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What We Now Know About Night Sweats

What We Now Know About Night Sweats. Jim Mold, M.D., M.P.H. Department of Family and Preventive Medicine OUHSC – OKC. Definition. “Sweating during the night even when it isn’t excessively hot in your bedroom”. They’re Common and Under-Reported. Night Sweats in Past Month

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What We Now Know About Night Sweats

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  1. What We Now Know About Night Sweats Jim Mold, M.D., M.P.H. Department of Family and Preventive Medicine OUHSC – OKC

  2. Definition “Sweating during the night even when it isn’t excessively hot in your bedroom”

  3. They’re Common and Under-Reported Night Sweats in Past Month • 30 – 40% of adults visiting a PCP • 10-20% of older adults (age > 65) in the general (OKLAHOMA Studies) population • Women are only slightly more likely to be affected than men • Only 12% of patients with night sweats have reported the symptom to their PCP • Only 47% of patients with severe (soaking) night sweats have reported them to their PCP

  4. They’re Annoying • Patients with night sweats report lower health-related quality of life, general health, physical functioning, mental health, and social functioning, and more bodily pain than those without night sweats after controlling for age, gender, education, income, and race • The night sweats are bothersome to at least one other person in 10% of cases

  5. They’re Associated with Many Other Symptoms • Fever • Symptoms of anxiety and depression • Symptoms of sensory impairment (e.g. impaired hearing, impaired vision, numbness of extremities) • Pain (e.g. muscle cramps) • Sleep disturbances (e.g. daytime tiredness, waking up with a bitter taste in mouth, legs jerk during sleep, and awakening with pain during the night)

  6. And Use of Some Medications • SSRIs • Tricyclic antidepressants • Other antidepressants • Antihistamines • Alcohol

  7. But Not with Objective Evidence of Disease • Not association with actual sensory deficits • Not associated with abnormalities on polysomnography other than more frequent awakening • Not associated with (stable/treated) diabetes, thyroid disease, depression, GERD, hypertension, osteoarthritis, osteoporosis, or autoimmune diseases • Probably associated with chronic infections

  8. Neither We nor Our Patients Know What Causes The Symptom or How to Evaluate Someone Who Has It • Less than 20% of physicians and patients, when asked, were able to even venture a guess as to the cause of the patient’s night sweats • Most frequent guesses were: • Menopause (48% of patients; 44% of their PCPs) • Stress (12% of patients; 8% of their PCPs) • Medications (9% of patients; 10% of their PCPs) • Diabetes (4% of patients; 11% of their PCPs)

  9. So Where Do We Go From Here?

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