What causes night sweats in men?

Sweating is like the body’s thermostat, helping to regulate your temperature when it gets too high. It’s how your body cools off on a hot day, when you workout, or any other activity that causes a spike in temperature. 

Sweating while you sleep is expected when the room is too warm or your blanket is too heavy. But if you find yourself soaked and need to change your sheets or clothes, this is a sign of night sweats and a possible underlying health issue. Excessive sweating during sleep is also linked to other symptoms like fever, weight loss, pain, cough, and diarrhea, according to Mayo Clinic.

What causes night sweats in men?

Many underlying medical conditions can set off sweating while you sleep. Here’s a look at some common causes of night sweats in men, how to prevent them, and when to contact a healthcare provider.

1. Anxiety 

When worry grows out of control, one of the physical signs is sweating—during the day and at night. It’s normal to feel anxious sometimes, especially in stressful situations. But ongoing worry that affects your everyday life could be a condition called generalized anxiety disorder. Here are some other physical and emotional symptoms:

• Difficulty sleeping
• Tense or achy muscles
• Nausea, diarrhea, or irritable bowel syndrome
• Trouble making decisions
• Restlessness and trouble relaxing
• Lack of concentration

2. GERD

Gastroesophageal reflux disease (GERD), or chronic acid reflux, is a common condition in which stomach acid regularly flows back into the esophagus—the tube that links the mouth and stomach. When food makes it to your stomach, a valve at the end of the esophagus has trouble closing well and allows acid backwash to stream back up through your throat and mouth. Night sweats are one symptom of GERD. Others include:

• Heartburn
• Swallowed food returns to your mouth (regurgitation) 
• A sensation of food stuck in your throat 
• Cough
• Chest pain
• Trouble swallowing
• Throwing up
• Sore throat and raspy voice

3. Hyperhidrosis

With this condition, overactive sweat glands cause excessive sweating. Hyperhidrosis can happen any time of day, even during sleep. There are two forms: 

• Focal or primary idiopathic hyperhidrosis is the most common type and usually causes excessive sweating on the armpits, hands, feet, and head. It’s passed down through your genes. Stress, heat, and some foods and odors like citric acid, coffee, chocolate, and peanut butter trigger sweating. 
• Generalized or secondary hyperhidrosis happens along with another medical condition and affects any part of the body. Diabetes, Parkinson’s disease, and other illnesses may cause more sweat than usual.

Night sweats only happen with generalized hyperhidrosis, not the focal type.

RELATED: Hyperhidrosis treatments and medications

4. Medications

Night sweats are a side effect of many medications, including:

• Antidepressants, especially SSRIs
• Steroids
• Opioids
• Drugs to treat diabetes
• Aspirin or acetaminophen

5. Sleep apnea

One of the most common signs of this sleep disorder is night sweats. Sleep apnea happens when breathing is disrupted while you sleep. Left untreated, the condition stops your breathing several, sometimes even hundreds of times a night. It affects about 25% of men and tends to happen more in people over 50 who carry extra weight. 

Sleep apnea happens when the tongue and soft tissue at the back of the throat block the airway (obstructive sleep apnea), and in people with disorders of the central nervous system such as a stroke or ALS (central sleep apnea). Besides night sweats, signs of sleep apnea include:

• Snoring
• Sleepiness during the day
• Restlessness and waking up many times a night
• Waking up choking or gasping
• Dry mouth or sore throat when you wake up
• Forgetfulness, irritability, and difficulty focusing 
• Depression or anxiety
• Waking up several times a night to use the bathroom
• Sexual dysfunction
• Headache

Sleep apnea is associated with other health problems such as high blood pressure, stroke, and diabetes, so talk to a healthcare provider if you notice any of these symptoms.

6. Low testosterone

While not a direct cause of night sweats, low testosterone levels are connected to other conditions like sleep apnea, which can set off excessive perspiration while you sleep.

One study found that men with severe sleep apnea had lower testosterone levels and a higher chance of erectile dysfunction than those who snored or had only mild sleep apnea. And, other research shows men with low testosterone get less restful sleep and tend to be overweight, which can make night sweats worse.   

