Waking up drenched in sweat can be more than just an uncomfortable inconvenience—it can disrupt your sleep quality. In addition, this may potentially signal underlying health issues that deserve attention. If you’re a man who regularly finds yourself changing your pajamas or bed sheets in the middle of the night due to excessive sweating, you’re experiencing what medical professionals call “night sweats.”
While occasional night sweating might happen to anyone on a particularly warm night or after a spicy meal, persistent night sweats warrant a closer look. In this article, we’ll explore the common causes of night sweats specifically in men, when you should be concerned, and what treatments can help you get back to dry, restful sleep.
What Exactly Are Night Sweats?
Night sweats are episodes of excessive sweating during sleep that soak your nightclothes or bedding, even when your bedroom environment isn’t particularly hot. Unlike the mild perspiration that might occur on a warm night, true night sweats are often described as “drenching” and may be accompanied by other symptoms depending on the underlying cause.
Dr. Michael Breus, a clinical psychologist and sleep specialist, explains: “When we talk about night sweats, we’re referring to perspiration that’s so severe it soaks through pajamas and sheets. This isn’t just feeling a little warm at night—it’s waking up feeling like you’ve run a marathon in your sleep.”
Night sweats affect both men and women, but the causes can sometimes differ based on gender. While women often experience night sweats related to hormonal changes during menopause, men have their own set of common triggers that we’ll explore below.
10 Common Causes of Night Sweats in Men
1. Hormone Imbalances
While hormonal changes are often associated with female night sweats, men can experience similar issues due to fluctuating hormone levels.
Low Testosterone (Hypogonadism)
As men age, testosterone levels naturally decline, but when this happens prematurely or severely, it can trigger various symptoms, including night sweats. Low testosterone affects approximately 2 in 100 men, with risk increasing significantly after age 40.
Symptoms that may accompany low testosterone include night sweats:
- Reduced sex drive
- Erectile dysfunction
- Fatigue
- Increased body fat
- Decreased muscle mass
- Mood changes
Treatment options:
- Testosterone replacement therapy (TRT) in various forms (gels, patches, injections)
- Lifestyle modifications to naturally boost testosterone (strength training, adequate sleep, stress management)
- Dietary adjustments (ensuring adequate zinc and vitamin D)
2. Infections
Various infections can trigger night sweats as your body fights off pathogens.
Tuberculosis (TB)
Though less common in developed countries, TB remains a significant cause of night sweats worldwide. The infection primarily affects the lungs but can spread to other body parts.
Symptoms that may accompany TB-related night sweats:
- Persistent cough (lasting more than three weeks)
- Chest pain
- Coughing up blood
- Unintentional weight loss
- Fatigue
- Low-grade fever
Treatment options:
- Antibiotic combinations are typically taken for 6-9 months
- Regular monitoring to ensure the infection is clearing
HIV/AIDS
Night sweats can be an early symptom of HIV infection or may develop as the disease progresses to AIDS.
Symptoms that may accompany HIV-related night sweats:
- Flu-like symptoms in early infection
- Fatigue
- Unexplained weight loss
- Swollen lymph nodes
- Opportunistic infections
Treatment options:
- Antiretroviral therapy (ART)
- Treatments for specific symptoms or complications
3. Medication Side Effects
Many commonly prescribed medications list night sweats as a potential side effect. These include:
- Antidepressants: Particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and sertraline (Zoloft)
- Fever reducers: Ironically, medications containing acetaminophen, aspirin, or ibuprofen can sometimes cause sweating
- Diabetes medications: Insulin and oral hypoglycemics, especially if they cause low blood sugar at night
- Blood pressure medications: Beta-blockers and some calcium channel blockers
- Hormone treatments: Particularly those used to treat prostate cancer
- Steroids: Such as prednisone
Treatment options:
- Never stop prescribed medications without consulting your doctor
- Discussing dosage adjustments or alternative medications with your healthcare provider
- Taking medications at different times of day (when appropriate)
- Managing the night sweats with environmental adjustments
4. Anxiety and Stress
In our high-pressure world, stress and anxiety have become common bedfellows for many men, and they can literally make you sweat in your sleep.
