If you’re waking up in a pool of sweat, you’re not alone. Recent studies suggest as many as 1 in 3 primary care patients reported experiencing night sweats in the past month. It could be those heavy blankets, or the spicy food you ate before bed. Or it could be any number of medical conditions — some minor, others more serious — manifesting as night sweats.
A literature review in the Journal of the American Board of Family Medicine covered the basics. Panic attacks, sleep problems, fever, numbness in hands and feet, anxiety and stress, and trouble breathing at night are all predictors for night sweats. A handful of medications can cause this too, including those prescribed to treat depression and diabetes. In extreme cases, according to the Mayo Clinic, night sweats can be a sign of autoimmune disease, cancer, stroke, or thyroid disease.
But there may be more likely, if less terrifying, cause: low testosterone.
Roughly 70 percent of women experience hot flashes at menopause, when their estrogen levels plummet. Men usually get off easy, because they do not typically experience an abrupt drop in their own sex hormone, testosterone. But when low-T does strike, it can have many of the same impacts as menopause — except in men. Men who have received androgen deprivation therapy for prostate cancer, for instance, often report hot flashes. And while the drop in testosterone that most new fathers experience is hardly significant enough to cause night sweats, it may contribute to a pre-existing low-T problem.
Scientists aren’t sure why low-T causes hot flashes and night sweats. The hypothalamus, the brain region responsible for temperature regulation, is a likely culprit. When the body is overheating, the hypothalamus directs blood vessels to dilate, increasing blow flow and causing the face to flush red. Meanwhile, to counter this temperature increase, the body converts that warm flush into cold, clammy sweat. Low testosterone may play a role in interrupting this careful balance, causing the hypothalamus to misfire and produce cold, clammy sweat in the middle of the night, when it is most unwelcome.
Supplemental testosterone may help (although this is not an option for men with prostate cancer), and other treatments are available. So it is important to talk with your doctor if you are regularly waking up cold, wet, and clammy. It’s probably nothing serious, and your testosterone is probably just fine. But the sooner you pinpoint the cause, the better.