Night Sweats

Night sweats, orexcessive sweating中sleep，很常见symptomin women and men.

• 许多医疗状况和疾病可能导致夜汗。
• 例子包括女性perimenopauseormenopause; medications,hormone问题（低-T），low blood sugar, andneurologicalproblems.
• You may have other symptoms likechills，或用fever,阴道干燥或心情改变，具体取决于原因。
• Less common causes of night sweats include infections andcancers。

Doctors treat the problem by diagnosing the cause of your night sweats.

Doctors inprimary care医学领域经常听到他们的患者抱怨夜汗，因为他们很常见。夜汗指的是任何多余的sweatingoccurring during the night. However, if you keep your bedroom温度unusually hot or you are sleeping in too many clothes, you maysweat中yoursleep, which is normal. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe热闪烁occurring at night that can drench sleepwear and sheets, which are not related to an overheatedenvironment。

In one study of 2267 patients visiting aprimarycaredoctor，有41％的人报告上个月经历夜间汗水，因此夜间过度汗水的看法很普遍。重要的是要注意，潮红（脸部或树干的温暖和发红）也可能很难与真实的夜汗区分开。

Depending upon the underlying cause of the night sweats, other symptoms may occur in协会withsweating。例如：

• Certain infections and cancers
• Shaking and chills can sometimes occur if you have a fever.
• Unexplainedweight lossdue tolymphoma。
• 由于更年期过渡而引起的夜汗通常伴随着更年期的其他症状，例如阴道干燥，白天的潮热和情绪变化。
• Night sweats that occur as a side effect of medications can be accompanied by othermedicationside effects, depending upon the specific drug.
• Conditions that result in increased sweating in general (as opposed to only night sweats) will result in increased sweating at other hours of the day.

根据夜汗的根本原因，其他症状可能与汗水有关。例如：

• Certain infections and cancers
• Shaking and chills can sometimes occur if you have a fever.
• Unexplainedweight lossdue to lymphoma.
• Night sweats due to the menopausal transition are typically accompanied by other symptoms ofmenopause例如阴道干燥，白天的潮热和情绪变化。
• Night sweats that occur as a side effect of medications can be accompanied by other medication side effects, depending upon the specific drug.
• Conditions that result in increased sweating in general (as opposed to only night sweats) will result in increased sweating at other hours of the day.

伴随更年期tran的潮热sition can occur at night and cause sweating. This is a very common cause of night sweats in perimenopausal women. It is important to remember that hot flashes and other symptoms ofperimenopausecan precede the actualmenopause（停止月经时期）到几年。

Sweating or flushing can be seen with several hormone disorders, includingpheochromocytoma(a type of肾上腺肿瘤that overproduces hormones known as catecholamines),carcinoid syndrome(overproduction of certain hormones by tumors of the lung or胃肠道system), and甲状腺功能亢进（过多甲状腺hormones）。

Idiopathichyperhidrosis是一个conditionin which the body chronically produces too much sweat without any identifiable medical cause.

经典，tuberculosisis the infection most commonly associated with night sweats. However,细菌感染, such as the following conditions can also be associated with night sweats:

• endocarditis(inflammationof theheartvalves),
• 骨髓炎(inflammation within the bones due to infection),
• abscesses (for example,boils,appendix,tonsils,perianal, peritonsillar,憩室炎), and
• 艾滋病virus(HIV） 感染。

Night sweats are an early symptom of some cancers. The most common type ofcancer与夜汗有关的是淋巴瘤。但是，没有诊断的人cancerfrequently have other symptoms as well, such as unexplained weight loss and fever.

Taking certain medications can lead to night sweats. In cases without other physical symptoms or signs of瘤或感染，通常确定药物是夜汗的原因。

Antidepressantmedications are a common type of medication that can lead to night sweats. All types of antidepressants including三环抗抑郁药, selectiveserotonin重击抑制剂（SSRI）和新代理商，venlafaxine(Effexor) andbupropion(Wellbutrin) can cause night sweats as a side effect, with arangeinincidencefrom 8% to 22% of persons taking antidepressant drugs. Otherpsychiatric药物也与夜汗有关。

我dicine taken to lower fever (antipyretics) such as阿司匹林and对乙酰氨基酚(泰诺and others) can sometimes lead to sweating.

