Night sweats

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

[1], [2], [3]

Epidemiology

The epidemiology of night sweats has not been studied by WHO, but according to some studies by US hospitals, up to 30-34% of patients over 64 years of age complain to general practitioners about this symptom. Sweat at night 75-80% of women during menopause and at least 16% of patients with cancer hospices.

[4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]

Causes of the night sweats

This symptom is nonspecific, that is, it manifests itself in many diseases: infectious, viral, endocrine, malignant, autoimmune. In almost a third of cases, doctors face difficulties in identifying the true cause of night sweats, and then it is an idiopathic overnight hyperhydration.

[18], [19], [20]

Symptoms of the night sweats

Night sweats for pulmonary tuberculosis, which causes Mycobacterium tuberculosis, refers to the typical signs of this infectious disease, along with general weakness, fever, slimming, coughing, etc. Despite different pathogens, almost all patients have night sweats in pneumonia and bronchopneumonia, pleurisy, abscess of the lung, infectious mononucleosis, coccidioidomycosis, brucellosis. The first signs, characteristic of the acquired immunodeficiency syndrome: weakness, loss of appetite, diarrhea, and night sweats in HIV.

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

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

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

In diabetes mellitus, there are night weakness, sweating and hunger, which in endocrinology is commonly called hypoglycemic syndrome. In diabetics, insulin levels and blood glucose levels drop at night, resulting in increased adrenaline synthesis by the adrenal glands, and adrenaline - getting into the blood and affecting specific receptors - activates the sympathetic nervous system.

With vegetative disorders of the nervous system, night sweats are associated with VSD - vegetative-vascular dystonia : in response to an increase in the synthesis of acetylcholine (lowering the level of blood pressure), the functions of sweat glands are activated. The VSD is characterized by night sweating of the neck, back and scalp.

Also night attacks of weakness and sweating are noted in cancer (leukemia, lymphoma, malignant corticosteroid 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, Istenko-Cushing's disease, Herpes zoster, herpes zoster, obesity, spinal cord injuries.

Night sweats are a side effect of some antipyretic, anti-edematous and antihypertensive drugs, tricyclic antidepressants, phenothiazine neuroleptics, opiates, corticosteroids, hormone replacement drugs, and food supplements with iron and zinc.

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 can signal a deficiency of calcipers (vitamin D), in which the head of the neck sweats, as well as congenital heart disease or Cerebral palsy.

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

One of the possible options for children from 4-12 years is night sweats due to nightly fears.

When infected with hepatic trisodium and the development of opisthorchiasis, the child has weakness and lethargy, poor appetite, night sweats, diarrhea and sore throat (or perspiration), abdominal pain on the right. It should be borne in mind that night sweats can occur in most helminthiases.

If there is snoring and night sweats in the child, you should contact the otolaryngologist, as only in its help can you find out the possible cause of these symptoms: tonsillitis, pharyngeal tonsillitis, curvature of the nasal septum, or obstructive sleep apnea syndrome.

Hyperactivity of the thyroid gland also causes severe sweating during sleep, and, according to endocrinologists, Graves' disease is often diagnosed in girls 11-15 years old. In children 6-14 years old, a rare tumor of the adrenal gland can appear - pheochromocytoma, which is manifested by night hyperhidrosis, episodic attacks of tachycardia and increased blood pressure.

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

Night Sweating in Women

One of the most common causes of nocturnal hyperhidrosis in women older than 43-45 years is hormonal changes associated with menopause and perimenopause. Night sweats with 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 violation of the circadian rhythm of the secretion of gonadoliberin.

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

By changing the content of hormones usually causes night sweats during pregnancy, and night sweating after childbirth is also associated with the removal of excess interstitial fluid accumulated during pregnancy.

Night sweats in men

Night sweating in men has many causes - see earlier 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 decline in testosterone levels, accompanied by increased blood pressure and impaired urinary tract. This condition refers to physiologically conditioned, that is, it is not pathology. However, it should be borne in mind that night sweats in men under 40 years may be a sign of such dangerous diseases as inflammatory prostate cancer or testicular cancer.

Night sweating after alcohol is due to the fact that the blood vessels reflexively expand, the acidity of the blood rises, 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) may be in the initial stage of liver cirrhosis ...

Diagnostics of the night sweats

Night sweating is not a disease, but a symptom, moreover, more often than not the only one. And only on this symptom to determine the cause of its occurrence can be, perhaps, only in the presence of obvious inflammation of the upper respiratory tract with increased temperature.

So "night sweats diagnostics" involve the detection of a disease, which may require extensive medical examination, including the collection of anamnesis, examination and blood tests (blood, urine, and feces) prescribed by the doctor to determine the functional characteristics of the body's basic systems. Especially important in the diagnostic plan is a biochemical blood test to the level of sex and thyrotopic, as well as antibodies.

Narrow specialists apply 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 increased sweating at night is a differential diagnosis, the purpose of which is to find the cause and choose the correct way to eliminate it.

[21], [22], [23], [24]

Treatment of the night sweats

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

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

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

But the symptomatic treatment of night sweats for today is not carried out for lack of necessary drugs. Recommended by some neuroleptics are ineffective, but very often they show a lot of side effects. Preparations of this group are suitable only in palliative therapy of cancer patients in the late stages of the disease.

Few people now prescribe the treatment of the skin before going to bed with a 20% solution of aluminum chloride hexahydrate, because with its continued use it is impossible to avoid the atrophy of the acrylic sweat glands.

Try to use means inhibiting acetylcholine - anticholinergic drugs, for example, intended for the treatment of gastric ulcers Glycopyrrolate (Robinul, Cuvposa). At the same time, a decrease in sweating is a side effect of this drug, so that its administration can cause other side effects in the form of dry mouth, difficulty urinating, problems with vision and taste, nervousness and drowsiness, indigestion, vomiting and constipation.

Treatment of night sweats and hot flushes with menopause is recommended for non-hormonal preparation Klimalanin (1-2 tablets a day).

A homeopathy with night sweats before the menstrual period suggests taking the drug with an extract of the fruits of the plant Agnus Castus (Cretaceous Common) - Cyclodinone (once a day on a tablet or 35-40 drops).

You also need to take vitamins: vitamin C, vitamins B6, B12 and folic acid. And dieticians advise to use products with a high content of silicon that regulates sweating: buckwheat, oat and barley porridge, onions, celery, tomatoes, almonds, strawberries, grapes.

Alternative treatment

From excessive sweating at night, alternative treatment offers:

• take a natural apple bite - a dessert spoon, half an hour after a meal, twice a day;
• Drink 200 ml of fresh tomato juice daily;
• before taking the shower, wipe the skin with a solution of soda and cornstarch (a teaspoon of a glass of warm water).

When sweating, herbal treatment is the use of sage broth, which has astringent properties due to the content of thiamine, magnesium and rosmarinic acid. The broth is prepared based on 10-15 g of fresh or dried sage leaves on a glass of water. In addition, herbalists recommend to make a decoction of astragalus (goatskin) or roots of crochet grass creeping and drink it during the day in between meals.

[25], [26], [27], [28], [29]

Prevention

Is prevention of night sweats caused by so many serious diseases possible?

 To facilitate the condition, doctors recommend the following:

• sleep at a temperature of not more than +20 ° C, before going to bed it is good to ventilate the room;
• Bed linen must be made of natural fabric;
• Do not drink before going to bed hot, do not drink drinks with caffeine and alcohol;
• for dinner do not eat greasy, sour and spicy food.

[30], [31], [32], [33]

Forecast

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