Sleep hyperhidrosis

(medicine) Drenching perspiration occurring at night or during sleep in the course of certain febrile diseases.

Key Terms: Hirsutism, Lymphatic system, Oophorectomy, Perimenopause.

Description

Night sweats can be a side effect of cancer treatment or a symptom of certain cancers. Night sweats are part of a variety of symptoms referred to as vasomotor. Vasomotor symptoms stem from the body's thermoregulatory center, which is affected by circulating hormones.

Women may undergo oophorectomy (the surgical removal of one or both ovaries), either for ovarian cancer or when accompanied by hysterectomy for endometrial cancer or uterine sarcoma, as part of their cancer treatment. Pelvic radiation may also damage the ovaries. Removal or permanent damage to the ovaries results in immediate menopause. Many women with ovarian cancer have already gone through menopause, as a function of their age. However, when ovarian or reproductive tract cancer strikes a pre-menopausal woman, the immediate, versus gradual, loss of circulating hormones is dramatic, and is a concern in the immediate postoperative period. In an American Cancer Society News Today of January 29, 2001, the ACS reported on a study that found women undergoing systemic treatment for breast cancer, especially those on tamoxifen, reported a higher frequency and intensity of menopausal symptoms such as night sweats, hot flashes, and fatigue. Men may also experience vasomotor symptoms with metastatic adenocarcinoma of the prostate, or following removal of the prostate for prostate cancer.

Vasomotor symptoms such as night sweats add to the existing stress for individuals undergoing cancer treatment, as they can reduce the quality of sleep, make daily life very uncomfortable, and decrease the quality of life.

Night sweats can be a sign of infection in the immuno-compromised cancer patient, as well as being a symptom of undiagnosed cancer and early AIDS. Drenching night sweats may be a sign of Hodgkin's or non-Hodgkin's lymphoma, both in children as well as in adults. Night sweats may also be present with liver hemangioma tumors. Generalized symptoms such as night sweats, fever, chills, and sweating are sometimes referred to as B symptoms. Night sweats have also been associated with malignant melanoma and with metastatic compression of the optic nerve. Children who are ultimately diagnosed with a malignancy may present to a rheumatologist with a variety of symptoms, including night sweats. Night sweats in the absence of explained fever or perimenopause should be brought to the attention of one's health care provider for evaluation.

Causes

The ovary produces the hormone estrogen. When the ovary is removed, there is a dramatic termination of circulating estrogen, with symptoms such as night sweats, hot flashes, and vaginal dryness. Estrogen replacement therapy (ERT) can relieve these symptoms. However, the use of ERT is controversial with some cancers, because of the association with estrogen-receptor positive cancers. Women who are approaching menopause at the time of chemotherapy may lose ovarian function as a result of treatment, thus undergoing significant menopausal symptoms. The use of tamoxifen in postmenopausal women has been associated with an increase in vasomotor symptoms.

Hodgkin's and non-Hodgkin's lymphomas are cancers of the lymphatic system. Symptoms include night sweats, painless swelling in the lymph nodes, especially in the neck, underarm or groin, unexplained weight loss, recurrent fevers, and itchy skin. The night sweats in Hodgkin's disease appears to be related to an instability in the thermoregulatory center of the hypothalamus. Risk factors for Hodgkin's and non-Hodgkin's lymphomas include reduced immune function, transplant surgery, occupational exposure to herbicides and other toxic chemicals, Sjögren's syndrome, and Epstein-Barr virus.

Treatments

Some research has been conducted using estrogenandrogen replacement therapy. The concerns about ERT and estrogen-sensitive cancers remains the same. The androgen component assists in the healing process, as well as in a sense of well-being, sexual desire and arousal, and increased energy level. The use of androgens can result in hirsutism (growth of male-pattern hair), which may be dose-dependent.

Successful diagnosis of the cause of the night sweats can lead to proper treatment for the condition. Successful treatment of Hodgkin's or non-Hodgkin's lymphoma resolves the night sweats.

