Sleep hyperhidrosis: Difference between revisions
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==Overview== | ==Overview== | ||
'''Sleep hyperhidrosis''', more commonly known as the '''night sweats''', is the occurrence of excessive sweating ([[hyperhidrosis]]) during [[sleep]]. The sufferer may or may not also suffer from excessive perspiration while awake. | '''Sleep hyperhidrosis''', more commonly known as the '''night sweats''', is the occurrence of excessive sweating ([[hyperhidrosis]]) during [[sleep]]. The sufferer may or may not also suffer from excessive perspiration while awake. A night sweat caused by a medical condition or infection can be described as ‘severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment’. [http://www.medicinenet.com/script/main/art.asp?articlekey=57394] True night sweats with medical causes should be properly investigated by a medical physician. | ||
==Classification of Sweating== | ==Classification of Sweating== | ||
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Night sweats may occur for [[genetics|genetic]] reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; the patient may be frequently awakened due to the discomfort of damp sleepwear. | Night sweats may occur for [[genetics|genetic]] reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; the patient may be frequently awakened due to the discomfort of damp sleepwear. | ||
== | ==Natural History, Complications and Prognosis== | ||
While some causes of night sweats, such as [[menopause]], may be relatively harmless, night sweats may also be a sign of a serious underlying disease. | |||
==Causes== | |||
===Common Causes=== | ===Common Causes=== | ||
One of the most common causes of night sweats in women over 40 is the hormonal changes related to [[menopause]] and perimenopause. This is a normal part of menopause and while annoying, it is not necessarily dangerous or a sign of underlying disease. Some women experience night sweats during [[pregnancy]] due to hormonal changes. | One of the most common causes of night sweats in women over 40 is the hormonal changes related to [[menopause]] and perimenopause. This is a normal part of menopause and while annoying, it is not necessarily dangerous or a sign of underlying disease. Some women experience night sweats during [[pregnancy]] due to hormonal changes. | ||
While there can be many causes of excessive sweating at night including the menopause and, for example, a bedroom that is unusually hot or too many bed clothes on the bed, it is important to distinguish night sweats that arise due to medical causes from those that occur because the sleep environment is too warm. | While there can be many causes of excessive sweating at night including the menopause and, for example, a bedroom that is unusually hot or too many bed clothes on the bed, it is important to distinguish night sweats that arise due to medical causes from those that occur because the sleep environment is too warm. | ||
==Complete differential diagnosis of causes of {{PAGENAME}} in alphabetical order== | ==Complete differential diagnosis of causes of {{PAGENAME}} in alphabetical order== | ||
Revision as of 12:36, 12 May 2012
| Sleep hyperhidrosis | |
| ICD-10 | R61.9 |
|---|---|
| ICD-9 | 780.8, 327 |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating (hyperhidrosis) during sleep. The sufferer may or may not also suffer from excessive perspiration while awake. A night sweat caused by a medical condition or infection can be described as ‘severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment’. [2] True night sweats with medical causes should be properly investigated by a medical physician.
Classification of Sweating
There are four types of sweats:
- Diaphoresis: Diaphoresis is a cold sweat. Diaphoresis is excessive sweating commonly associated with shock and other medical emergency conditions. It is distinguished from hyperhidrosis by the "clammy" or "cold state" state of the patient.
- Primary Hyperhidrosis: Primary hyperhidrosis is a condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. This is not a cold sweat.
- Secondary Hyperhidrosis: Secondary hyperhidrosis is a condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature that is secondary to an underlying pathologic process such as infections, disorders of the thyroid or pituitary gland, diabetes mellitus, tumors, gout, menopause, certain drugs, or mercury poisoning. This is not a cold sweat.
- Night sweats: Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating (hyperhidrosis) during sleep. The sufferer may or may not also suffer from excessive perspiration while awake.
Epidemiology and Demographics
Sleep hyperhidrosis may occur at any age, but is most commonly seen in early adulthood.
