FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HUSBAND'S "NIGHT SWEATS" MAY SIGNAL UNDERLYING DISEASE

Question: My husband has severe night sweats, so much so that he is soaking wet -- his clothes, the bed sheets, everything. Can you tell me what I can do about this? I know diabetes runs in his family. His mother sweats a lot as well, and she is a diabetic. Is this something that I should be worried about?

Answer: You are right to be concerned about your husband's night sweats as they are often a symptom of an underlying medical problem. Sometimes, however, they can be due to things as simple as anxiety over a family or work situation, taking an aspirin or acetaminophen before bedtime, or drinking an alcoholic beverage too close to bedtime. One study at Hershey Medical College even discovered that the tendency to sweat at night may sometimes be hereditary.

However, since I have not had the opportunity to examine your husband or to talk with his physician, it’s impossible for me to make a diagnosis or to discuss his exact problem. I can, however, give you some general information about night sweats.

Night sweats are relatively common in menopausal women due to hormone fluctuations. These can be quite severe and last from weeks to years. Severe night sweats in this group of people are usually managed by hormone replacement therapy (HRT). We know that this is not your husband’s problem, however.

Night sweats in either gender are often a symptom of an infection. Your husband should check his temperature in the early evening for about a week and see if he’s running a fever. Many infections -- such as an abscess, tuberculosis or even HIV -- can cause a low-grade fever associated with night sweats, and few other symptoms. Sinus or dental infections can also be smoldering and cause only night sweats without many other symptoms. Malaria, a classic night sweat producer, is becoming more common in the southern, humid regions of the United States.

Non-infectious illnesses, such as diabetes, thyroid disorders, sleep apnea or even malignancies, can cause night sweats. They are also linked to pheochromocytomas -- usually benign tumors that are most often found in the adrenal glands.

It’s important to note if night sweats are associated with other symptoms such as swollen lymph nodes, chest pain, daytime sweating or unintentional weight loss. The total constellation of symptoms will help your physician close in on the correct diagnosis and treat any underlying cause that may exist.

Here’s a summary for your husband as well as any of my other readers who may be experiencing night sweats: Go to your doctor with a good history and be able to answer some basic questions. How long has this been going on? Are you running a temperature? Have you noticed other symptoms like weight loss, swollen glands or chest pain? Did you travel outside of the country, especially to tropical or subtropical areas immediately prior to the start of your symptoms.

Don’t assume that the sweats are due to menopause just because you are a middle-aged women. If they are, your doctor can help. Otherwise a thorough workup to determine the cause may be in order. In the meantime, avoid caffeine, alcohol and vigorous exercise too close to bedtime. Light bed clothes and covers can be helpful as well as a tepid shower before bed. Ultimately, finding and treating the underlying cause is the best way to deal with persistent night sweats.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.