Other types of drugs can cause flushing (redness of theskin，通常在脸颊上neck), which, as mentioned above, may be confused with night sweats. Some of the many drugs that can cause flushing include:

• niacin（Niacor，Niaspan，Slo -Niacin-服用的较高剂量lipiddisorders)],
• tamoxifen(Nolvadex)
• hydralazine,
• nitroglycerine, and
• sildenafil(Viagra).

Many other drugs not mentioned above, includingcortisone,prednisone, and泼尼松龙, may also be associated with flushing or night sweats.

Uncommonly, neurologic conditions may cause increased sweating and possibly lead to night sweats including

• autonomic dysreflexia,
• post-traumatic syringomyelia,
• stroke, and
• autonomic neuropathy。

The treatment for night sweats depends upon the underlying cause.

In summary, night sweats are usually a harmless annoyance; however, they are sometimes asignof an underlying medical condition. Persons with unexplained night sweats should seek medical care.

Night sweats are commonly treated by internists,家庭实践specialists, or gynecologists. If they are related to specific medical conditions, other specialists, including endocrinologists, neurologists, infectious疾病specialists, or oncologists, may be involved in the care of patients with night sweats.

医学作者：Jasmine Shaikh博士，MD

医学编辑：Pallavi Suyog Uttekar, MD

更年期的一些症状，例如潮热（身体上部突然的温暖感觉）通常持续一到两年。但是，它们可以持续10年或更长时间。

更年期是从她开始的女人生活的正常阶段最后的月经至少一年没有月经周期。我nstrual periods stop permanently and she can no longer conceive. To say that a woman has reached her menopause, her periods should not have occurred for at least 12 months after her last period.

我nopause can happen anytime between 45 and 55 years of age. The average age for menopause in the United States is 52.

从不规则的月经开始到最后的过渡（或时间）月经periodis known as perimenopause and the time after menopause is termedpostmenopause。绝经期通常从40多岁的女性中部开始，可以在更年期罢工前一到四年持续一到四年。经历更年期的妇女被称为绝经后女性。

我nopause that sometimes occurs early is known as更年期。This happens after the surgical removal of the ovaries (卵巢切除术) oruterus(hysterectomy）。也可能是由于autoimmunedisorder, in which theimmune systemof the body attacks the body’s own cells.

更年期期间会发生什么？

As a woman enters her 40s, her body starts producing low levels of the hormonesestrogenandprogesterone。这些激素水平降低会导致更年期期间她身体的生理和情绪变化。女人的风险health诸如cardiac问题和diabetesalso increases.

在某些女性中，更年期的症状可能会立即开始，或者随着时间的流逝缓慢爬行。过渡到更年期时发生的一些症状包括

• Irregular periods
• 乳房感觉嫩
• Periods that are shorter or longer than they were before
• Periods that are heavier or lighter than before
• Hot flashes/flushes
• Vaginalitching和燃烧（由于阴道干燥）
• Trouble sleeping
• Mood swings or irritability
• Forgetfulness
• 尿失禁（持有的麻烦尿when the urge comes)
• 疼痛中sex
• 失去对性的兴趣

How is menopause diagnosed?

The doctor usually diagnoses menopause after taking the menstrual history of thepatient其中包括两个时期之间的差距blood在期间的流动以及自上一段时间以来的时间。

A blood test that measures the levels of the follicular stimulating hormone (FSH) can also help the doctor ascertain thediagnosisof menopause. However, for many women, a blood test is not necessary. Most of the time, their menstrual history is enough to diagnose menopause. How to deal with menopause?

How to deal with menopause?

我et thephysician并讨论发生的症状。

Healthy饮食模式和体育活动可以帮助减轻许多绝经症状，例如体重增加和情绪波动。

Herbal补品例如豆浆和red clovermay help with some menopause symptoms. These contain an estrogen-like compound. However, one must discuss with their healthcare provider before starting any herbal补品。These are to be avoided in women who takehormone replacement therapy。

Hormonal and nonhormonal treatments can help with some symptoms. Women need to discuss potential treatments with their doctors.

