Night sweats, also known as sleep hyperhidrosis, are a common clinical complaint and may herald malignancy, especially lymphoma, or infections. Patients typically report waking up in the night with sweating so severe that their clothes and bed sheets are soaked through ("drenching sweats") and need changing.
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Pathology
Night sweats are a potentially serious symptom in view of their association with lymphoma, indeed they are one of the so-called B symptoms. However, night sweats are found in the context of many serious pathologies, including other cancers, infections, particularly tuberculosis, and some hormonal disturbances.
Etiology
Malignancy
- lymphoma
- other cancers
Infection
- tuberculosis
- brucellosis
- bacterial
- HIV
Recreational drugs
- ethanol
- MDMA ("ecstasy")
- withdrawal
- ethanol
- opiates
- cocaine
Medications
- antidepressants e.g. SSRIs, tricyclics
- antipyretics e.g. aspirin, NSAIDs, acetaminophen
- glucose-lowering agents e.g. insulin, sulfonylureas
- endocrine e.g. antioestrogens, estrogen receptor antagonists
- miscellaneous (many agents)
- sildefanil
- niacin
- glyceryl trinitrate (GTN)
- beta blockers
Endocrine
CNS
Miscellaneous
- idiopathic "hyperhidrosis"
- sleep apnea
- gastro-esophageal reflux disease: rare but well-recognized
- diabetes insipidus
- giant cell arteritis
- sarcoidosis
Treatment and prognosis
Night sweats may be extremely unpleasant, especially in advanced cancer, when both the disease process and also treatments contribute to this phenomenon. Various treatments have been tried with variable success. Synthetic cannabinoids have shown potential, as they may induce hypothermia e.g. dronabinol or nabilone 2.