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Coping with night sweats for older adults

Night sweats for older adults

Night sweats are known to be frustrating and uncomfortable. They can be a problem for anyone, but can be particularly troublesome for older women who may experience them more than the average person. Here, we are looking at what night sweats are, how they impact sleep quality, what causes the issue, their links to menopause in older women, and how they can be diagnosed. We will also cover how to manage night sweats effectively, how to avoid them, lifestyle changes and self-care strategies that could help, and when you should seek medical help. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about night sweats, we can help. 

night sweats in elderly adults

What are night sweats?

Night sweats are periods of excessive sweating that occur while trying to sleep, which can be extremely uncomfortable and cause frequent waking and significant disruption to sleep. When this happens at night, often bedding and sleepwear can become soaked through, which can dry cold. Flushing or chills could also occur during night sweats, and the more sleep is disrupted, the more distressing this symptom can be for older adults. 

Night sweats are common in older adults, with one study finding that 14% of people were bothered by this symptom. Women are thought to experience this symptom more than men.

What causes night sweats in older adults? 

Night sweats can start to happen for a number of reasons, for example:

  • Medical conditions, such as cancer or a serious infection 
  • Medications, such as antidepressants or hormone therapies
  • Chronic illnesses, such as diabetes or hyperthyroidism 
  • Stress or anxiety 
  • Common illnesses such as colds or the flu 
  • Sleep disorders, such as sleep apnoea 
  • Mental health conditions such as anxiety, panic attacks or severe stress 
  • Consuming certain things, like spicy food, alcohol or excessive caffeine 

One of the leading causes of night sweats in older women specifically is hormonal changes due to the menopause. The National Institute of Ageing estimates that menopause occurs between the ages of 45 and 55, and can last around 7 years, but it could last for up to 14 years for some women. While menopause is commonly known as a hormonal shift that happens with age, perimenopause (the lead up to menopause) and post menopause (which happens after menopause) can also be culprits when it comes to night sweats.

Menopause is known to cause hot flashes for many women, among other unpleasant symptoms, and these typically last on average 5.2 years. They could last longer for some, or may not occur at all – every woman will have unique symptoms during menopause. The British Menopause Society found that, when surveyed in 2016, 22% of women aged between 45 and 65 reported having sleeping problems or insomnia, 79% reported hot flushes, and 70% reported night sweats. 

These hormonal changes can lead to decreased oestrogen levels in the body, which can affect the body’s ability to regulate temperature, leading to potential hot flashes and excessive sweating during the night.

Identifying the underlying cause of night sweats is important in order to minimise their impact on sleep and to effectively manage them going forward. If night sweats are persistent or severe, or you also experience other symptoms alongside, you should consult a healthcare provider as soon as possible to get a proper diagnosis and begin necessary treatment.

Other than menopause, what else might the diagnosis be if an older adult is experiencing night sweats? 

While menopause is a common cause of night sweats in older women ,men can also experience them, and a medical professional should take a full medical history and physical exam to find out what the cause is. If you are an older woman experiencing night sweats as described above, you could be going through perimenopause, menopause, or post-menopause, or any older adult could have a condition such as:

  • Hyperthyroidism – If, alongside night sweats, you also notice symptoms like anxiety, mood swings, difficulty staying still, daytime tiredness, sensitivity to heat, muscle weakness, diarrhoea, extreme thirst, or excessive need to urinate, you should speak to your doctor about the possibility of hyperthyroidism being the underlying cause. 
  • Diabetes – Diabetes can also cause night sweats, so if you are experiencing symptoms such as increased thirst and urination, increased hunger, fatigue, blurred vision, numbness or a tingling sensation in the feet or hands, sores on skin that do not heal, or unexplained weight loss, then you should seek an assessment for diabetes through your doctor. Do not delay this as ignoring symptoms could lead to long-term, serious health consequences. You can learn more about diabetes in older adults in our guide to diabetes in older adults.
  • A chronic infection – Infections such as tuberculosis (an infection of the lungs) and endocarditis (an infection of the lining of the heart) can lead to night sweats in some cases, so if you also have tuberculosis symptoms such as a cough lasting more than 3 weeks, endocarditis symptoms such as a very high temperature and chills, or you experience general infection symptoms like exhaustion, a fever, loss of appetite, weight loss or you feel generally unwell, see your doctor as soon as possible. 
  • An autoimmune disorder – Conditions like rheumatoid arthritis might be a contributing factor for night sweats, so be mindful of any other symptoms, such as pain, stiffness, swelling, warmth and redness in any of your joints. 
  • Cancer – Certain cancers, particularly lymphomas, are associated with night sweats, so if you notice symptoms such as pain-free swelling in a lymph node (usually located in the neck, armpit or groin area) then do not delay seeking a check-up with your doctor who may refer you to a specialist for more tests.

By undertaking a thorough medical evaluation, and taking a detailed history of your medical needs, your doctor can find out more about why you are experiencing night sweats. Depending on your other symptoms, they may also carry out a physical examination and other diagnostic tests such as blood tests to determine the underlying cause and guide appropriate treatment.

night sweats in elderly adults

What are the best ways to manage night sweats?

