Night sweats

Among the symptoms of various diseases and pathologies, such a sign as the occurrence of excessive sweating during sleep stands out - night sweats. ICD-10 classifies it as class XVIII (symptoms and signs without specifying any diagnosis), category R (general symptoms), subcategory R61.9 - unspecified hyperhidrosis, night sweats.

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Epidemiology

The epidemiology of night sweats has not been studied by the WHO, but according to some studies of US medical institutions, up to 30-34% of patients over 64 years of age who visit general practitioners complain of this symptom. 75-80% of women sweat at night during menopause and at least 16% of patients in oncology hospices.

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Causes night sweats

This symptom is non-specific, i.e. it manifests itself in many diseases: infectious, viral, endocrine, malignant, autoimmune. In almost a third of cases, doctors encounter difficulties in identifying the true cause of night sweats, and then we are talking about idiopathic night hyperhydration.

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Symptoms night sweats

Night sweats in pulmonary tuberculosis, which is caused by Mycobacterium tuberculosis, are typical signs of this infectious disease, along with general weakness, fever, weight loss, cough, etc. Despite the different pathogens, almost all patients experience night sweats in pneumonia and bronchopneumonia, pleurisy, lung abscess, infectious mononucleosis, coccidioidomycosis, brucellosis. The first signs characteristic of acquired immunodeficiency syndrome: weakness, loss of appetite, diarrhea, as well as night sweats in HIV.

Night sweats in syphilis, the causative agent of which is the spirochete Treponema pallidum, are explained by venereologists by the penetration of treponema into the systemic bloodstream and its negative polyneurogenic effect on the body.

Night sweats in chronic hepatitis, which can occur without yellowing of the skin and sclera, are considered to be the body's response not only to the introduction of the virus, but also to the formation of lymphoid infiltrates in the liver parenchyma.

Severe night sweats are among the symptoms of hyperthyroidism (thyrotoxicosis) - an increased level of thyroid hormones. And in this case, the pathogenesis is due to the ability of thyroid hormones to increase the body's heat production.

In diabetes mellitus, night weakness, sweating and a feeling of hunger are observed, which in endocrinology is called hypoglycemic syndrome. In patients with diabetes, the level of insulin and glucose in the blood drops at night, as a result of which the synthesis of adrenaline by the adrenal glands increases, and adrenaline - entering the blood and affecting specific receptors - activates the sympathetic nervous system.

Night sweats in VSD ( vegetative-vascular dystonia) are also associated with vegetative disorders of the nervous system: in response to increased synthesis of acetylcholines (which reduce blood pressure), the functions of the sweat glands are activated. VSD is characterized by night sweats of the neck, back, and scalp.

Night attacks of weakness and sweating are also observed in oncological diseases (leukemia, lymphomas, malignant corticosteroidoma and pheochromocytoma, lung and kidney cancer), myeloproliferative diseases, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, gastroesophageal reflux, chronic nephritis, insulinoma, Parkinson's disease, obstructive sleep apnea-hypopnea syndrome. In addition, the causes of night sweats can be associated with strokes, infective endocarditis, osteomyelitis, Itsenko-Cushing's disease, shingles (Herpes zoster), obesity, spinal cord injuries.

Night sweats are a side effect of some antipyretic, decongestant, and antihypertensive drugs, tricyclic antidepressants, phenothiazine antipsychotics, opiates, corticosteroids, hormone replacement drugs, and iron and zinc supplements.

Night sweats in children

In addition to most of the reasons listed above (hepatitis, pneumonia, etc.), night sweats in children of the first two years of age may indicate a deficiency of calciferols (vitamin D), in which the back of the head sweats during sleep, as well as a congenital heart defect or cerebral palsy.

Night cough and sweating in children are caused by almost all infectious inflammatory diseases of the respiratory tract, accompanied by fever.

One possible variant in children aged 4-12 years is night sweats due to night terrors.

When infected with liver flukes and developing opisthorchiasis, the child experiences weakness and lethargy, poor appetite, night sweats, diarrhea and sore throat (or tickling), abdominal pain on the right. It should be borne in mind that night sweats can be observed with most helminthiases.

If a child starts snoring and sweating at night, you should consult an otolaryngologist, since only with his help can you determine the possible cause of these symptoms: tonsillitis, inflammation of the pharyngeal tonsil, curvature of the nasal septum, or obstructive sleep apnea syndrome.

An overactive thyroid gland also causes excessive sweating during sleep, and according to endocrinologists, Graves' disease is diagnosed quite often in girls aged 11-15. Children aged 6-14 may develop a rare adrenal tumor called pheochromocytoma, which manifests itself as nighttime hyperhidrosis, episodic attacks of tachycardia and high blood pressure.

Pediatricians warn that night sweats in adolescent children may not only be a physiological sign of puberty (teenage "hormonal storms"), but also a symptom of leukemia (acute lymphoblastic or myeloblastic leukemia) or Hodgkin's lymphoma.

Night sweats in women

One of the most common causes of night hyperhidrosis in women over 43-45 years old is hormonal changes associated with menopause and perimenopause. Night sweats during menopause and daytime "hot flashes" are classic vasomotor symptoms of this condition, which is caused by a decrease in the level of estradiol in the blood and a disruption in the circadian rhythm of gonadotropin-releasing hormone secretion.

