Understanding Night Sweats and Insomnia
Night sweats are more common than you might think. A significant number of people (41% in one study) report them on a regular basis. Some consistently are awakened in the middle of the night soaked with sweat, and may do so for years, even decades. Beyond the obvious reason of a too-hot sleeping environment, there can be many medical causes for night sweats, and some nonmedical sources as well.
We’ll focus on the common nonmedical basis for night sweats, and what you can do about it to help yourself sleep better.
First, if you are concerned about night sweats a checkup with your healthcare provider is in order, as the condition can be caused by a number of treatable medical conditions. For instance, older women experience hormonal changes associated with menopause which can cause hot flashes and subsequent night sweats. This is treatable. Men also are subject to hot flashes as they age, although less frequently. Certain prescription drugs, hyperthyroidism, some types of disease, influenza, hypoglycemia, and other medical conditions may also contribute. An assessment from a healthcare professional can help diagnose if any of these issues can be identified and treated.
Beyond medical causes, two other common sources of night sweats are excessive levels of stress and anxiety experienced during waking hours. These also are treatable, although getting to the root source for stress and anxiety is not strictly a medical issue. Instead, managing stress and controlling anxiety require understanding one’s own perception and reaction to stressful situations, and a method to manage the negative thought patterns that underlie anxiety.
Excessive levels of stress and anxiety experienced during the day often create a hyperaroused state that contributes to night sweats. Cortisol, the stress hormone, may play a role. Created in the body in response to perceived stress and anxiety, cortisol acts to increase heart rate, respiration, and blood pressure.
For some people stress is chronic, experienced nearly nonstop throughout the day and often well into the night. This has the effect of elevating blood cortisol levels, which can remain in the body hours later. In this way stressful events experienced hours earlier can potentially contribute to the hyperaroused state associated with sweats in the middle of the night.
Night sweats often occur between cycles of sleep. That’s when sleep is typically lightest and we experience the least self-control. Normal sleepers briefly awaken the five or six times between cycles of sleep experienced each night, and then fall back asleep within seconds. Typically these very short periods of awakening are so short they are forgotten by morning.
But if you are in a hyperaroused state because of excessive levels of chronic stress and/or anxiety experienced during waking hours, instead of falling back asleep quickly between cycles you may go the other way – toward an increased level of worried wakefulness. You may suddenly feel your heart pounding, like a shot of adrenaline is coursing through your body. Overheating and sweating then quickly follow. If and when that happens, it understandably takes longer than a few minutes to fall back asleep.
When night sweats occur, there are a number of things you can do to help yourself cool off and fall back asleep. But it’s important to recognize that sweating and insomnia are only symptoms of something going on deeper. To get to the true root of the problem requires good methods to both manage stress and control anxiety.
Fortunately, there are effective ways to do this. A good CBT-based sleep training program will include potent methods to reduce levels of both stress and anxiety experienced during waking hours. You also learn relaxation tools and techniques to deploy during the night. These tools enable you to more easily let go, quiet your mind, and thereby move naturally back toward Stage 1, a drowsy state more conducive to sleep.