There’s nothing worse than waking up in a puddle of your own sweat when you are supposed to be dreaming away. Yet for 80 percent of women, this is the reality during menopause. Beyond that, the American Family Physician reports that 41% of primary care patients experience night sweats for any reason.
Night sweats are heavy sweating episodes while you are sleeping that can cause you to soak through clothing or bedding, according to Dr. Francesco Callipari, medical director of the Carolyn Rowan Center for Women’s Health and Wellness and medical director for the OB/GYN faculty practice at The Mount Sinai Hospital in New York. Here’s what causes night sweats and how to stop them before you lose too much sleep.
What Causes Night Sweats?
While menopause is the most common time for night sweats, there are other less common causes. Those include depression and opioid use disorder medications, along with drugs used to lower blood sugar for those with diabetes. In addition, a variety of conditions can cause night sweats, from sleep disorders to cancers to autoimmune diseases, the Mayo Clinic reports.
What Are Night Sweats?
Here’s how to know it’s true night sweats: “A warm room or too many blankets makes you uncomfortable, but you adjust the thermostat or kick off the covers and you’re fine,” Callipari says. “True night sweats are different − they tend to come in waves regardless of room temperature, often preceded by a sudden flush of heat, and they leave you genuinely drenched, sometimes needing to change your nightclothes or sheets.” So, if you are in a cool room and still waking up soaking wet, that’s a “distinguishing feature” of night sweats, he says.
He says patients often show up with ongoing sleep disruption, rather than much concern about the heat and sweat itself, as some menopausal night sweats go on for 7-10 years or more. “The disruption is real and often underestimated: The repeated awakenings cause daytime fatigue, irritability, brain fog and mood changes,” Callipari adds. He wants more women to bring up the issue sooner to their doctors.
What’s Really Happening in the Body During Night Sweats in Menopause?
Someone who has always slept well might wonder what’s really causing their night sweats during menopause. Callipari says we can blame estrogen levels fluctuating and declining, causing the brain’s “thermostat,” which is in the hypothalamus, to become dysregulated.
“Even a tiny rise in core temperature that you’d never normally notice triggers a full vasomotor response,” he says. “Blood vessels dilate, you flush, you sweat to shed heat and then often you get a chill afterward. At night, this fragments sleep, which compounds everything else.”
What Experts Recommend for Stopping Night Sweats
If menopause is behind your night sweats, there are both traditional and holistic treatment options, along with lifestyle changes, including:
Menopausal hormone therapy: The most effective treatment for vasomotor symptoms in appropriate candidates, Callipari says.
Non-hormonal treatment options: Callipari also says night sweats can be treated with medications like Veozah and Lynkuet, as well as certain SSRIs and gabapentin.
Good sleep hygiene and environment: “Keep the bedroom cool, layer bedding so you can shed it, limit alcohol and spicy food in the evening, moderate caffeine, maintain a healthy weight and address stress,” he says. Also try paced breathing and a wind-down routine.
Supplements: You can try them, he shares, but keep expectations moderate. “I’m candid with patients that supplement evidence is mixed; black cohosh and soy isoflavones help some women modestly, but not all.”
Cooling sheets and pajamas: He notes that they won’t stop the night flash, but they can temper how drenched you get. “When shopping, look for moisture-wicking, breathable fabrics − merino wool (surprisingly good at temperature regulation), bamboo/Tencel or technical performance fabrics designed to pull moisture off the skin, rather than traditional cotton, which absorbs and stays wet. For bedding, the same principle applies, plus phase-change materials engineered to absorb body heat. A medium-firm, breathable mattress topper helps too.”
He adds that, though night sweats are common, they’re still treatable. “You don’t have to ‘tough it out,’” he says. “That’s an outdated message. We can do better.”
