If you’ve ever woken up suddenly drenched in sweat-soaked clothing and sheets, you’ve likely experienced night sweats. Though they can have a number of potential causes, night sweats are one of the most common symptoms affecting women in the lead-up to menopause: Up to 74 percent of perimenopausal women get them, research suggests.

Not only are night sweats uncomfortable, but they can seriously interfere with the quality of your sleep—and your overall well-being as a result. Below, learn how to stop night sweats and other sleep support tips, including when to speak to your doctor about your symptoms. (TL;DR: Night sweats absolutely don’t need to be severe to warrant seeking help!)

What are night sweats?

The term “night sweats” refers to hot flashes (also known as vasomotor symptoms, or VMS) that occur while you’re asleep. “Why some people have them at night and for other people, they only happen during the day, we don’t really have an answer for,” says Rajita Patil, MD, an OB/GYN and director of the Comprehensive Menopause Care program at UCLA Health.

We do know that night sweats occur suddenly, lasting anywhere from one to 10 minutes, and can make you feel flushed with upper body and facial sweating, “then a chilled feeling as the hot flash fades away,” says OB/GYN Sherry Ross, MD, women’s health expert and author of the books She-ology and The She-quel. You might also experience heart palpitations.

Night sweats are common during the menopause transition, but some women have them more frequently than others: Hot flashes may occur just a few times a month for some perimenopausal people, while others experience them multiple times a day, per the American College of Obstetricians and Gynecologists (ACOG).

These symptoms can continue for years—up to a decade in some cases. In a long-term study of women transitioning to menopause published in 2015 in JAMA Internal Medicine, 7.4 years was the mean duration for vasomotor symptoms. But women who experienced their first hot flash before their menstrual periods stopped had symptoms for longer (up to nine or 10 years), while those whose first hot flash occurred after menstrual periods ended had a shorter average duration (three and a half years).

What causes night sweats during menopause?

Everyone’s body has a comfortable temperature range. When you’re exposed to very cold temperatures, your body triggers a response (shivering) to warm itself; hot temperatures cause the body to sweat, helping to cool things off. As women approach menopause, this range becomes more limited. “Our bodies exist within a more neutral zone (not shivering or sweating), and menopause narrows that zone,” explains Dr. Patil.

There’s a lot we still don’t understand about why this happens. But like most changes that occur during perimenopause and menopause, estrogen is thought to be a likely culprit. One theory is that decreased estrogen causes a disruption in the way body temperature is regulated in the brain.

“Hot flashes and night sweats occur when the body’s temperature regulator, known as the hypothalamus, is negatively affected by decreased estrogen levels seen in menopause,” says Dr. Ross. “The brain’s thermostat is completely offset, causing body temperature to fluctuate and triggering erratic night sweats.”

Other causes of night sweats

Of course, menopause symptoms aren’t the only thing that can trigger sweating in your sleep. Other internal and external factors can lead to night sweats:

1. Room temperature

According to Michael Breus, PhD (aka The Sleep Doctor), the temperature of your room or surroundings greatly affects the body’s ability to regulate its own temperature. If the room is too hot, it’s natural for your body to start sweating to cool down. (The ideal room temperature for sleeping varies from person to person, but tends to be in the 60-67 degree Fahrenheit range.)

“In fact, your body needs to lower to a particular temperature in order for it to produce [the hormone] melatonin—which is kind of the key that starts the engine for sleep,” Dr. Breus adds. “So when you are hot, no melatonin, and no sleep.”

2. Heavy bedding or sleepwear

You may love snuggling up with thick quilts, ultra-fluffy comforters, and fluffy socks and sweats in fall and winter, but during spring and summer, they can be way too warm. Enter: night sweats.

3. Bed-sharing

If you’ve ever wondered why do I get so hot when I sleep?, it could be because of your bed partner. Sleep expert Nilong Vyas, MD, founder of Sleepless in NOLA, says that sharing a bed can often make people overheat. Think about it: If your body has trouble regulating its own temperature, imagine what happens when you get in bed with people (and pets) that are up against the same fight.

4. Alcohol consumption too close to bed

There’s a good reason why sleep experts pretty universally recommend that people consume less alcohol: It is a notorious sleep disruptor. Alcohol can also trigger night sweats, Dr. Vyas says. The mechanism is a little complicated. But according to the American Addiction Centers, alcohol acts as a vasodilator, meaning it widens your vessels. Wider blood vessels let blood travel faster throughout your body, distributing heat and making you flushed. Your liver also creates heat as it works to process the alcohol. This might make you feel warm and trigger sweating.

