Waking up with damp sheets is more common than many people think—and it's not just happening to menopausal women, says Robin Berzin, MD, CEO of the functional medicine practice Parsley Health. Here, the Well+Good Council member explains why night sweats might be happening to you…and what you can do to keep things cool going forward.
Most people associate night sweats with menopause. And it's true that night sweats are one in a constellation of symptoms associated with menopause and peri-menopause, including mood swings, weight gain, vaginal dryness, decreases in libido, and urinary urgency. These symptoms can start as early as a woman’s late 30s or early 40s, although in the United States, the average age for menopause is 51.
Anywhere from 10 to 40 percent of adults report night sweats in a given year.
Yet some women in their 20s and 30s who are not in menopause report night sweats coming in waves, leading to drenched pajamas and sheets, and they mistakenly fear that they are going into early menopause. Usually though, this isn’t the case.
Night sweats are actually relatively common. Anywhere from 10 to 40 percent of adults report them in a given year. There are a few reasons you might be having night sweats, even if you’re far from menopause and your cycles are perfectly normal.
Keep reading for a few habits and scenarios that could lead to (unplanned) p.m. sweat sessions.
Normal variations in your menstrual cycle
We know that as estrogen decreases, the body’s “thermoneutral zone,” which is dictated by the brain, gets narrower. This means there's a smaller window of ambient environmental temperature window your body will tolerate before it tries to compensate by changing its metabolic rate or using evaporative heat loss—AKA sweating.
This is part of the reason for night sweats in menopause, but during a woman’s regular menstrual cycle, estrogen levels are quite low for the first week (when she has her period) and again on days 26 to 28, right before she gets her period (assuming a 28-day cycle). So if you're getting night sweats periodically, notice if they're falling in this window of your cycle.
Low blood sugar
When blood sugar drops—causing either hypoglycemia or something known as “relative hypoglycemia,” meaning the level of sugar in the blood is technically normal, but the sudden drop is enough to trigger hormones like adrenaline and cortisol—night sweats can result. This is more common in people with diabetes, who have a hard time regulating blood sugar in general. It also can happen in people who are eating an imbalanced diet, with too little protein and fat to balance blood sugar over time. At Parsley Health, we analyze dietary patterns and encourage the consumption of protein, fat, and fiber in the evening to help regulate blood sugar throughout the night. Tip: Have a tablespoon of almond butter or an egg before bed to regulate blood sugar while you sleep.
Almost everyone has anxiety at times, whether it comes in the form of racing thoughts and generalized anxiety, or if it flares up here and there situationally. Underlying anxiety increases sympathetic tone, or the activation of the fight-or-flight side of your nervous system. This, in turn, increases the hormones and neurotransmitters cortisol, adrenaline, and norepinephrine in the body. That leads to the constriction of your peripheral blood vessels (vasoconstriction). And ultimately: The body’s temperature increases, and the body triggers sweating to cool off.
Diet and detoxification
Overeating, especially refined carbohydrates and sugar, results in frequent insulin spikes. Over time, that can lead to an overproduction of testosterone by the ovaries, which in turn results in the overproduction of estrogen (because estrogen comes from testosterone). These estrogens then need to be broken down and excreted. If you don't excrete your estrogens routinely (perhaps because you're low in crucial B vitamins, eat a low-antioxidant diet, have a genetic variant known as MTHFR, or are regularly constipated—among other reasons), you can end up with excess estrogen metabolites and, ultimately, more symptomatic menstrual cycles.
Infections and cancer
Underlying infections like tuberculosis, brucellosis, and some parasites can cause periodic night sweats—as can cancer. In these conditions, periodically inflammatory chemical messengers called cytokines (like IL-6 and TNF) are released in the blood. This triggers changes in the thermoneutral zone, and the body then compensates to lower your core temperature by sweating.
Alcohol and medications
Certain medications, including antidepressants like SSRIs, diabetes medications like metformin, and opioids like oxycodone, can also disrupt the body’s ability to regulate temperature. If you are taking any of these medications, discuss with your doctor whether they could be the cause of your symptoms. In addition, notice if alcohol could be the culprit. Alcohol disrupts the body’s ability to thermoregulate in both directions, causing both sweating and shivering. Even a glass or two of wine can be enough to interrupt sleep and disrupt body temperature in some people.
Originally published February 18, 2018; updated October 6, 2018.
Robin Berzin, MD, is the founder and CEO of Parsley Health, an innovative primary care practice with offices in New York, Los Angeles, and San Francisco. Dr. Berzin attended medical school at Columbia University. She is a certified yoga instructor and a meditation teacher.
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