7. Other hormone disorders

The endocrine system controls the body’s hormone levels, and changes to it can cause night sweating. Here are some medical conditions linked to hormone imbalances:

• Hyperthyroidism, which is when the thyroid gland becomes overactive
• Diabetes mellitus, or elevated blood sugar levels. Excessive sweating can also happen with low blood sugar (hypoglycemia) when you take too much insulin or other diabetes medications.
• Hypothalamic dysfunction involves the endocrine system and area of the brain that controls body temperature (called the hypothalamus)
• Pheochromocytoma, or an adrenal gland tumor
• Carcinoid syndrome, which is caused by a type of tumor that creates hormones

8. Cancer and cancer treatment

In certain cases, night sweats could be a sign of cancer. “Certain malignancies such as lymphoma or solid organ cancers can lead to excessive night sweats,” says Anis Rehman, MD, the medical director at District Endocrine and a member of the SingleCare Review Board. “Hence, it is essential to pay attention and seek medical attention if one has drenching night sweats.”

Cancer treatments such as radiation therapy and chemotherapy can also lead to night sweats. Men who have surgery to remove one or both testicles after a prostate cancer diagnosis may notice them. Hormone therapy to treat prostate cancer is also a trigger for this common symptom. 

Unfortunately, night sweats may be around long-term—those who have finished with treatment could still have them. 

9. Infection or infectious disease

An infection or infectious disease can cause night sweats. Some common culprits include:

• Tuberculosis (TB), a bacterial infection that usually attacks the lungs. Many people with the condition have night sweats several times a week. Your healthcare provider may ask if you’ve traveled to countries where the disease is more prevalent.
• Human Immunodeficiency Virus (HIV), or the virus that causes AIDS
• Endocarditis, or inflammation of the heart valves, typically from infection
• Osteomyelitis, or inflammation within the bones, typically from infection
• Pyogenic abscess, which is a pus pocket in the liver

How to prevent night sweats

Treating the underlying cause of night sweats is the best way to prevent them. “In some cases, patients will need prescription antiperspirants, creams, nerve-blocking medications, antidepressants, and botulinum toxin injections to help patients with night sweats,” Dr. Rehman says.

1. Lifestyle changes

There are also lifestyle changes you can make for better sleep.

• Limit caffeine, alcohol, and spicy foods. Cut back on these things, particularly in the hours before your bedtime. They can elevate your temperature and cause night sweats. 
• Keep your bedroom cool. A warm bedroom could set off night sweats. “When I see [a patient] I’ll ask at what temperature they’re keeping their room or if they’re using a comforter every night, even in the summer,” says Praveen Rudraraju, MD, medical director, Center for Sleep Medicine at Northern Westchester Hospital. “Some people may be very sensitive and their body is trying to cool off, causing night sweats.” He suggests turning the thermostat down to a lower temperature, using lightweight blankets and sheets, turning on a fan, or opening a window to help circulate air. If night sweats seriously impact your sleep, think about trading in your mattress for one that’s more breathable.
• Wear breathable clothing. Material like cotton that allows more airflow is preferable over tight-fitting clothing that keeps in heat.  
• Sip cold water and take a cold shower. It can help bring down your body temperature before bed.

2. Medications

If none of these changes work, medication is an option for extreme cases of nighttime sweating. Doctors typically prescribe alpha-blockers to treat high blood pressure and prostate problems in men. An added benefit could be preventing night sweats caused by antidepressants. Commonly prescribed alpha-blockers include:

• Cardura (doxazosin)
• Minipress (prazosin)
• Hytrin (terazosin)

Alpha-blockers can cause low blood pressure, dizziness, headache, and an increased risk of heart failure, so you should use them sparingly for night sweats.

3. Supplements

Scientists have studied the effects of some natural products and supplements like phytoestrogens, black cohosh, DHEA, dong quai, and vitamin E on menopause or perimenopause symptoms, including hot flashes and night sweats. Still, there’s no clear evidence that they work on symptoms of menopause—or for men. These products may also cause side effects and interact with medications you’re already taking.

When should I be concerned about night sweats?

Contact a healthcare provider about night sweats if they:

• Happen regularly
• Disrupt your sleep
• Impact other parts of your everyday life
• Happen along with fever, weight loss, pain in one area, diarrhea, or other troubling symptoms

Based on your symptoms and general health, a healthcare provider can offer medical advice to help figure out what’s causing your night sweats and develop a treatment plan.