5. Medications

Certain medications can have night sweats as a side effect because they can affect your body’s ability to regulate temperature. Antidepressants, hormone therapies, and steroids are the general drug categories most likely to cause night sweats, says Abhinav Singh, MD, medical director at the Indiana Sleep Center.

There are various reasons why a medication could cause night sweats. For example, selective serotonin reuptake inhibitors (SSRIs), a common type of antidepressant medication, may block a certain kind of receptor in your brain that affects your heart rate and body temperature, which could trigger excessive sweating. (In fact, an estimated 20 percent of people on antidepressants deal with excessive sweating.)

6. Infection

According to Dr. Singh, night sweats may be a clear indication of your body’s attempt to fight off an infection. Infections can lead to fevers, which can obviously lend to feeling particularly hot (or developing cold sweats) at night. Common colds and the flu are known to trigger fevers, chills, and cold sweats. Your night sweats might coincide with other symptoms like fever, muscle aches, and swollen lymph nodes. “Infections such as tuberculosis, HIV, and endocarditis [when bacteria makes its way through the bloodstream into the heart valve] are associated with night sweats,” he adds.

7. Hyperhidrosis

Breus says hyperhidrosis is another potential cause of night sweats. Hyperhidrosis is the clinical term for excessive (i.e., dripping) sweating, and is caused by certain illnesses, medications, or having an underlying genetic condition, per the Cleveland Clinic. In most instances, hyperhidrosis shows up on the hands, feet, face, and under the arms. This condition is diagnosed through lab and/or sweat tests to determine the severity and to identify if there are any other underlying causes for your excessive sweating.

8. Stress and anxiety

Dr. Singh says that for some people, chronic stress and anxiety can manifest as night sweats. People with post traumatic stress disorder (PTSD) also often experience night sweats and other sleep disturbances. This makes sense, considering both stress and anxiety can cause nervousness, which can lead to sweating in waking activities, too. In fact, researchers found that people with hyperhidrosis have anxiety and depression at higher rates compared to the general population.

9. Sleep apnea

Sleep apnea—a serious sleep disorder where breathing stops and starts while you’re asleep— and night sweats can go hand in hand, Dr. Singh says. This happens because when a person with sleep apnea stops breathing, their blood oxygen levels drop, which then triggers the body to sweat. Other potential signs of sleep apnea include loud snoring, feeling sleepy or having trouble focusing during the day, high blood pressure, and waking up in the morning with a dry mouth, sore throat, or headache.

10. Thyroid problems

According to both Breus and Dr. Singh, an overactive thyroid—the gland that releases hormones to regulate your metabolism and more—can also be to blame for night sweats. Hyperthyroidism (where the thyroid gland produces too much thyroid hormone) can make people very sensitive to heat and is associated with night sweats and excessive sweating in general. Other symptoms of hyperthyroidism might include rapid or irregular heartbeat, weight loss (despite an increased appetite), feeling nervous or irritable, frequent bowel movements, and having shaky hands and/or muscle weakness.

How to stop night sweats

1. Practice healthy sleep habits

The first preventive approach for night sweats is to follow good sleep hygiene, experts say. Try the following nighttime habits to keep your body temperature as cool as possible:

• Keep your room cold and dark. Invest in blackout shades if you don’t have them already, and turn on a fan or set your thermostat to a low temperature to help keep core body temperature down. “A good temperature may be closer to 65 to 68 degrees Fahrenheit,” says Taniqua Miller, MD, an obstetrician-gynecologist, empowerment coach, and expert in midlife and menopause health.
• Consider your bedding. “Pajamas and sheets that allow breathing or are made with cooling technology may help,” says Dr. Miller.  Fabrics like 100% cotton and bamboo have good moisture management, and pillows or mattresses made with cooling gels may also help regulate body temperature. If you’d prefer not to buy lots of new bedding, try putting a cool pack under your pillow, then flipping it, per the Cleveland Clinic.
• Think layers. That includes your pajamas (look for loose clothing in lightweight fabrics) as well as your bedding (having both a blanket and a sheet to allow you to shed a layer if you’re getting warm).

