Night Sweats Are Kind of a Nightmare
The good news: They won’t last forever and you don’t have to suffer in silence.
(Tap the heart if you’ve joined the Night Sweat Club!)
I’ve been cold my whole life. I’m the girl who always grabs a sweater or a scarf before leaving the house. I’m notorious for blasting the heat in the winter and barely using the air conditioner in the summer. I’ve bundled up so often that it came as no surprise that two different family members gifted me blankets at Christmas. My unofficial motto: One can never be too toasty!
At least, I was that girl. These days, I run H-O-T (which would be amusing if it wasn’t so aggravating). My body temperature can sometimes spike at night. I go to bed around 10pm, doze for a few hours only to wake up in the middle of the night in complete and utter misery. Rivulets of sweat can pool on my chest, leaving my pajama top wet and clammy. In haste, I kick off my sheets and comforter in search of relief. And this calamity happens after I’ve already cranked the AC down to a crisp 70 degrees and set the ceiling fan to high. If I could feasibly sleep in a meat locker, I just might. Anything to survive my perimenopausal night sweats and actually get a full night’s sleep.
I first started to experience night sweats in my early 40s. First, my sleep patterns became irregular. If I had a glass of wine, I would wake up around 4 a.m. (Because I don’t regularly drink, it was easy to figure out that alcohol was the culprit.) Night sweats, which are more related to shifting hormones, eventually followed. I can’t sugar coat it: They feel absolutely awful. While the sweating part is more manageable (it’s not enough that I need to change my pajamas or my sheets), the cumulative interrupted sleep is incredibly debilitating.
Why do night sweats happen?
Night sweats and hot flashes are extremely common during perimenopause. In fact, the vast majority of women will experience them. Vasomotor symptoms (their technical term) affect the body’s ability to regulate temperature normally, which is why you may suddenly feel like you’re burning up like a furnace or sweating like you’re in a sauna for a few minutes without warning. This temperature dysregulation is related to hormonal fluctuations that occur during perimenopause and can continue after you reach menopause, too.
Hot flashes and night sweats force you to deal with the discomfort of unexpectedly warming up and the inconvenience of profuse sweating and its aftermath. (In my experience, daytime hot flashes can be quick with minimal sweating. Nighttime has been a different story; I’ve woken up in the middle of the night covered in varying degrees of sweat. Sometimes it’s a light dampening, some clamminess on your torso, or it can be fully drenching with your pajamas soaked. But unlike daytime hot flashes, night sweats have the distinction of ALSO disrupting your sleep and impacting your body’s ability to get enough rest, which has cascading effects on your overall health and well-being.
And here’s the kicker: Night sweats can last for years. So I’m not talking about a night or two of overheated and soggy sleep, but weeks, even months of feeling tired, crabby, and struggling to function. When your internal thermostat is this out of whack, your mental health takes a dive, not to mention your ability to breeze through your day. Research shows that vasomotor symptoms can also disrupt hypothalamic-pituitary-adrenal axis (HPA) function and lead to chronic stress. They are depressing in every sense of the word.
Increased chronic stress coupled with ongoing lack of sleep can lead to a variety of health issues including metabolic disorders, chronic inflammation and cognitive issues. Ready for a deep dive? Check out Matthew Walker’s Why We Sleep for a comprehensive look at the importance of consistent sleep. Written by a neuroscientist, I found it fun to read and illuminating as well.
Recommended Lifestyle Changes: There are many simple steps and natural (non-medical) approaches you can take to reduce the impact of night sweats. Trust me, I’ve tried them all.
Sleep in a cool bedroom. You have less control over your body’s core temperature, but you can optimize the room temperature for better sleep. Turn on the air conditioning, use a fan, or open the window to let in a breeze. Sleep experts recommend a room temperature in the mid-60s for a good night’s sleep.
Choose bedding, blankets and pajamas in breathable and lightweight fabrics. I wear loose clothing made of natural fibers such as cotton or linen. Keep an extra pair of pajamas and bed sheets nearby so you can quickly change when overheated.
