What Actually Causes Those Uncomfortably Damp Night Sweats

Have you ever woken up tangled in uncomfortably damp sheets? If so, there’s a good chance you’ve experienced night sweats. As its name implies, the hallmark sign of this issue is excessive sweating at night. Such sweating happens despite being in a comfortable and temperate environment. 

Night sweats can affect women due to a number of factors. Hormonal shifts, particularly those that happen during perimenopause and menopause, are among the most common causes. Other medical conditions and certain medications can also be the culprit behind your night sweats. 

Below, get all the important intel on night sweats, including tips for staying dry.

What Are Night Sweats?

Night sweats happen when you sweat excessively at night, even though your bedroom is a comfortable temperature. A good sign you experienced night sweats is if you wake up amid damp pajamas and bedsheets.

Because night sweats often happen as a result of hormonal changes, women may experience them at many points in their life, such as during perimenopause and menopause, during their menstrual cycle, and during pregnancy.

As mentioned, the main symptom of night sweats is excessive sweating in a temperate environment. If you’re having night sweats, you may:

• Wake up at night feeling hot and flushed

• Wake up feeling wet and chilly, as sweat begins to evaporate

• Have damp or soaked-through pajamas, bedsheets, or pillowcases 

• Feel sticky in the morning and need to take a shower

Because night sweats can wake you up at night and lead to general discomfort due to wet pajamas and sheets, the issue can also interfere with the quality of your sleep. This can lead to excessive daytime sleepiness and may also impact your mood or productivity. 

If you’ve been wondering, “Why do I sweat in my sleep?” know that there are many potential causes of night sweats. Among the most common causes for women are changes in hormone levels. 

Menopause and perimenopause are common causes of night sweats in women. In fact, vasomotor symptoms, which include hot flashes and night sweats, impact up to 75 percent of women in perimenopause.

During perimenopause, your levels of estrogen and progesterone start to drop, and this continues into menopause. 

Research suggests that estrogen helps to regulate heat loss, while progesterone helps to increase body temperature. Fluctuations in these two hormones, which each play a role in temperature regulation, may boost the risk of night sweats or hot flashes.

Other hormone-related causes of night sweats in women include: 

• Premenstrual dysphoric disorder (PMDD): Night sweats are a symptom of PMDD, which is a collection of symptoms that occur prior to your period. 

• Pregnancy: Pregnancy and the postpartum period are times of great change in estrogen and progesterone levels, meaning hot flashes and night sweats may occur.

• Primary ovarian insufficiency (POI). POI is a condition where the ovaries stop functioning normally before age 40. Drops in estrogen in women with POI can lead to symptoms like night sweats and hot flashes.

Other Causes of Night Sweats in Women

Other potential causes of night sweats in women include:

• Hyperhidrosis, a condition of excessive sweating of the extremities

• Low blood sugar (hypoglycemia)

• Gastroesophageal reflux disease (GERD), a condition where the contents of your stomach come back up into your esophagus

• Overactive thyroid (hyperthyroidism), a condition where your thyroid gland makes too much thyroid hormone

• Chronic stress, which may trigger the sweat glands

• Mental health conditions, such as anxiety disorders, depression, or post-traumatic stress disorder (PTSD)

• Sleep disorders like obstructive sleep apnea

• Infections, such as HIV, tuberculosis, osteomyelitis, and endocarditis

• Cancers, such as leukemia and both Hodgkin and non-Hodgkin lymphoma

• Autoimmune diseases like rheumatoid arthritis

• Certain medications, such as antidepressants, steroids, pain medications, and some cancer treatments

• Excess alcohol consumption

• Smoking

Some risk factors may predispose you to a higher likelihood of experiencing night sweats. You could have a higher risk of experiencing night sweats if you: 

• Are in perimenopause or menopause

• Have primary ovarian insufficiency

• Often experience symptoms of PMDD before your period

• Are pregnant

• Have underlying medical conditions that can cause night sweats

• Take medications that have night sweats as a potential side effect

• Consume alcohol in excess

• Smoke

It’s important to understand that night sweats themselves are a symptom of other primary conditions and not their own specific diagnosis. Determining the cause of your night sweats can help a healthcare provider recommend strategies to manage them.

If you experience persistent night sweats, the best first step is to make an appointment with a healthcare provider.

At the beginning of your appointment, your healthcare provider will get your medical history, so come prepared to answer questions about: 

• The characteristics of your night sweats, including how frequent they are, how long they last, and their severity

• Whether you experience any other symptoms in addition to night sweats

• Any underlying medical conditions

• Medications you take

• Lifestyle habits, such as those related to sleep, diet, smoking, and alcohol consumption

A provider may also perform a physical exam to check for fever, weight loss, and swollen lymph nodes, all of which can signal a more serious cause of night sweats, such as cancer or an infection.

Often, it’s possible to identify the cause of night sweats based only on medical history and a physical exam. For example, if you’re in the typical age range for perimenopause or menopause and have other symptoms of menopause, it makes sense that you may experience night sweats.

For reference, most women enter perimenopause between the ages of 45 and 55. You’ve reached menopause when it has been 12 months or more since your last period. The average age of menopause in the United States is 52.