Alternative and Complementary Therapies

Acupuncture has been effective for both men and women. Individuals considering herbal remedies or supplements for reproductive-related night sweats associated with cancer treatment should seek the counsel of a knowledgeable practitioner. Substances that function through mimicking estrogenic properties could have an adverse effect in estrogen-sensitive tumors.

Resources

Organizations

American Cancer Society. 800–ACS–2345. .

National Cancer Institute. Building 31, Room 10A31, 31 Center Drive, MSC 2580, Bethesda, MD 20892–2580. 301–435–3848. .

National Center for Complementary and Alternative Medicine. NCCAM Clearinghouse, P.O. Box 8218, Silver Spring, MD 20907-8218. (888) 644-6226. .

Other

Memorial Sloan-Kettering Cancer Center. [cited July 18, 2005]. .

National Cancer Institute Cancer Trials Web Site. [cited July 18, 2005]. .

Natural Health Village. [cited July 18, 2005]. .

—Esther Csapo Rastegari, R.N., B.S.N., Ed.M.

This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (July 2009)

Sleep hyperhidrosis

ICD-10	R61.9
ICD-9	780.8, 327

Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating (hyperhidrosis) during sleep. The sufferer may or may not also suffer from excessive perspiration while awake.

Sleep hyperhidrosis may occur at any age, but is most commonly seen in early adulthood.

Night sweats may occur for genetic reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; the patient may be frequently awakened due to the discomfort of damp sleepwear, or if the patient sleeps in the nude, due to damp sheets.

One of the most common causes of night sweats in women over 40 is the hormonal changes related to menopause and perimenopause. This is a very common occurrence during the menopause transition years and while annoying, it is not necessarily dangerous or a sign of underlying disease. Some women experience night sweats during pregnancy due to hormonal changes.

It should be noted that while some causes of night sweats may be relatively harmless, others may not and can be a sign of a serious underlying disease. While there can be several possible causes of excessive sweating at night, it is important to distinguish night sweats due to medical causes from those that occur simply because the sleep environment is too warm, either because the bedroom is unusually hot or because there are too many covers on the bed.

A night sweat caused by a medical condition or infection can be described as ‘severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment’.[1]

True night sweats with medical causes should be properly investigated by a physician. There are many ways to help relieve night sweats. By keeping a cool glass of water on the night stand and wearing moisture wicking pajamas, many people suffering from night sweats have found relief.

Associated conditions

The condition may be a sign of various disease states, including:

• Steinerosis
• Brucellosis
• Cancer, Leukemia or Lymphoma
• Cerebral palsy
• Cerebral and brain stem strokes
• Epilepsy
• Familial dysautonomia
• Gastroesophageal Reflux Disease
• Head injury
• HIV
• Hypoglycaemia (Chromium deficiency)
• Hypothalamic lesions
• Infectious Mononucleosis
• Influenza
• Menopause
• Obstructive Sleep Apnea
• Pneumonia
• Pulmonary histoplasmosis
• Subacute endocarditis
• Tuberculosis
• Chronic Fatigue Syndrome
• Lyme Disease
• Urinary tract infection

Certain medications, including anti-depressants (such as sertraline) have also been known to cause night sweats in some individuals. Another cause could be withdrawal from various drugs (opiates, benzodiazepines, etc.).

References

v • d • e Symptoms and signs: general / constitutional (R50-R61, 780.6-780.9) Temperature heat: Fever (Fever of unknown origin, Drug-induced fever) • Hyperhidrosis (e.g., Sleep Hyperhidrosis; "Sweating") • Hyperpyrexia • Hyperthermia cold: Chills Aches/Pains Headache • Chronic pain Malaise and fatigue Atrophy (e.g., Muscle Atrophy) • Debility (or Asthenia) • Lassitude • Lethargy • Muscle tremors • Tenderness Miscellaneous Flu-Like Symptoms

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