Sweating During Sleep: Causes, Diagnosis and Treatment

Sweating during sleep can be harmless but at the same time when it is profuse, it can majorly disrupt sleep and cause frequent waking due to wet bed clothes, etc. There could be plenty of causes for sweating during sleep, medically known as sleep hyperhidrosis.

While many of the causes do not entail any risk, like genetic factors, hormonal changes in women, etc, some possible causes of this condition can be indicative of a serious underlying condition.

For initiating treatment, it is necessary to identify whether the night sweating is caused by simple reasons like uncomfortable bed room temperature or medical factors; the reason being many underlying medical conditions that cause sweating during sleep can be life-threatening.

Though the condition can show up at any age, it is most common during early adulthood 

What are the causes of night sweats?

For primary hyperhidrosis (mainly affects armpits, hands and feet), there are no known causes; but excessive sweating starts to interfere with daily life. Treatment involves removing the sweat glands.  Though close to 2 to3% of the population suffer from this, less than 40% seek treatment.

However there are plenty of causes for developing secondary night sweats most of which are linked to some underlying medical condition.

Some of the underlying medical conditions that cause sweating during sleep are:

  • Conditions that results in fever
  • Diabetes accompanied by excessive pale urine and thirst.
  • Underactive thyroid
  • Hypothalamic lesions
  • Cerebral strokes
  • Sudden onset of migraine
  • Obstructive sleep apnea
  • Cerebral palsy
  • Sudden shortfall of blood supply to the spine (Familial dysautomia)
  • Anxiety
  • Cancer
  • Some medications or substance abuse
  • Lung disease
  • Menopause
  • Spinal injury

How is excessive sweating diagnosed

  • Starch iodine test. This involves applying iodine solution to the sweating area where starch is sprinkled after the area has dried. The solution turns dark blue in areas which are excessively sweating.
  • Absorbing paper is placed in the areas of sweating and then weighed. The more it weighs, the more sweat has accumulated.
  • Treating doctor usually reviews other parameters like location of excessive sweating, triggers, time schedules, association with memory of trauma, etc. Certain symptoms like weight loss, increased heart beat, cold hands, fever etc are also studied.

What about treatment? 

Sweating during sleep should never be left untreated, especially if the sweating is excessive. Some of the common treatment options include:

  • Use of anti-perspirants which plug sweat ducts. Usually the first line of therapy most of the products contain aluminum chloride. However some people can have skin problems with its use.
  • Drug therapy includes anticholinergic drugs to prevent sweat gland stimulation. Side effects include dry mouth, dizziness, etc.
  • Iontophoresis is a FDA-approved procedure that involves use of electricity to shut the sweat glands.
  • Botox is also FDA-approved procedure for severe underarm sweating.

Endoscopic thoracic sympathectomy (ETS) is a procedure that is reserved for very severe conditions where none of the above therapies provide satisfactory results. It essentially involves turning off the signal that commands the body to sweat excessively. This procedure is performed on patients who sweat a lot on their palms and faces.

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