我dical Author: Karthik Kumar, MBBS

医学编辑：Pallavi Suyog Uttekar, MD

Night sweats are episodes of excessiveperspirationthat happen during sleep. They are often described as soaking or drenching and may require a change of sheets or even clothes. Night sweats can occur during sleep and without physical exertion. They aren’t caused by a heavy blanket or a warm bedroom. Instead, other underlying health issues may be responsible for these episodes of considerable sweating during sleep. Night sweats can reduce sleep quality, concern a bed partner, and provoke serious discomfort.

What is the outcome of patients with night sweats?

Night sweatsaffectmany people. They are sometimes no cause for concern, but they can interrupt sleep and reduce thequality of life。In some cases, night sweats are a sign of a health issue that requiresattention。Sleeping in a cool room with bedding and pajamas made from light, natural fabrics may help. If not, a doctor can recommend other approaches, which may include medications and therapies.

What are the eight causes of night sweats?

There are many different causes of night sweats. The most common include the following

• Hypoglycemia:Low bloodsugarcan cause sweating. People who take胰岛素ororaldiabetes药物可能有hypoglycemiaat night that is accompanied by sweating.
• 激素疾病:Sweating or flushing can be seen with several hormone disorders such as甲状腺功能亢进(hyperactive甲状腺), carcinoidsyndrome, and肾上腺瘤s.
• Neurologic conditions:Neurologic conditions includingstrokeand autonomicneuropathymay cause increased sweating and may lead to night sweats.
• Infections:结核病是一种与夜汗有关的感染。然而，细菌感染，例如心内膜炎（心脏瓣膜的炎症），骨髓炎（骨骼的炎症）和脓肿会引起夜间汗水。夜汗也是human immunodeficiency virus(HIV） 感染。
• 我nopause:The hot flashes that accompany menopause can occur at night and cause sweating. This is a very common cause of night sweats in women.
• Cancers:Night sweats are an early symptom of some cancers. The most common type ofcancer与夜汗有关的是淋巴瘤。However, people who have undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fever.
• Idiopathichyperhidrosis:Idiopathichyperhidrosis是机体长期连续ces too much sweat without any identifiable medical cause.
• 我dications:某些药物已知与夜汗有关。其中包括一些称为选择性5-羟色胺再摄取抑制剂（SSRIS）的抗抑郁药，类固醇和药物，用于减少发烧，例如阿司匹林或对乙酰氨基酚，可能会引起出汗。
• Lifestyle:Excessive intake of drugs,alcohol, andcaffeinecan also increase the risk of night sweats. Excessstressor workload may also increase night sweats.

Other medical conditions such asgastroesophageal reflux disease(GERD),heart failure,anxiety, andpanic attackshave been correlated with night sweats.

如何治疗夜汗？

The treatment for night sweats will vary for any individual patient and should always be overseen by a health professional. Some potential treatment methods include modifications to environment and behavior,认知行为疗法(CBT), and medications.

• Lifestyle modifications:Avoidingcaffeine，酒精和辛辣食物；饮酒足够water; maintaining a healthy weight; utilizing relaxation techniques, and wearing breathable clothing before sleeping are a few modifications that may relieve night sweats.
• CBT:This is a type of talktherapythat is commonly used for health problems such asdepression, anxiety, andinsomnia。It is normally conducted in person by a精神科医生or counselor, but numerous self-directed programs have been developed. Studies have found that CBT for hot flashes and night sweats can reduce their frequency and improve mood and quality of life in menopausal women. CBT is compatible with other approaches, such as behavior modifications, and likely has the greatest effect on night sweats when combined with other approaches.
• 我dications:Sometimes existing medications may cause night sweats.
  • 切换到不同diabetes或甲状腺药物可能有助于应对夜间汗水。改变药物剂量和时机也可能有助于管理夜间汗水。
  • If night sweats are caused by an underlying infection or hormone problem, medication to treat the underlying condition may help relieve symptoms. For example, starting hormone replacement therapy for menopause or taking medicines if tuberculosis is present may help.
  • A doctor may be in the best position to discuss the potential benefits and downsides of any specific medication.