Patient information · General health
Night sweats
when sweating at night is worth investigating
Waking hot and damp because the room is warm or the duvet is heavy is common and means nothing. Drenching night sweats — soaking through nightclothes and bedding, requiring a change — are different, and when they persist they deserve investigation rather than a cooler bedroom.
Arrange prompt assessment if night sweats come with
- unexplained weight loss
- swollen glands in the neck, armpits or groin lasting more than three weeks
- persistent fever, or feeling generally unwell
- a persistent cough, coughing blood, or breathlessness
- unusual bruising or bleeding, or persistent itching all over
- bone pain, or a new lump anywhere
Drenching night sweats with weight loss and fever are the classic 'B symptoms' of lymphoma and are also typical of tuberculosis, which is more common in East London than nationally. Neither should be attributed to the menopause or stress without assessment.
What counts as significant
- Soaking through nightclothes or bedding, needing to change them
- happening regularly over weeks rather than occasionally
- occurring in a cool room and unrelated to bedding or nightwear
- waking you rather than being noticed in the morning
- particularly significant when accompanied by fever, weight loss or lumps
The common causes
- Menopause and perimenopause — by far the commonest cause in women in their forties and fifties, often with daytime flushes.
- Anxiety and stress, including nightmares and post-traumatic symptoms.
- Medicines — antidepressants (a very common cause), tamoxifen and hormone treatments, steroids, some diabetes medicines, and opioids.
- Low blood sugar overnight, particularly on insulin or sulfonylureas.
- Alcohol, particularly withdrawal after heavy drinking, and recreational drugs.
- Infection — tuberculosis, HIV, endocarditis, abscess, and some viral illnesses.
- Overactive thyroid.
- Obstructive sleep apnoea, which is under-recognised as a cause.
- Reflux, and cancers — particularly lymphoma and leukaemia.
Medicines are the most overlooked cause
Antidepressants — SSRIs and SNRIs in particular — cause night sweats in a substantial minority of people taking them, and the connection is rarely made because the sweats often begin weeks after starting. The same applies to tamoxifen, and to some blood pressure and diabetes medicines. Before embarking on extensive investigation, it is worth reviewing everything you take, including anything started in the previous few months.
What gets tested
- Full blood count and blood film — to look for blood disorders
- Inflammatory markers (CRP, ESR), and LDH
- Thyroid function, HbA1c or glucose
- Kidney and liver function, calcium
- HIV and TB testing where there is any relevant risk or exposure
- Chest X-ray where there is cough, weight loss or TB risk
- In women, hormone testing is usually not needed — menopause is diagnosed clinically over 45
Practical measures
Helps
- Cotton or moisture-wicking nightwear and bedding; layers you can shed
- A cooler bedroom, a fan, and a cool shower before bed
- Avoiding alcohol, spicy food and heavy meals in the evening
- Keeping a spare set of nightclothes and a towel by the bed
- For menopausal sweats, treatment is effective — see our menopause leaflet
Worth reviewing
- Recent new medicines, particularly antidepressants
- Alcohol intake, and any pattern of heavy drinking
- Whether you snore or stop breathing at night
- Blood sugar overnight if you are on insulin
- Whether you also have daytime symptoms
Why come to us. Night sweats sit awkwardly — usually benign, occasionally the first sign of something serious, and rarely investigated properly. We take a full history including a medication review, examine for lymph nodes and organ enlargement, and take the full panel — blood count, film, inflammatory markers, LDH, thyroid, HbA1c, liver and kidney function, plus HIV and TB testing where relevant — in-house, with results explained in the same visit. Chest X-ray and further imaging are arranged rapidly through our partners.
Investigated properly, results the same visit
Full panel in-house, imaging arranged fast. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.