2. Ask your doctor about hormone replacement therapy (HRT)

While lifestyle strategies may help make night sweats more manageable, many perimenopausal women benefit from medications to improve their symptoms. And leading expert groups, including ACOG and the North American Menopause Society, say hormone replacement therapy, or HRT, is currently the most effective treatment option.

“Ultimately, the best way to manage disruptive night sweats is HRT,” says Dr. Ross.

Hormone replacement therapy is often thought to be unsafe, but this is a common misconception, experts stress. A type of medication that replaces lost estrogen (and potentially also progestin), HRT can be a safe way to reduce hot flashes and improve overall quality of life for many women during the menopause years.

3. Or ask about other medications

Hormone replacement therapy isn’t right for everyone, such as those with a personal or strong family history of breast, ovarian, or endometrial cancer. And other women may simply prefer to avoid hormone treatments.

If that’s the case, there are other medications that have also been shown to ease hot flashes. They include certain antidepressants, the antiseizure drug Gabapentin, the blood pressure medication clonidine, and selective estrogen receptor modulators (or SERMs). In 2023, the U.S. Food & Drug Administration also approved a new oral medication called Veozah (fezolinetant) for moderate to severe hot flashes.

“There are both hormonal, non-hormonal, and mindfulness options that are evidence-based in treating [menopause] symptoms,” says Dr. Miller. “Discussing with your doctor what your needs are and what can work best for you is a great first step.”

4. Consider cognitive behavioral therapy 

The North American Menopause Society recommends cognitive behavioral therapy (also known as CBT) as an effective nonhormone treatment for menopause, and Dr. Patil notes that CBT has been found to be “extremely helpful” for women experiencing hot flashes. Research supports its benefits: In addition to hot flashes, CBT may help improve menopause-related depression symptoms. You can search for a CBT therapist via the Association for Behavioral and Cognitive Therapies.

5. Try stress-reducing habits

Although more research on alternative approaches is needed, some women find it helpful to practice stress-reduction strategies such as mindfulness meditation, acupuncture, and hypnosis, the Mayo Clinic notes. Hypnosis may be particularly beneficial: Research has found that clinical hypnosis may make hot flashes less frequent and severe, and the North American Menopause Society recommends it as another nonhormone treatment.

6. Make time to move

“Exercise at this time is key,” says Banafsheh Bayati, MD, an OB/GYN and the medical co-founder of Perelel. Maintaining muscle mass, balance, and strength are all important, but simply focusing on making time for regular daily movement should be the main goal, she adds.

In one small 2016 study of women who had been experiencing hot flashes, those who completed 16 weeks of supervised exercise were found to have better cardiorespiratory fitness and fewer hot flashes compared to those in the control group.

7. Eat a healthy diet

Getting enough protein and fiber in your diet, reducing the amount of sugar you consume, cutting back on caffeine and alcohol, and not smoking all help support your overall health, which may ease menopause symptoms. Pay particular attention to what you eat at the end of the day: “Avoid alcohol, tobacco, hot and spicy foods, and caffeinated beverages before bedtime,” says Dr. Ross.

When to see a doctor about night sweats

Night sweats and hot flashes in general may be common during the menopause years, but they don’t need to simply be endured. Many women think they need to wait out their night sweats, hoping for an improvement in symptoms while they make lifestyle changes. In a 2023 online survey conducted in the United Kingdom and published in BMC Women’s Health, 39 percent of respondents said they didn’t reach out to a health care practitioner for support managing menopause symptoms such as night sweats, partly because they thought their symptoms would have to be severe to warrant care.

This shouldn’t be the case, says Dr. Patil, adding that there’s no reason not to schedule an appointment with your doctor as soon as you start experiencing hot flashes. “You don’t have to have tried everything before coming in.”

That’s important, and not only because night sweats are unpleasant when they’re happening. They can have a detrimental effect on your quality of life, affecting your sleep, mood, and energy levels during the day. Severe night sweats may also increase your risk of cardiovascular disease, research has found.

The bottom line? “We don’t want to have to wait to deal with them,” says Dr. Patil.

You should also see your doctor if you think your night sweats could be a symptom of another underlying condition, such as sleep apnea or hyperthyroidism. Getting a proper diagnosis and treatment plan can help stop the night sweats and get you on the path to better health overall.

—medically reviewed by Angela Holliday-Bell, MD