Night sweats are not as disturbing for the patient as other forms but because undisturbed sleep is so important to our body, it can have a significant impact on our health – no on like to wake up to wet sheets, especially in the cold!

There are 2-4 million sweat glands that are used by our nervous system to cool off the body and keep it within a constant and acceptable temperature. When the sweating process exceeds its normal production, such as night sweats, we are dealing with the phenomenon called hyperhidrosis. The condition is acknowledged when the production of sweat by the axillary glands exceeds 100 mg in an interval of five minutes.

The hypothalamic preoptic sweat center is located in the brain and it sends commands through the brain stem and medulla to the innervations of the sweat glands. The nerves enter the spinal cord and synapse in the anterolateral cell column of the spinal cord. Neurons then exit the spinal cord and enter the sympathetic ganglia found in the chest and from there they supply the upper limbs. A hyperactive sympathetic nervous system is believed to be responsible for hyperhidrosis or excessive sweating. The deregulation of the sympathetic nervous system may occur when the individual is exposed to various distressful stimuli. Thermal stimuli may also trigger the negative effects of hyperhidrosis.

The most common areas of the body where emotionally triggered excessive sweating appears are the hands, the underarms and the feet. When, during sleep, emotional stimuli are reduced, hyperhidrosis may manifest itself through thermal sweating.

Symptoms of Night Sweats

• Damp and clammy bedding. You wake up to find your bedding soaked. You either feel too hot or clammily cold.

Night Sweats – Causes

• Menopause or Andropause. Menopause in women is the most common cause of night sweats. However, some men also suffer from night sweats during the male menopause, or andropause.
• HIV, tuberculosis. In fact, any infectious disease or condition that brings on a fever can cause night sweats.
• Diabetes. Diabetes can also cause night sweats.
• Sleep apnea. This is the one that most concerns us. Night sweats can also be a sign of sleep apnea. If you also suffer from severe snoring and excessive daytime sleepiness, it might be time for a study.
• Alcohol, some drugs, spicy foods. Consumption of any of these can cause night sweats. And by drugs, I’m not necessarily referring to street drugs. Some prescription drugs, like Zoloft, can also cause night sweats.

A visitor named Christina wanted us to include Cancer as a possibility and commented:

Your article is well written but has one serious omission. Under the section about causes of night sweats, you fail to list cancer as a potential cause and this could mislead readers into thinking they don’t need to see a doctor all that urgently. As someone who’s survived breast cancer and now has lymphoma, night sweats were *the* predominant symptom I had that eventually led to diagnosis. While I agree that there are many other, more likely and more benign, causes of night sweats, I feel that it’s important to at the very least include cancer in the list of potential causes so that those who do suffer from night sweats know they need to take discovering their root cause seriously and to be persistent until they do. With respectful thanks, Christina

Treatment of Night Sweats

Various anticholinergic medications have success in treating excessive sweating. A treatment with Robinul starts at 1 or 2mg one to three times a day and has good effects on excessive manifestations of hyperhidrosis. Higher doses are usually needed to help sustain a favorable environment for a successful treatment.
Excessive Sweating Medications

The side effects that appear with an increase in dosage are to be considered. Hyperhidrosis medications, especially when used intensively, produce mouth dryness, also known as cotton mouth. Other patients suffer from side effects such as blurry vision, constipation or urinary retention. Reflex tachycardia and moderate memory impairment were also signaled with some patients undergoing medication treatment for hyperhidrosis.

Another medication used in the treatment of excessive sweating is Propranolol, a beta-blocker that has both sympathetic and generalized activity. It mostly targets stress induced hyperhidorsis and is successful in eliminating most of the negative effects of the condition. Side effects are considerable and include a slow heart rate and a low blood pressure. As a consequence of the two side effects mentioned before, the patients also accuse a continuous state of tiredness and apathy.

Anticholinergic medications such as Propentheline Bromide (Probanthine) and Oxybutynin (Ditropan) are also used in the treatment process. They are used orally and have been known to improve the excessive sweating process, reducing the sweat amount. Anticholinergic drugs are not suitable for targeted local use, as the skin does not absorb them properly.

Botox to Control Sweating

Botulinum toxin type A (BTX-A) is sometimes used to treat night sweating. It is injected into the skin and it acts as a temporary blockage for the sympathetic nerves that stimulate the excessive sweat production. This type of medication works well on local areas, where it is injected. When applied in 15 or 20 locations in the under arm area, Botox is usually effective; noticeable decreases in the sweat levels are observed after the injections. The downside of this treatment method is that it needs to be repeated every 3 or 4 months for facial treatment and up to 12 months for other areas.

The high cost of the Botox injections may prove to be a difficult obstacle to remove for a patient. The repeated usage of this treatment is expensive and the cure itself is temporary, not final. Another deterrent has been the pain that is associated to the Botox injections.

Before your receive treatments, you should first ask your doctor exactly what steps they take during the process. Most experienced doctors will apply topical numbing creams before the treatment which greatly reduces any pain. You should also look for doctors who perform a starch-iodine test to map out the sweat glands prior to treatment.

Don’t ask these questions directly, but rather look for them in the response to your questions. If during the consultation you don’t hear these or similar answers, then ask them directly and make your evaluation. Many patients suffering from Night Sweats have been very happy with the results of this treatment.

Apart from axillary hyperhidrosis, Botox is also used to treat facial sweating and palmar excessive sweating. Many patients, who wish to avoid the pain of receiving the injection, do not accept treating the face and hands with Botox injections. Temporary paralysis of the hand muscles was observed in some cases, but this is not a frequent side effect.

Just a Bad Dream?

Just because you wake up with wet sheets does not mean you have a problem, it could be as simple as a dream, stress at work or similar factors. If however, you wake up at night with bedding and nightclothes damp with sweat at least 4 of 7 days, then you should seek medical attention.