Mark, a 42-year-old financial analyst, shares: “During a particularly stressful project at work, I started waking up completely soaked almost every night. My doctor found nothing physically wrong, but when the project ended, so did the night sweats. That’s when I realized how powerfully stress was affecting my body.”
Symptoms that may accompany stress-related night sweats:
- Difficulty falling or staying asleep
- Racing thoughts
- Increased heart rate
- Muscle tension
- Irritability
- Digestive issues
Treatment options:
- Cognitive-behavioral therapy (CBT)
- Stress management techniques (meditation, deep breathing exercises, yoga)
- Regular physical activity
- Establishing a relaxing bedtime routine
- In some cases, anti-anxiety medications
5. Sleep Apnea
This common sleep disorder, characterized by repeated interruptions in breathing during sleep, affects men more frequently than women. The body’s stress response to these breathing pauses can trigger sweating episodes.
Symptoms that may accompany sleep apnea-related night sweats:
- Loud snoring
- Observed pauses in breathing during sleep
- Gasping or choking during sleep
- Morning headaches
- Excessive daytime sleepiness
- Difficulty concentrating
- Irritability
Treatment options:
- Continuous positive airway pressure (CPAP) therapy
- Oral appliances to keep airways open
- Lifestyle changes (weight loss, avoiding alcohol before bed, changing sleep position)
- In some cases, surgery to remove tissue blocking the airways
6. Hypoglycemia (Low Blood Sugar)
Men with diabetes who take insulin or certain oral medications may experience night sweats due to nocturnal hypoglycemia. When blood sugar drops too low during sleep, the body releases adrenaline and other hormones that can cause sweating.
Symptoms that may accompany hypoglycemia-related night sweats:
- Waking with headaches
- Nightmares
- Restless sleep
- Morning confusion
- Irritability upon waking
- Fatigue despite adequate sleep
Treatment options:
- Adjusting diabetes medication dosage or timing
- Having a small, protein-rich snack before bed
- Regular blood sugar monitoring
- Discussing continuous glucose monitoring with your healthcare provider
7. Hyperthyroidism
An overactive thyroid gland produces excess thyroid hormones, which speed up your metabolism and can cause increased sweating, including at night.
Symptoms that may accompany hyperthyroidism-related night sweats:
- Unexplained weight loss
- Increased appetite
- Rapid or irregular heartbeat
- Nervousness or irritability
- Tremor in the hands
- Heat intolerance
- Frequent bowel movements
Treatment options:
- Anti-thyroid medications
- Radioactive iodine therapy
- Beta-blockers to relieve symptoms
- In some cases, thyroid surgery
8. Gastroesophageal Reflux Disease (GERD)
This digestive disorder, which causes stomach acid to flow back into the esophagus, can trigger night sweats, particularly after eating large or spicy meals before bedtime.
Symptoms that may accompany GERD-related night sweats:
- Heartburn, especially when lying down
- Regurgitation of food or sour liquid
- Difficulty swallowing
- Coughing or wheezing
- Disrupted sleep
Treatment options:
- Over-the-counter or prescription acid reducers
- Elevating the head of your bed
- Avoiding large meals before bedtime
- Eliminating trigger foods (spicy, fatty, acidic)
- Maintaining a healthy weight
9. Alcohol and Substance Use
Excessive alcohol consumption, particularly before bed, can cause night sweats as your body metabolizes the alcohol. Additionally, recreational drugs and withdrawal from various substances can trigger sweating episodes.
James, a 38-year-old recovering alcoholic, recalls: “I used to think night sweats were just part of getting older. When I quit drinking, I was shocked to discover I slept through the night completely dry. It was one of the unexpected benefits of sobriety.”
Substances commonly associated with night sweats:
- Alcohol (especially during withdrawal)
- Opioids (both use and withdrawal)
- Cocaine
- Marijuana
- Tobacco
Treatment options:
- Reducing or eliminating substance use
- Seeking professional help for addiction if needed
- Medically supervised detox for severe dependencies
- Support groups
10. Cancers and Serious Medical Conditions
While less common than the causes above, certain cancers and serious medical conditions can manifest with night sweats as an early symptom.