Night sweats before menstruation are a physiologically normal phenomenon and are associated with the same sex hormones. But if a young woman suffers from night sweats, and this is not associated with the menstrual cycle, then she should be wary of problems with the thyroid gland or pituitary gland, as well as premature fading of ovarian function or the possible development of a hormone-dependent tumor.

Night sweats during pregnancy are usually caused by changes in hormone levels, and night sweats after childbirth are also associated with the removal of excess interstitial fluid that has accumulated during pregnancy.

Night sweats in men

Night sweats in men have many causes – see previously Causes of Night Sweats.

But there are also specific reasons. After 50, night attacks of weakness and sweating may indicate the onset of andropause - an age-related decrease in testosterone levels, accompanied by increased blood pressure and genitourinary disorders. This condition is physiologically determined, that is, it is not a pathology. However, it should be borne in mind that night sweats in men under 40 can be a sign of such dangerous diseases as inflammatory prostate cancer or testicular cancer.

Night sweats after alcohol are caused by the fact that blood vessels reflexively expand, blood acidity increases, insulin production by the pancreas decreases, and the toxic load on the liver increases. By the way, increased sweating (as a result of subfebrile temperature) can also be in the initial stage of liver cirrhosis…

Diagnostics night sweats

Night sweats are not a disease, but a symptom, and more often than not, not the only one. And only by this symptom can the cause of its occurrence be determined, perhaps, only in the presence of obvious inflammation of the upper respiratory tract with elevated temperature.

So, "diagnosing night sweats" involves identifying the disease, which may require an extensive medical examination, including anamnesis, examination and tests prescribed by a doctor (blood, urine, feces) - to determine the functional characteristics of the main body systems. Particularly important in diagnostic terms is a biochemical blood test for the level of sex and thyroid hormones, as well as antibodies.

Narrow specialists use instrumental diagnostics: X-ray and ultrasound examination of internal organs, CT and MRI, laparoscopic examination, etc.

In any case, the diagnosis of diseases that cause excessive sweating at night is a differential diagnosis, the purpose of which is to find the cause and choose the right way to eliminate it.

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Treatment night sweats

Treatment of night sweats depends on its cause. That is, night sweats with pneumonia, tuberculosis or syphilis require etiotropic therapy of the diseases themselves - with antibiotics and appropriate special drugs. And the treatment should be prescribed by the appropriate doctor.

For pathogenetic treatment of night sweats in diabetes mellitus, insulin is used to compensate for the deficiency of its synthesis by the pancreas.

If attacks of night sweats are caused by malignant tumors, then oncologists conduct treatment with the most optimal methods, including chemotherapy and surgery.

But symptomatic treatment of night sweats is not carried out today due to the lack of necessary drugs. Neuroleptics recommended by some are ineffective, but very often show a lot of side effects. Drugs of this group are appropriate only in palliative therapy of cancer patients in the late stages of the disease.

Few people now prescribe treatment of the skin before bed with a 20% solution of aluminum chloride hexahydrate, since with its prolonged use, atrophy of the eccrine sweat glands cannot be avoided.

They try to use drugs that inhibit acetylcholine - anticholinergic drugs, for example, Glycopyrrolate (Robinul, Cuvposa), which is intended for the treatment of stomach ulcers. However, decreased sweating is a side effect of this drug, so taking it can cause other side effects in the form of dry mouth, difficulty urinating, problems with vision and taste, nervousness and drowsiness, upset stomach, vomiting and constipation.

Treatment of night sweats and hot flashes during menopause is recommended with the non-hormonal drug Klimalanin (1-2 tablets per day).

And homeopathy for night sweats before menstruation suggests taking a drug with an extract of the fruits of the Agnus Castus plant (common chaste tree) - Cyclodinone (one tablet or 35-40 drops once a day).

You also need to take vitamins: vitamin C, vitamins B6, B12 and folic acid. And nutritionists advise eating foods with a high silicon content, which regulates sweating: buckwheat, oatmeal and barley porridge, onions, celery, tomatoes, almonds, strawberries, grapes.

Folk remedies

For excessive sweating at night, folk remedies suggest:

• take natural apple cider vinegar - a dessert spoon, half an hour after meals, twice a day;
• drink 200 ml of fresh tomato juice daily;
• Before taking a shower, wipe your skin with a solution of baking soda and cornstarch (a teaspoon per glass of warm water).

For sweating, herbal treatment involves drinking sage decoction, which has astringent properties due to the content of thiamine, magnesium and rosmarinic acid. The decoction is prepared at the rate of 10-15 g of fresh or dried sage leaves per glass of water. In addition, herbalists recommend making a decoction of astragalus (goat's rue) or creeping wheatgrass roots and drinking it during the day between meals.

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Prevention

Is it possible to prevent night sweats, which are caused by so many serious diseases?

To alleviate the condition, doctors recommend the following:

• sleep at a temperature no higher than +20°C, ventilate the room well before going to bed;
• bed linen should be made of natural fabric;
• do not drink hot drinks before going to bed, do not consume drinks with caffeine or alcohol;
• Do not eat fatty, sour or spicy foods for dinner.

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Forecast

The prognosis for any symptom, including something as common as night sweats, depends on the severity of the disease and the effectiveness of its treatment.