Genetics
Night sweats may occur for genetic reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; the patient may be frequently awakened due to the discomfort of damp sleepwear.
Natural History, Complications and Prognosis
While some causes of night sweats, such as menopause, may be relatively harmless, night sweats may also be a sign of a serious underlying disease.
Causes
Common Causes
One of the most common causes of night sweats in women over 40 is the hormonal changes related to menopause and perimenopause. This is a normal part of menopause and while annoying, it is not necessarily dangerous or a sign of underlying disease. Some women experience night sweats during pregnancy due to hormonal changes.
While there can be many causes of excessive sweating at night including the menopause and, for example, a bedroom that is unusually hot or too many bed clothes on the bed, it is important to distinguish night sweats that arise due to medical causes from those that occur because the sleep environment is too warm.
Complete differential diagnosis of causes of Sleep hyperhidrosis in alphabetical order
The condition may be considered a sign of various disease states, including:
- Alcohol withdrawal
- Anxiety disorder
- B symptoms
- Benzodiazepine withdrawal
- Beryllium
- Blastomycosis
- Brucellosis
- Cancer
- Cerebral palsy
- Chromium deficiency
- Chronic eosinophilic pneumonia
- Chronic fatigue syndrome
- Cerebral and brain stem strokes
- Diabetes
- Drugs side effects
- Abatacept Injection (patient information)
- Adalimumab Injection (patient information)
- Camphoric acid
- Creeping Cinquefoil
- Cyclosporine (patient information)
- Estroven
- Imatinib (patient information)
- Lamotrigine
- Letrozole (patient information)
- Leuprolide (patient information)
- Levomepromazine
- Natalizumab injection (patient information)
- Pegaspargase (patient information)
- Pentamidine Inhalation (patient information)
- Rituximab injection (patient information)
- Sertraline
- Trenbolone
- Eosinophilic pneumonia
- Epilepsy
- Excess bedcovers
- Familial dysautonomia
- Fungal infection
- Gastroesophageal reflux disease
- Head injury
- HIV
- Hodgkin's disease
- Hyperthyroidism
- Hypoglycaemia
- Hypothalamic lesions
- Kikuchi disease
- Leukemia
- Lung abscess
- Lymphoma
- Mantle cell lymphoma
- Mediastinal tumor
- Menopause
- Mononucleosis
- Mycobacterium avium complex infection
- Nocardiosis
- Nontuberculous mycobacteria
- Obstructive Sleep Apnea
- Opiate withdrawal
- Orchiectomy
- Osteomyelitis
- Osteotomy
- Pneumocystis pneumonia
- Pneumonia
- Pregnancy
- Premature ovarian failure
- Prinzmetal's angina
- Pulmonary histoplasmosis
- Relapsing fever
- Solid tumors [1] [2]
- Subacute endocarditis
- Substance abuse
- Takayasu's arteritis
- Temporal arteritis
- Tree marigold
- Tuberculosis
- Urinary tract infection
- Waldenstrom's macroglobulinemia
- Warm bedroom
Diagnosis
History and Symptoms
Note: facial redness, pain and tachycardia
- History:
- medical
- social
Physical Examination
- Full exam with focus on endocrine, dermatologic and lymphatic systems
Echocardiogram
An echocardiogram can be obtained if there is a high suspicion of endocarditis
Laboratory Findings
- CBC w/ differential
- BUN/Creatnine
- Eosinophil count
- Electrolytes
- Calcium
- Magnesium
- TSH
- Urinalysis
- ESR
- FSH
- PPD
- HIV w/ viral load
- Blood cultures
- Monospot
- Nocturnal hypoglycemia
- free T4
- 5-hydroxyindoleacetic acid
MRI and CT
- Suggest MRI/CT if necessary (chest/abdomen/pelvis)
Treatment
Treat the underlying etiology with appropriate therapy
Acute Pharmacotherapies
- Ibuprofen or acetaminophen
- Antimicrobial if infection is the cause
References
Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs