Night sweats in older adults

Overview

Night sweats are episodes of heavy sweating that happen while you sleep, often soaking through your clothes or bedding. This is not just feeling a little warm from too many blankets.

Night sweats are fairly common in older adults, but they are not something you should just accept. Many people experience them at some point.

Night sweats can affect anyone, but they are more common in older adults, especially those with certain medical conditions or taking certain medicines.

Symptoms

Common symptoms

• Heavy sweating that soaks your pajamas or sheets
• Waking up drenched in sweat
• Needing to change clothes or bedding during the night

Symptoms in children

• Night sweats in children are less common and usually due to infections or teething. See a paediatrician.

Symptoms in older adults

• Heavy sweating during sleep that disrupts rest
• May be accompanied by fever, chills, or weight loss
• Can be a sign of infection, hormone changes, or other medical conditions

Causes

Main causes

• Infections (such as tuberculosis or an infection of the heart's inner lining, called endocarditis)
• Hormone changes (like menopause in women or low testosterone in men)
• Certain medications (antidepressants, diabetes drugs, hormone therapies)
• Cancer (such as lymphoma or leukaemia)
• An overactive thyroid (hyperthyroidism)
• Anxiety or stress

Risk factors

• Being overweight or obese
• Having chronic infections like HIV or hepatitis
• Taking medications that affect sweating
• Having a family history of certain cancers
• Smoking or heavy alcohol use

When to see a doctor

See a doctor urgently if:

• If you have night sweats with a high fever, chills, and feel very unwell
• If you have night sweats after starting a new medicine and feel dizzy or confused

Book a routine appointment if:

• If night sweats last more than two weeks without an obvious cause
• If they are disturbing your sleep and affecting your daily life

Diagnosis

Your doctor will ask about your symptoms, medical history, and any medicines you take. They may also do a physical exam.

Tests that may be done

• Blood tests to check for infection or thyroid problems
• A chest X-ray or scan to look for tuberculosis or lymphoma
• A sleep study if sleep apnea is suspected

What to expect at your appointment

The doctor may ask questions about your night sweats – how often, how severe, whether you have other symptoms. They will work with you to find the cause. It may take a few visits.

Treatment

Treatment for night sweats depends on the cause. If an infection is causing them, treating the infection will often stop the sweats. If medication is the cause, the doctor may adjust the dose or switch to another drug. Hormone therapy may help in some cases.

Self-care at home

• Keep your bedroom cool – around 18-20°C (64-68°F)
• Use lightweight cotton bedding and breathable nightwear
• Avoid spicy foods, caffeine, and alcohol before bed
• Practice relaxation techniques like deep breathing before sleep

Medical treatments

If a specific condition is found, your doctor will treat that condition. For example, infections are treated with antibiotics or antivirals. Hormone imbalances may be treated with hormone therapy. Never take over‑the‑counter remedies for night sweats without talking to your doctor.

When is surgery considered?

Surgery is rarely needed for night sweats themselves. It may be needed to treat an underlying condition such as a tumour or an infection that requires drainage.

Living with this condition

If you have night sweats, try to keep a change of clothes and a towel by your bed. Use a waterproof mattress protector. Keep a fan nearby.

Lifestyle tips

• Keep a sleep diary to track when sweats happen
• Stay hydrated during the day
• Maintain a healthy weight
• Quit smoking and limit alcohol

Diet and exercise

A balanced diet and regular exercise can help regulate body temperature and reduce stress, which may help with night sweats. Avoid heavy meals close to bedtime.

Mental health and emotional wellbeing

Night sweats can be stressful and disrupt sleep, leading to tiredness and mood changes. It's important to talk about your feelings and seek support if needed.

Prevention

It is not always possible to prevent night sweats, but you can reduce your risk by staying at a healthy weight, treating underlying conditions, and avoiding triggers.

Vaccines

Vaccines against infections (flu, pneumonia, etc.) may reduce the risk of night sweats from those illnesses. Ask your doctor which vaccines are right for you.

Screening programmes

Regular health checkups can help detect conditions that may cause night sweats, such as diabetes or thyroid problems.

Complications

If left untreated

• Persistent night sweats can lead to dehydration and electrolyte imbalances
• Sleep disruption can cause fatigue, mood changes, and poor quality of life
• Underlying causes like infection or cancer may worsen if not treated

Long-term outlook

For many people, night sweats go away once the cause is treated. Even when the cause is serious, early diagnosis and treatment often lead to good outcomes. Your doctor will work with you to find the best plan.

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