoea also feature regularly. Less often, night sweats signal infection, thyroid overactivity or, rarely, lymphoma, particularly when they come with unintentional weight loss, fever or persistent swollen glands. Because the causes are so varied, the useful first step is pattern-spotting rather than supplementation: note timing, room temperature, alcohol, medications and cycle phase across 2-3 weeks. Supplement evidence here is thin. For menopausal sweats, isoflavones and black cohosh show small and inconsistent benefits over placebo, and cooling measures plus cognitive behavioural approaches perform at least as well in trials.

• •Waking with soaked nightclothes or bedding
• •Episodes recurring most nights
• •Daytime flushing in perimenopause
• •Fragmented sleep and daytime fatigue
• •Chills after sweating episodes

• •Menopause and perimenopause
• •Infections — tuberculosis, endocarditis, HIV, abscesses
• •Lymphoma and other cancers
• •Medications — antidepressants, antipyretics, steroids
• •Hyperthyroidism
• •Low blood sugar in diabetes
• •Sleep apnoea
• •Alcohol and spicy food late in the evening

Sweating is controlled by the hypothalamic thermoregulatory centre. Falling oestrogen narrows the thermoneutral zone so trivial temperature shifts trigger flushing and sweating. In systemic disease, cytokine release produces the same response — which is why the pattern, and what accompanies it, matters more than the sweating itself.