Practice good sleep hygiene. I support my body’s own melatonin production by avoiding screens at night and getting sunlight first thing in the morning. I also maintain good boundaries with my inbox and don’t work past a certain point in the evening.
Move your body. On top of reducing stress and boosting your mood, regular exercise increases melatonin and regulates body temperature. The caveat: Intense exercise in the evening can make it harder to fall asleep so best to get your steps or workout done earlier in the day.
Watch the wine. I’ve cut out alcohol almost entirely, except for extremely rare occasions, like a birthday party or special dinner.
Manage stress. Elevated stress can raise cortisol levels which can be disruptive to sleep and possibly increase your risk for other metabolic disorders.
Rx solutions for night sweats
If you’ve tried everything and night sweats are still making you miserable, then it’s time to schedule an appointment with your doctor to rule out sleep apnea, other diseases, possibly a change in medication, or to consider hormone therapy. Menopausal hormone therapy (MHT) is often the next step when you’ve exhausted other options.
In my case, I discovered that low blood sugar was contributing to my disrupted sleep. Way back when I was pregnant with my first child (who is now 18), I had gestational diabetes. Unfortunately, this diagnosis increases my risk of developing diabetes later in life. Because of that, I’ve avoided sugar and have been mindful of my carbohydrates intake especially as insulin sensitivity can increase during perimenopause.
I recently started using a continuous glucose monitor to track my blood sugar overnight to see if it was contributing to the night sweats and waking up. Turns out my blood sugar was dropping while I sleep, which then signals my body to release hormones including cortisol. As you may know, cortisol is a stress hormone that stimulates alertness, so you don’t want it spiking during rest time.
I recognize that few women may be dealing with the same blood sugar issues, and that there is no way to know without seeing a doctor about testing your blood glucose levels. However, having this information has been profound for me.
What about supplements?
I recently had my hormones tested to see if I qualify for MHT, and my doctor says no. Because of that, I’ve been exploring the use of supplements such as magnesium bisglycinate, pycnogenol, DIM (diindolylmethane) and red clover. Lifestyle changes have helped improve my sleep, but I can’t say that those changes have completely eliminated the night sweats. After doing my own research, and speaking with my doctor, I added some supplements to see if they helped, and they did. I even stopped taking the supplements for a couple of months, and the night sweats showed up in full force. Now that I’m taking them again, the amount of sweat at night has noticeably decreased.
When considering supplements, it's important to do your own research and look for clinical trial results for the ingredients in the supplements. The Vagenda (Dr. Jen Gunter’s substack) just released a newsletter on supplements that may be worth checking out. Many supplement companies overpromise results and supplements are not regulated by the FDA, so always check with your doctor before taking them.
Work in Progress
Some days you can do all the right things, but it’s not possible to avoid all night sweats. My experience has led me to consider just about every aspect in my life, from maintaining my circadian rhythm, exercising regularly, managing stress, and incorporating slow breathing during my bed time routine to activate my parasympathetic nervous system. I take comfort in knowing night sweats are not forever; they do end at some point.
If your night sweats are ruining your days, please speak with your doctor about your options. Many women find relief with MHT and there are newer non-hormonal options now becoming available for women. A change in medication could also be useful and in my case, ruling out hyper- or hypoglycemia.
Have you experienced night sweats? What has your experience been like? I’d love to hear about what’s working (or not working) for you!
This Week’s Movement Snack
This week’s movement snack is for those mornings when you’ve been awoken with night sweats. While reaching for coffee first thing in the morning is tempting, taking a few minutes to move your body before caffeine will bring lasting benefits.
Cheers to looking and feeling your best,
Susan
Susan Campbell
Founder & CEO, Phosis
Bio HRT has all but eliminated hot flashes and night sweats. I still get warmer than I used too, for sure. What tests did your doctor do that ruled out HRT?