Night sweats usually have a fixable cause, whether it’s your sleep environment, something you ate or drank, a medication, or a hormonal shift. The first step is identifying what’s triggering yours, because the solution depends entirely on the cause. Here’s how to work through the most common culprits and what actually helps.
Start With Your Sleep Environment
The simplest fixes are often the most effective. Your bedroom temperature should be between 60 and 67°F (15–19°C) for comfortable sleep. If your room runs warmer, a fan or adjusted thermostat alone can make a noticeable difference.
Your bedding matters more than marketing suggests. After extensive testing, Wirecutter found that cotton percale and linen sheets are the most reliably cool, breathable, and durable options for hot sleepers. Percale has a loose, plain weave that doesn’t cling to your body and lets air circulate freely. Linen works the same way. Both allow sweat to evaporate quickly, which is what actually keeps you comfortable. Sheets marketed as “cooling,” including bamboo rayon and Tencel alternatives, performed no better than good cotton percale in head-to-head comparisons, and they often cost more. There’s no such thing as sheets that actively cool you the way an ice pack does. The best you can do is pick a fabric that breathes well and doesn’t trap heat.
Lightweight, breathable sleepwear (or none at all) follows the same logic. Synthetic fabrics tend to trap heat. Cotton or moisture-wicking athletic fabrics are better choices.
Check Your Diet and Habits
Several common foods and drinks can raise your body temperature while you sleep, especially if consumed in the hours before bed.
- Alcohol dilates blood vessels and disrupts sleep cycles, raising body temperature and triggering sweating. Even a glass or two of wine at dinner can be enough.
- Caffeine stimulates your nervous system, increasing heart rate and metabolism. It makes it harder for your body to stay cool, and its effects can linger for hours.
- Spicy foods contain compounds that stimulate heat production, raising your core temperature and prompting sweating.
- High-fat, fried, or heavily processed foods require more metabolic effort to digest, which generates extra body heat during sleep.
- Sugary foods and refined carbs cause blood sugar spikes and crashes. When your blood sugar drops overnight, your body works to stabilize glucose levels, which can trigger sweating.
Try eliminating these triggers one at a time for a week or two. If your night sweats improve after cutting alcohol or late-night coffee, you’ve found your answer without needing any further workup.
Medications That Cause Night Sweats
A number of common prescriptions can trigger night sweats as a side effect. Antidepressants are among the most frequent offenders, particularly SSRIs and SNRIs. Other common culprits include diabetes medications (especially if they cause low blood sugar overnight), hormone-blocking drugs used in cancer treatment, steroids like prednisone, and some blood pressure medications. Over-the-counter fever reducers like aspirin and acetaminophen can also cause rebound sweating as they wear off.
If your night sweats started around the same time you began a new medication, or after a dosage change, that’s a strong clue. Don’t stop a prescription on your own, but do bring it up at your next appointment. Sometimes a dosage adjustment, switching to a different medication in the same class, or changing when you take it can resolve the problem.
Hormonal Causes and Treatment Options
Menopause is one of the most common causes of night sweats. Declining estrogen levels disrupt the brain’s temperature regulation, making your body overreact to small changes in heat. Night sweats can begin during perimenopause (the years leading up to menopause) and persist well into postmenopause.
Hormone replacement therapy remains the most effective treatment for menopausal night sweats. Short-term use of up to three to five years is not considered unsafe for most women, according to researchers at Massachusetts General Hospital’s Center for Women’s Mental Health. For women who can’t or prefer not to take hormones, the FDA approved Veozah (fezolinetant) in 2023 specifically for moderate to severe hot flashes and night sweats caused by menopause. It works by blocking a receptor in the brain involved in temperature regulation. It’s taken as a daily pill and represents the first medication in its class approved for this purpose. It does require liver function monitoring through blood work every three months for the first nine months of use, and it isn’t appropriate for people with liver disease or severe kidney problems.
Low-dose antidepressants (particularly certain SSRIs) are also sometimes prescribed off-label for menopausal night sweats and can reduce their frequency, though they’re generally less effective than hormonal options.
What About Herbal Supplements?
Black cohosh is the most widely marketed herbal remedy for menopausal night sweats, but the clinical evidence is discouraging. In a trial of 351 women taking 160 mg daily of black cohosh extract, the number and intensity of hot flashes and night sweats were no different from placebo after 3, 6, and 12 months. A separate trial of 88 women found the same result, and the black cohosh group actually reported worse symptom intensity at the 6- and 9-month marks. A 2016 meta-analysis pooling data from four trials confirmed no significant benefit. Both the American College of Obstetricians and Gynecologists and the North American Menopause Society recommend against herbal therapies like black cohosh for night sweats, concluding they are “unlikely to be beneficial.”
Other Medical Causes
Beyond menopause and medications, night sweats can be a symptom of several other conditions. Infections, including tuberculosis and endocarditis (an infection of the heart valves), are classic causes. Viral illnesses like mononucleosis can also trigger them. Hyperthyroidism speeds up your metabolism and raises body temperature. Obstructive sleep apnea causes repeated drops in oxygen that trigger stress hormones, which can produce sweating. Low blood sugar overnight, whether from diabetes management or other causes, is another trigger.
Less commonly, night sweats can signal certain cancers, particularly lymphomas. In these cases, sweats are typically drenching (you’d need to change your sheets), persistent, and accompanied by other symptoms like unexplained weight loss or fevers.
When Night Sweats Need Medical Attention
Occasional night sweats after a warm evening or a few drinks are not a concern. But the Mayo Clinic recommends scheduling a visit if your night sweats occur regularly, interrupt your sleep, or are accompanied by a fever, unexplained weight loss, pain in a specific area, a persistent cough, diarrhea, or other worrying symptoms. Night sweats that begin months or years after your menopause symptoms had already ended also warrant evaluation, since they may point to a new cause rather than a hormonal one.
Your doctor will likely ask about your medication list, check thyroid function, and may order basic blood work. If sleep apnea is suspected, a sleep study can confirm or rule it out. In most cases, the cause turns out to be identifiable and treatable.