In some cases, lifestyle changes can have a positive impact on your sleep and minimise night sweats. There are a few ways you can do this yourself: 

  • Maintain a cool sleeping environment – It is always best to keep your room cool when sleeping, with the optimum temperature estimated to be around 18.3°C according to the Sleep Foundation. You can do this with air conditioning, a fan, or by opening your windows at night to let cool air flow through. 
  • Choose breathable bedding – Lightweight, breathable bedding and moisture-wicking sleepwear can help you to stay cool in bed and avoid overheating. If you tend to start off cold in bed, you could also wear several layers that can be easily removed if you start to feel too warm. 
  • Stay hydrated – Drinking enough liquids throughout the day, especially water, can help to regulate your body temperature and keep you cool. Many people avoid drinking water before bed as they believe this will make them need to use the bathroom in the middle of the night, but in some cases it can be better to hydrate before bed in order to stay cool. 
  • Change your diet – Some foods can trigger body temperature to rise, so avoid things like spicy foods, caffeine or alcohol, particularly in the evening, and try to notice if any specific foods trigger your night sweats by keeping a food diary for a while.
  • Get regular exercise – Staying fit and healthy with regular exercise can help to reduce stress and regulate hormones, which can reduce the risk of experiencing night sweats. This does not need to be vigorous exercise; gentle and moderate exercise can also help depending on your abilities and other health conditions. Try exercises like yoga, brisk walking, tai chi, or if you have limited mobility, you can try exercises that are comfortable for you while sitting in a chair to move your body. You may find more ideas for exercise in our guide to fitness and exercise for older adults.
  • Try relaxation techniques – For some, relaxation can make a big difference to night sweats and sleep quality, so even if you do not feel particularly stressed, try relaxing mindfulness techniques such as deep breathing and meditation to manage stress.
  • Optimise your sleep hygiene – Sleep hygiene is the quality of the sleep you get and the surrounding activities. For example, improving your sleep hygiene may mean establishing a regular sleep schedule, creating a calming bedtime routine, or anything else that you know makes you fall asleep faster, and experience a more restful night’s sleep. 

You may find more helpful information in our guide to healthy sleep and insomnia in older adults.

Can night sweats be prevented? 

Your ability to prevent night sweats will depend on the underlying cause and your health. If your doctor has been unable to pinpoint a specific cause of your night sweats then the best way to avoid them is to identify your own personal triggers. You could do this by keeping a diary of the foods you eat, how much you are drinking, your bedtime routine, your relaxation activities, your fitness regime, and anything else you think may contribute to the quality of sleep you get each night. The longer you track your daytime activities, the more data you can gather on how this impacts your sleep, which will allow you to identify which activities are helpful and what should be avoided to reduce frequency and severity of night sweats. 

There is a limited amount of evidence to suggest that certain natural supplements could have a potentially positive effect on hot flashes in women going through menopause, such as a combination of vitamin E and omega 3 (according to one 2022 study), but much more research is needed to conclusively prove that any natural supplement can help with hot flashes or night sweats. Keep in mind that you should never begin taking any supplement, even if it is considered natural, without consulting your doctor first. 

When should an older adult seek medical help for night sweats? 

If night sweats are negatively affecting your sleep and, as a result, your everyday life, this is something you can bring up with your doctor or another medical professional to get their advice. While hormones are a common cause, you should never assume your night sweats are hormone related, especially if you have been experiencing any of the other concerning symptoms mentioned above such as unexplained weight loss, a fever, or if you feel chest pain at night. 

If you are experiencing persistent or severe symptoms, or your night sweats are significantly affecting your sleep quality (and therefore causing tiredness during the day), then don’t be afraid to reach out to your GP for help.

As well as investigating the underlying cause and diagnosing, your doctor can:

  • Offer advice on lifestyle changes to minimise your night sweats
  • Review any medications you are on that could be causing night sweats
  • Prescribe medications to help control night sweats, such as anticonvulsants, antidepressants, clonidine (sometimes used to treat high blood pressure, ADHD, anxiety and more), megestrol (sometimes used to treat certain types of cancer, or to increase appetite), or oxybutynin (sometimes used to treat urinary conditions)
  • Discuss the possibility of starting Hormone Replacement Therapy (HRT) to alleviate some of your menopause symptoms, if this is the reason for night sweats

Your doctor may also refer you to any relevant specialists if they think this is required, such as an endocrinologist, a gynaecologist, or a sleep expert who can provide advanced care.

How can I help a loved one who is experiencing night sweats?

If you have an older loved one who is finding it difficult to cope with night sweats, this can be distressing. They may need emotional support as they try to figure out the cause and how they can minimise this symptom. If they struggle with mobility or other health concerns, you can assist by helping them to carry out some of the lifestyle changes mentioned above. This could be things like adjusting their sleeping environment to make it more cool in temperature, or helping them to manage their diet more effectively. You could also help them by finding local community resources such as support groups, wellness programs and other educational gatherings that offer support for older adults with sleeping problems. 

Sometimes the best thing you can do for a loved one who is experiencing any sleep issues is to offer them a listening ear. They may need emotional support as they navigate the lifestyle changes they may need to make, and as disrupted sleep can have a major emotional impact, you can provide the reassurance and understanding they need to make positive changes and eventually improve their sleep without being bothered by night sweats.  

Ultimately, older women can rest assured that in many cases, night sweats are attributed to menopausal symptoms and are not a medical issue to worry about. This does not mean they are not extremely distressing for some people, so you can speak to your doctor if you would like to learn what options you have. Also, if you have other symptoms or suspect something else could be the underlying cause, consult your doctor to ensure you are in good health. 

With these lifestyle changes and preventative measures, you can start to learn how your night sweats operate and make positive changes to manage them so they no longer affect your life in a negative way. 

If you or a loved one struggle with night sweats and could benefit from support from an overnight care professional to manage these during the night, companionship or live-in care to help adhere to a better sleep hygiene routine, or to keep a symptom diary, you can reach out to your local Home Instead office to learn more.

Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. 

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.