You typically won’t need hormone tests to diagnose perimenopause and menopause. However, it’s possible that your healthcare provider may order some. Such tests measure the levels of:

• Follicle-stimulating hormone (FSH), which is high in women after menopause

• Estrogen, which is lower in women after menopause

• Luteinizing hormone (LH), which is typically higher women after menopause

• Anti-Mullerian hormone, which is low in women going through menopause

Your provider may order additional tests to rule out other medical conditions that can potentially cause night sweats, including:

• Blood tests, such as those for complete blood count, thyroid hormone levels, autoimmune disease markers, or infections like HIV

• A sleep study to check for sleep disorders

• Imaging tests

As for options for stopping hormonal sweating at night during perimenopause or menopause, your healthcare provider may recommend trying hormone replacement therapy (HRT).

HRT supplements the body’s estrogen (and sometimes progesterone), which helps to manage the hormonal fluctuations and their associated symptoms.

HRT is quite effective for addressing vasomotor symptoms of menopause, which include hot flushes and night sweats. In fact, researchers have found that estrogen, with or without progesterone, can reduce the frequency of these symptoms by about 75 percent. 

However, HRT may not be appropriate for all women going through the menopausal transition. That’s because certain forms of HRT may increase the risk of serious blood clots, gallbladder disease, and certain cancers.

If you cannot or choose not to take HRT, there are also a variety of nonhormonal treatments that may help with vasomotor symptoms like night sweats. Three of these options are approved by the Food and Drug Administration (FDA) to reduce moderate to severe vasomotor symptoms.

One of those is paroxetine (Brisdelle^TM), which is an oral selective serotonin reuptake inhibitor (SSRI). According to its prescribing information, the exact way that it helps to reduce night sweats and hot flashes is unknown.

Another FDA-approved medication is fezolinetant (Veozah^TM), which reduces night sweats and hot flashes by blocking a chemical messenger called NK3. NK3 helps to manage the body temperature. 

The third FDA-approved medication is elinzanetant (Lynkuet^®), which works as a NK1 and NK3 receptor blocker. 

According to the North American Menopause Society, some medications prescribed off-label can also be effective nonhormonal treatments for vasomotor symptoms. These medications include gabapentin, a type of epilepsy medication, and oxybutynin, which treats overactive bladder. When taking a medication for an off-label uses or otherwise, be sure to only use it as your provider prescribes.

Talk therapy may also be helpful for coping with night sweats. Some research suggests that cognitive behavioral therapy (CBT), a type of talk therapy, can lower the impact of vasomotor symptoms, help improve sleep, and boost quality of life.

Addressing Other Causes of Night Sweats

Treatment options for putting your night sweats to bed depend on the underlying cause. For example, if your night sweats are due to an infection, treating that issue may alleviate your night sweats.

Lifestyle changes can also help. For example, if you smoke or drink in excess, your provider may recommend you address those habits. Doing so may make a difference in your night sweats episodes. 

There’s no one-size-fits-all strategy to completely prevent night sweats. But, if your night sweats are due to hormonal shifts, an appropriate treatment plan may help reduce the frequency of your night sweats.

If you’ve been experiencing night sweats regularly, the following lifestyle changes may help:

• Lowering the temperature in your bedroom at night by adjusting your air conditioning or using a fan

• Layering your bedding to accommodate a night sweat

• Avoiding spicy foods, alcohol, caffeine, or smoking before bed

• Taking steps to maintain a healthy weight, as having overweight or obesity may lead to more night sweats or hot flashes

• Incorporating mindfulness practices into your routine, such as hypnotherapy or meditation.  

If night sweats disrupt your sleep, consider making the following adjustments: 

• Going to bed and waking up around the same time each day

• Keeping your bedroom quiet and dark (in addition to maintaining a comfortable temperature)

• Limiting your screen time close to your bedtime

• Doing a relaxing activity before turning in for the night, such as reading or listening to calming music

• Avoiding large meals, alcohol, or caffeine before bed

• Exercising during the day

How common are night sweats?

Getting night sweats is pretty common. They’re estimated to impact up to 41 percent of people.

Why am I waking up soaked in sweat?

There are several potential causes of night sweats, including hormonal changes, other underlying medical conditions, and certain medications.

What’s the most common cause of night sweats in women?

Hormone fluctuations, particularly those associated with perimenopause and menopause, are a common cause of night sweats in women. You may also experience night sweats prior to your period and during pregnancy.

When should I see a healthcare provider for night sweats?

If you’ve been having frequent night sweats, see your healthcare provider to discuss the situation. If you’re in your 40s or 50s, there’s a good chance your night sweats may be due to the effects of perimenopause or menopause, and effective treatment options are available. Also, make sure to seek care promptly if you have persistent night sweats that happen with symptoms like unintended weight loss, fever, or a cough, which could signal a more serious medical condition. 

How can I stop night sweats?

The best way to reduce or eliminate night sweats is to address the underlying cause.For women who are going through perimenopause or menopause, HRT or effective nonhormonal treatments may help.