Night sweats in men are surprisingly common and usually tied to something identifiable, whether that’s a hormonal shift, a medication, an underlying health condition, or simply a sleep environment that’s too warm. While occasional sweating at night is normal, true night sweats are episodes intense enough to soak through your clothes or sheets, and they happen regardless of how cool your bedroom is.
Most causes are manageable once you know what’s behind them. Here’s what could be driving yours.
Low Testosterone
Testosterone plays a direct role in how your body regulates temperature. When levels drop, the brain’s internal thermostat becomes less stable, triggering sudden heat surges and sweating, particularly at night. This is the male equivalent of what happens during menopause in women, and it’s more common than most men realize.
Testosterone naturally declines about 1% per year after age 30. By the time men reach their 50s or 60s, the drop can be significant enough to cause noticeable symptoms: night sweats, reduced energy, lower sex drive, mood changes, and difficulty maintaining muscle mass. Night sweats from low testosterone tend to come on gradually and worsen over months or years rather than appearing overnight. A simple blood test can confirm whether your levels have fallen below the normal range.
Medications That Trigger Sweating
Several widely prescribed medications cause night sweats as a side effect, and antidepressants are among the most common culprits. Nearly every major class of antidepressant can induce excessive sweating, including SSRIs, SNRIs, and older tricyclic antidepressants. The mechanism involves how these drugs alter signaling in the brain’s temperature regulation pathways. With some medications, sweating is dose-dependent. Venlafaxine, for example, tends to cause less sweating at lower doses, but at higher doses the effect on the body’s stress-response system overpowers the brain’s ability to suppress perspiration.
Other medications linked to night sweats include blood pressure drugs, diabetes medications (especially if blood sugar drops too low overnight), hormone therapies, and over-the-counter fever reducers like aspirin or acetaminophen. If your night sweats started around the same time as a new prescription or a dosage change, that connection is worth exploring with whoever prescribed it.
Sleep Apnea
Obstructive sleep apnea, a condition where the airway repeatedly collapses during sleep, is significantly more common in men and is an underrecognized cause of night sweats. About 19% of people with sleep apnea report night sweats, compared to roughly 12% of people without it. The reason: each time your airway closes and oxygen levels drop, your body jolts into a partial arousal. These frequent awakenings spike your nervous system’s fight-or-flight response, raising heart rate and triggering sweating.
If your night sweats come alongside loud snoring, gasping during sleep, morning headaches, or daytime exhaustion, sleep apnea is a strong possibility. It’s especially common in men who are overweight, though it can affect men of any body type. Treating the apnea, typically with a device that keeps the airway open during sleep, often resolves the sweating.
Infections
Night sweats are a hallmark symptom of several infections, some mild and some serious. Common viral infections like the flu can cause temporary night sweating that resolves as the illness clears. Bacterial infections are a bigger concern when sweats persist for weeks.
Tuberculosis is one of the classic infections associated with drenching night sweats. Active TB typically develops gradually over weeks and includes a persistent cough, weight loss, fatigue, fever, and chills alongside the sweating. TB that spreads beyond the lungs can cause night sweats even without respiratory symptoms. HIV is another infection where night sweats appear early and persistently, often before other symptoms become obvious. Endocarditis (an infection of the heart valves) and abscesses can also produce recurring night sweats. In all of these cases, the sweating is the body’s response to fighting an active infection, and it tends to happen at night because the immune system ramps up activity during sleep.
Acid Reflux
This one catches most people off guard. Gastroesophageal reflux disease, commonly known as acid reflux or GERD, can cause night sweats even when heartburn isn’t the main symptom. The connection appears to involve the body’s discomfort response: acid irritating the esophagus during sleep triggers the nervous system in ways that produce sweating. Clinical reports have documented patients whose unexplained night sweats resolved completely once their reflux was treated, and a review of the medical literature supports GERD as a genuine, if often overlooked, cause of nocturnal sweating.
If you tend to eat late, sleep flat, or notice a sour taste in your mouth when you wake up, reflux could be contributing to your sweats even if you don’t feel obvious heartburn.
Alcohol and Diet
Alcohol is one of the most straightforward triggers. It dilates blood vessels near the skin, raises core body temperature, and disrupts the body’s ability to regulate heat during sleep. Even moderate drinking in the evening can produce noticeable sweating a few hours later as your body metabolizes the alcohol. Heavy or regular drinking amplifies this significantly, and alcohol withdrawal in people who drink daily can cause intense, drenching sweats.
Spicy foods, caffeine, and large meals close to bedtime can have a similar but milder effect. They raise metabolic activity and core temperature right when your body is trying to cool down for sleep.
Anxiety and Stress
Chronic stress and anxiety disorders keep the nervous system in a heightened state, which directly affects temperature regulation. Men dealing with sustained work stress, financial pressure, or untreated anxiety may find that their body stays “switched on” at night, producing sweat even in a cool room. The sweating can also create a cycle: waking up drenched increases anxiety about sleep, which makes the next night worse.
Nightmares and post-traumatic stress can produce particularly intense episodes. These tend to be sudden, often waking you mid-sweat with a racing heart, and they correlate with the content and intensity of the dream rather than the room temperature.
When Night Sweats Signal Something Serious
Most night sweats have a benign or treatable cause. But certain patterns warrant prompt attention. Lymphoma and other blood cancers list drenching night sweats as one of their defining symptoms, what oncologists call “B symptoms.” The key distinction is severity: these are sweats so intense that your pajamas, sheets, and blankets are soaking wet, not just damp. They typically come alongside unexplained weight loss (more than 10% of body weight over six months), persistent fevers without an obvious infection, and sometimes painless swelling in the lymph nodes of the neck, armpit, or groin.
Night sweats that persist for more than two to three weeks without an obvious explanation like a warm bedroom, recent illness, or new medication deserve investigation. The same applies to sweats that come with fevers, unexplained weight loss, or a new lump anywhere in the body. A basic workup including blood tests and sometimes imaging can rule out the serious causes quickly.
Practical Steps to Reduce Night Sweats
While identifying the root cause matters most, a few changes can reduce the severity of sweats regardless of the trigger. Keep your bedroom between 60 and 67 degrees Fahrenheit, which is the range that best supports the body’s natural temperature drop during sleep. Use breathable, moisture-wicking sheets and sleepwear rather than synthetic fabrics that trap heat. Avoid alcohol, caffeine, and large meals within three hours of bedtime.
If you suspect low testosterone, a blood draw taken in the morning (when levels peak) gives the most accurate reading. If you snore heavily or wake feeling unrefreshed, a sleep study can confirm or rule out apnea. And if you recently started or changed a medication, check whether sweating is a known side effect before assuming something else is wrong. In many cases, the fix is simpler than the worry that comes with waking up drenched at 3 a.m.