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So menopause for you was 10 years ago, but now you're getting hot at night. Are you normal?
Normal Temperature Fluctuations
Well, it turns out that, first of all, we have to talk a little bit about normal circadian rhythms. That's one of my favorite topics. This is where throughout the day, your temperature is not exactly the same. It's at its lowest in the morning and at its highest in the evening before bedtime. Now, that means your body has to get rid of about 1 degree of heat from the time you go to bed until you wake up. And how do you get rid of heat? Well, your body gets rid of heat by vasodilating, meaning making your skin get warm so you can make the heat go off and sometimes sweat. And this happens while you're asleep. There are some other very important things that happen during REM sleep where your ability to regulate your temperature isn't quite as good.
Sleep Patterns' Impact on Thermal Regulation
So this is a perfectly normal phenomenon that happens to most people. If you're a really great sleeper, then you actually sleep through this. If you can remember, this happens to babies and grownups, when you put your little babies to bed, you've wrapped them up in probably too many blankets and you check them if you're totally compulsive sometime about 1 or 2 in the morning and they were totally sweaty, sleeping through it if you're lucky.
Now, as you get older, you may not sleep through this as well. So, when you get a little hot and sweaty, maybe you also have to go to the bathroom or maybe you've got a joint that's uncomfortable and you're rolling over and you notice that you have too many covers on and you're just too warm. So this is a normal biological phenomenon that happens to everyone, but if you're not such a great sleeper anymore, you may not sleep through this.
Menopausal Symptoms: Hot Flushes and Night Sweats
Number two is certainly at menopause, women have hot flushes which can be very difficult during the middle of the night. Now, this is a very short event. So a hot flush can wake people up or the process of waking up may trigger a hot flush where you feel very sweaty often around your chest. Some people soak their sheets. It lasts three to four minutes and then you kind of get chilled.
So this is a flash. When people talk about hot flashes or flushes, this is a short episode. It's not being, "I'm not hot all night." That is not hot flushes and it's not menopause. Although at menopause, there are lots of things to think about that may keep you from being the good sleeper that you used to be. So hot flushes can be but remember they're short and are often quite intense, and then they go away, and often people get a little chilled because at that point, they've given off too much heat and their body has to recalibrate.
So, first of all, yes, it's normal to get a little hot in the middle of the night or quite warm. Stick a leg out, throw your covers off and that can happen. The hot flushes mean that you wake up multiple times a night throwing your covers off and then you chill and throw them back on. So that's something that happens around the beginning of menopause the early years but can last for as much as five to seven years in some women or longer.
Abnormal Night Sweats
So it turns out there are some other oddball things that can cause night sweats which are more troublesome and that includes infectious diseases like tuberculosis, believe it or not, can cause night sweats, some other infectious diseases, which are kind of chronic, not an acute infection, although anything that makes your temperature go up, any fever or infection makes it go up and it's at its highest at bedtime, and then you often have your fever break when you're sleeping. So that certainly can be a sign of infection.
Uncommon though, there are also some cancers which may certainly cause night sweats, but it's mostly, blood cancers like lymphomas, but those are also quite rare and those cause night sweats. So, for a 70-year-old saying, "Gee, I just seem like I'm so hot at night," number one, we're getting into summer and your bedroom may not be as cool as it should be. Maybe you haven't put your big quilt away, which I just did yesterday so that I don't have to have so many warm things on me all night long. It could be that you're not sleeping through that normal drop in temperature as well as you should be, but that's pretty common for people in post-menopause. They could be hot flushes, but remember those are short episodes and very unlikely and not normal would be tuberculosis, conditions like some kinds of cancer, some kinds of diabetes where your blood sugar drops in the middle of the night and you get sweaty when your blood sugar drops. Those are not normal.
When to Seek Medical Help for Night Sweats
But if this process ends up being very disturbing for you or you really are feeling that it's interfering with your sleep and you're not feeling otherwise well, then you should talk to your clinician about it. If you're otherwise just thinking that this is because you're not sleeping through the night that well, this is summertime coming. Get into your skinny nighties, get down to your skinny blankets, and get a good night's sleep. And thanks for joining us on The Scope.
updated: March 8, 2024
originally published: June 24, 2021