Lymphoma
Both Hodgkin and non-Hodgkin lymphoma, cancers that affect the lymphatic system, commonly present with night sweats as one of their defining symptoms.
Symptoms that may accompany lymphoma-related night sweats:
- Painless swelling of lymph nodes in the neck, armpits, or groin
- Persistent fatigue
- Unexplained weight loss
- Fever
- Itchy skin
Other cancers that may cause night sweats include leukemia, prostate cancer, kidney cancer, and liver cancer.
Treatment options:
- Specific to the type and stage of cancer
- May include chemotherapy, radiation, immunotherapy, or surgery
General Tips for Managing Night Sweats
Regardless of the underlying cause, these strategies can help manage night sweats:
Bedroom Environment Adjustments
- Keep your bedroom cool (65-68°F/18-20°C is ideal for sleeping)
- Use breathable, moisture-wicking bedding materials like cotton or bamboo
- Consider a cooling mattress pad or pillows
- Use a fan to improve air circulation
- Try a dehumidifier if you live in a humid climate
- Use lighter blankets or a layered approach for easy adjustment
Lifestyle Modifications
- Avoid known triggers like spicy foods, caffeine, and alcohol, particularly before bedtime
- Maintain a healthy weight
- Exercise regularly, but not within 2-3 hours of bedtime
- Practice stress-reduction techniques
- Establish a consistent sleep schedule
- Stay well-hydrated during the day, but reduce fluids close to bedtime
- Avoid eating large meals within 3 hours of sleep
Clothing and Bedding Solutions
- Wear loose-fitting, lightweight pajamas made of natural fibers
- Keep a change of clothes near your bed for quick changes if needed
- Use layered bedding that can be easily removed
- Consider moisture-wicking sleepwear specifically designed for night sweats
- Change to performance fabrics designed to pull moisture away from the body
- Keep a towel beside your bed to dry off without getting up
Preventative Measures Before Bed
- Take a cool shower before sleeping
- Use a cooling spray on pulse points
- Practice relaxation techniques like deep breathing or meditation
- Keep a glass of cool water by your bed
- Use a cooling gel pad or cold compress on your forehead or neck
The Physiology of Night Sweats: Why Do They Happen?
Understanding the mechanisms behind night sweats can help make sense of why so many different conditions can cause this symptom.
Sweating is controlled by the autonomic nervous system—specifically the sympathetic branch—and is primarily a method of temperature regulation. However, sweating can also be triggered by:
- Hormonal fluctuations – Hormones like adrenaline, norepinephrine, testosterone, and thyroid hormones all influence sweat gland activity.
- Inflammatory response – When fighting infections, your body releases pyrogens that raise your temperature set point. As the infection subsides (often at night), your body tries to return to normal temperature by sweating.
- Nervous system activation – Stress, anxiety, and certain neurological conditions can activate the sympathetic nervous system, triggering sweating even when cooling isn’t needed.
- Medication effects – Some medications directly affect the sweat glands or influence hormones that regulate sweating.
- Circadian rhythm factors – Your body temperature naturally fluctuates throughout the day, with the highest temperatures typically occurring in late afternoon and evening, followed by a drop during sleep. Any disruption to this pattern can affect sweating.
Night sweats specifically tend to occur during the transition from deeper to lighter sleep stages, when the body’s temperature regulation system is more active. This is why you might wake up during an episode rather than sleeping through it.
When to See a Doctor About Night Sweats?
While night sweats can have benign causes, they should never be ignored, especially when they occur regularly or are accompanied by other symptoms. Seek medical attention if your night sweats:
- Occur regularly over a period of weeks
- Are severe enough to disrupt your sleep
- Are accompanied by fever, weight loss, pain, or other concerning symptoms
- Begin after starting a new medication
- Occur with coughing or breathing difficulties
- Cause significant distress or affect your quality of life
FAQs
1. Are night sweats in men always a sign of something serious?
No, night sweats can have many causes ranging from benign to serious. Environmental factors, spicy foods, stress, or temporary infections can cause night sweats without indicating a serious underlying condition.
