Night sweats are a symptom of many disorders, some quite serious. A comprehensive health history and physical exam by a physician is necessary to obtain an accurate diagnosis. Night sweats may indicate hidden infection in the body, an autoimmune digestive disease such as Chron's, or the presence of malignant tumors or leukemia. More commonly, night sweats are a result of hormonal imbalance or the side effects of medications.
Night sweats are a classic symptom of active tuberculosis. A latent TB infection may not have symptoms for years, followed by chronic pneumonia, cough, fever, weight loss and night sweats. However, the presence of night sweats with no other symptoms for six to eight weeks makes it less likely that this symptom is the result of tuberculosis infection.
Initial HIV infection can cause flu-like symptoms of fever, chills, night sweats and rashes. After five to seven years, early- to medium-stage HIV infection might be characterized by fatigue, night sweats, weight loss and mouth ulcers. Early detection and treatment can slow the progress of HIV infection.
Endocarditis is a condition characterized by inflammation of the inner layer of the heart, including the cardiac valves. Risk factors include congenital heart defects, history of cardiac surgery, advanced age, intravenous drug use, colorectal cancer, or a history of rheumatic fever. Symptoms may include a spiking fever and a new or worsening heart murmur. Blood tests and echocardiography are diagnostic for endocarditis.
The endocrine system includes hormone-secreting glands. If you're female, between 35 and 50, having irregular menstrual cycles and daytime hot flashes, the most likely reason for night sweats is not a disease but menopause, or a deficiency of the hormone estrogen.
Hypoglycemia, or low blood sugar, is most likely to occur during the night when the liver releases less glucose because the body has minimal need for energy. The pancreas normally responds by reducing secretion of the hormone insulin. Heavy sweating that saturates bedsheets, along with headaches and disturbed dreams, may occur when blood sugar drops. Diabetes is a serious disorder requiring careful monitoring and medical management. Small, frequent, high-protein snacks and avoiding junk food may remedy mild hypoglycemia.
Hyperthyroidism is a condition of excess thyroid hormones, characterized by night sweats, weight loss, insomnia, increased heart rate, anxiety and dry eyes. Treatment options include medication, radiation, or surgery, depending on the disease's severity and individual response to therapy.
Abrupt withdrawal of alcohol or opioid drugs produces night sweats as an early symptom of detoxification. Tremors, abdominal pain, nausea, cravings and body aches follow. Alcohol withdrawal can be severe and may require hospitalization to prevent seizures.
Prescription medications may also cause night sweats as a side effect. They include some blood pressure, anti-depressant, muscle relaxant and cholinergic (used to treat glaucoma) medications such as propranolol (Inderal), pilocarpine (Salagen), amitriptyline (Elavil), fluoxetine (Prozac), venlafaxine (Effexor) and cyclobenzaprine (Flexeril). Don't discontinue medications without discussing concerns about side effects with a doctor or pharmacist.