What We Now Know About Night Sweats

1
What We Now Know About Night Sweats

• Jim Mold, M.D., M.P.H.
• Department of Family and Preventive Medicine
• OUHSC OKC

2
Definition

• Sweating during the night even when it isnt
  excessively hot in your bedroom

3
Theyre Common and Under-Reported

• Night Sweats in Past Month
• 30 40 of adults visiting a PCP
• 10-20 of older adults (age gt 65) in the general
  (OKLAHOMA Studies) population
• Women are only slightly more likely to be
  affected than men
• Only 12 of patients with night sweats have
  reported the symptom to their PCP
• Only 47 of patients with severe (soaking) night
  sweats have reported them to their PCP

4
Theyre Annoying

• Patients with night sweats report lower
  health-related quality of life, general health,
  physical functioning, mental health, and social
  functioning, and more bodily pain than those
  without night sweats after controlling for age,
  gender, education, income, and race
• The night sweats are bothersome to at least one
  other person in 10 of cases

5
Theyre Associated with Many Other Symptoms

• Fever
• Symptoms of anxiety and depression
• Symptoms of sensory impairment (e.g. impaired
  hearing, impaired vision, numbness of
  extremities)
• Pain (e.g. muscle cramps)
• Sleep disturbances (e.g. daytime tiredness,
  waking up with a bitter taste in mouth, legs jerk
  during sleep, and awakening with pain during the
  night)

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And Use of Some Medications

• SSRIs
• Tricyclic antidepressants
• Other antidepressants
• Antihistamines
• Alcohol

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But Not with Objective Evidence of Disease

• Not association with actual sensory deficits
• Not associated with abnormalities on
  polysomnography other than more frequent
  awakening
• Not associated with (stable/treated) diabetes,
  thyroid disease, depression, GERD, hypertension,
  osteoarthritis, osteoporosis, or autoimmune
  diseases
• Probably associated with chronic infections

8
Neither We nor Our Patients Know What Causes The
Symptom or How to Evaluate Someone Who Has It

• Less than 20 of physicians and patients, when
  asked, were able to even venture a guess as to
  the cause of the patients night sweats
• Most frequent guesses were
• Menopause (48 of patients 44 of their PCPs)
• Stress (12 of patients 8 of their PCPs)
• Medications (9 of patients 10 of their PCPs)
• Diabetes (4 of patients 11 of their PCPs)

9
So Where Do We Go From Here?