Why Am I Sweating in My Sleep? 6 Reasons

If you sweat in your sleep, you know how annoying it can be. Waking up and needing to change your clothes or ... ugh, the sheets ... again ... can take a toll on your sleep and wreak havoc on your morning.

Sweating at night is a common concern and can be a real bother. How are you supposed to feel refreshed and ready for your day when you wake up flushed and sweating like you ran a marathon in your sleep?

We talked with family medicine physician Colleen Clayton, MD, about the common causes of night sweats and steps you can take to find some relief.

Understanding night sweats

If you’re waking up drenched in sweat, you’ve got night sweats. It’s not the same as feeling a little clammy after a night of being cuddled up with too many blankets.

“Night sweats are intense episodes of heavy sweating in your sleep,” Dr. Clayton says. “If you have night sweats, it’s more than a matter of turning on a fan or kicking off the blankets.”

6 causes of sweating in your sleep

Sweating is your body’s natural response to help you cool down, like when you’re exercising or out in the hot sun.

But while you’re sleeping? Unless you’re burrowed under the comforter with the heater on full blast, you probably don’t need to sweat. And yet you do.

Why? Dr. Clayton shares some of the most common reasons.

1. Menopause and perimenopause

Perhaps the best-known causes of night sweats are menopause and perimenopause (the transitional time before your periods end).

Here’s why: As you enter menopause, your body produces less estrogen, progesterone and testosterone. Those hormonal shifts are what cause your periods to become irregular and, eventually, stop altogether.

But they also trigger other changes in your body, including how your body regulates temperature.

That can lead to hot flashes during the day and sweating while you sleep.

By definition, you enter menopause when you haven’t had a period for a year. But night sweats can linger even after the onset of menopause. So, even if you’re in postmenopause, hormonal changes can still cause you to sweat in your sleep.

2. Medication

Several commonly used medications are also known to cause night sweats. These include:

• Aspirin
• Opioids
• Pain relievers
• Steroids
• Medication used to manage conditions, like cancer, high blood pressure, diabetes, depression and anxiety

If you’re concerned that your medication is making you sweat in your sleep or causing other unwanted side effects, talk with your healthcare provider about your options. Don’t stop taking medication without consulting them.

3. Stress and anxiety

Ever find yourself sweating when you’re presenting at a big meeting? When your nervous system is on edge, it can bring on the sweat. And your fight-or-flight response doesn’t just kick in when you’re dealing with a momentary stressor, like driving at night in a blizzard. Stress can become chronic, and that can affect how your body works.

One of the ways your body deals with stress is by increasing your heart rate and narrowing your blood vessels. That heats up your body and can cause more sweat, day and night.

4. Infections

It’s no surprise that your body temperature can elevate when you’re fighting off a bug, like a cold, the flu or COVID-19. But even a low-grade fever can make you sweat in your sleep.

“Fevers themselves can lead to night sweats. But so can having the chills, which is typical of some viral infections,” Dr. Clayton points out. “When you have chills, you’re probably going to dress warmer and use more blankets. That can add to your odds of sweating at night, even if you don’t feel hot.”

5. Substance use

Using (and abusing) alcohol and other substances can trigger a sweaty night.

“Drinking can increase anxiety, cause dehydration and raise your body temperature, all of which can lead to night sweats,” Dr. Clayton notes. Same goes for misusing prescription medications or using non-prescription drugs.

Alcohol and substance withdrawal can also cause night sweats.

If substances are interfering with your life, seek professional support for overcoming substance use disorder.

6. Chronic conditions

Several common chronic conditions are associated with night sweats, including:

• Cancer, particularly leukemia and lymphoma
• Diabetes
• Endocrine tumors
• Hyperthyroidism (overactive thyroid)
• Obesity
• Sleep disorders, like sleep apnea

Tips to stop sweating in your sleep

Pinpointing what’s causing your nighttime sweat sessions can help you find ways to get some relief.

Start with setting the stage for a cool night: Keep your bedroom between 60 and 67 degrees Fahrenheit (15 degrees to 19 degrees Celsius) and sleep in lightweight PJs.

If that doesn’t do the trick, try:

• Identifying and avoiding triggers: Think caffeine, alcohol, spicy foods or cigarettes.
• Practice stress-reducing activities: Try meditation, breathing exercises, exercising and journaling.
• Seek help for menopause symptoms: Prescription medication and hormone therapy can help manage night sweats and other menopause symptoms. “Perimenopause can last years and cause a lot of disruptions,” Dr. Clayton acknowledges. “Treatments can drastically improve your well-being.”
• Manage chronic conditions: Keep up with your treatment plans, including medications, maintaining a healthy diet and other measures.

Most causes of night sweats aren’t serious, Dr. Clayton says, “But there are enough causes that I recommend getting evaluated if your symptoms last more than a week. You deserve a good night’s rest — both for your own peace of mind and for your overall health.”