However, persistent night sweats, especially when accompanied by other symptoms like weight loss, fever, or fatigue, should be evaluated by a healthcare provider to rule out more serious causes.
2. Can weight affect night sweats in men?
Yes, excess weight can contribute to night sweats in several ways. Being overweight increases insulation, making it harder for your body to cool down during sleep.
It also raises the risk of conditions that cause night sweats, such as sleep apnea, diabetes, and acid reflux. Many men report a reduction in night sweats after losing weight, particularly if the weight loss improves an underlying condition like sleep apnea.
3. Does aging increase the likelihood of experiencing night sweats?
Yes, men become more likely to experience night sweats as they age. This is partly due to age-related hormonal changes (andropause), but also because many conditions that cause night sweats—like low testosterone, sleep apnea, and certain medications—become more common with age. That said, severe night sweats are not a normal part of aging and should be evaluated by a doctor.
4. Can certain foods trigger night sweats?
Absolutely. Common dietary triggers include:
- Spicy foods (especially those containing capsaicin)
- Hot beverages consumed close to bedtime
- Alcohol
- Caffeine
- Very high-sugar foods
- MSG (monosodium glutamate)
- Tyramine-rich foods (aged cheeses, cured meats, fermented foods)
Keeping a food diary can help identify whether specific foods correlate with your night sweat episodes.
5. How can I tell if my night sweats are caused by anxiety or something physical?
This can be challenging, as anxiety can cause physical symptoms, and physical problems can trigger anxiety. Generally, anxiety-related night sweats may:
- Occur during periods of high stress
- Be accompanied by racing thoughts, worry, or panic
- Improve with stress management techniques
- Happens alongside other anxiety symptoms
However, the only way to rule out physical causes is through proper medical evaluation. Even if anxiety is contributing to your night sweats, it’s important to ensure there’s no underlying physical condition.
6. Can supplements help with night sweats?
Some supplements have shown promise in managing night sweats, although evidence varies:
- Black cohosh (more commonly used for menopausal women, but may help men)
- Sage leaf extract
- Vitamin E
- Evening primrose oil
- Melatonin (may help regulate sleep-wake cycles)
Always consult with your healthcare provider before starting any supplement, as they may interact with medications or be inappropriate for certain conditions.
7. Are night sweats hereditary?
Night sweats themselves aren’t directly inherited, but many conditions that cause night sweats have genetic components. For example, there are genetic factors in developing:
- Certain types of hyperhidrosis (excessive sweating)
- Autoimmune disorders
- Sleep apnea
- Thyroid disorders
- Some cancers
If close family members experience night sweats, mention this to your doctor, as it may help guide diagnosis.
8. Can dehydration cause night sweats?
Paradoxically, yes. When you’re dehydrated, your body has a harder time regulating temperature. This can trigger compensatory mechanisms that sometimes include sweating, particularly when the dehydration is accompanied by electrolyte imbalances.
Additionally, the body may sweat in an attempt to conserve remaining internal water by reducing the need for cooling through respiration. Staying properly hydrated throughout the day (but limiting fluids right before bed) can help prevent this.
9. Why do I only sweat from certain parts of my body during night sweats?
The distribution of sweat during night sweats varies based on the underlying cause. Some conditions cause generalized sweating, while others might affect primarily the head, neck, and chest. For example:
- Hormonal causes often produce sweating in the chest, face, and neck
- Neurological causes might create unusual patterns, like sweating only on one side of the body
- Infection-related sweats tend to be more generalized
The pattern of your sweating can provide your doctor with diagnostic clues.
10. Can night sweats be a side effect of supplements or vitamins?
Answer: Yes, certain supplements and vitamins can trigger night sweats in some individuals:
- Zinc supplements
- Niacin (vitamin B3), especially in high doses
- Some herbal supplements like ginseng, valerian, and St. John’s Wort
- Fish oil supplements
- Pre-workout supplements containing stimulants
If your night sweats began after starting a new supplement, this temporal relationship should be discussed with your healthcare provider.
