Rem Sleep Sweating: Understanding The Science Behind It

Sweating during sleep, or night sweats, can be caused by a variety of factors, including environmental, physiological, and psychological reasons. While it is normal to experience variations in body temperature while sleeping, excessive sweating can be indicative of underlying health issues. This article will explore the potential causes of night sweats during REM sleep and provide insights into when to seek medical advice.

The impact of menopause

Night sweats are a common symptom of menopause, caused by changing hormone levels. They can happen at any time of the day or night and usually last a few minutes, leaving you hot, red, and sweaty. This is known as a hot flush or hot flash.

During perimenopause, which is the period before menopause, your ovaries produce less estrogen, progesterone, and testosterone, and your periods become irregular. Perimenopause usually happens between the ages of 40 and 50.

Changing hormone levels during perimenopause and menopause can cause your hypothalamus (the part of the brain that controls your body heat) to have trouble regulating your body temperature. This can result in sudden warmth or a flush in your face, neck, and chest. In response, your body tries to cool itself by sweating excessively.

Menopause night sweats and hot flashes can interrupt a woman's sleep for years. 26% of menopausal women experience severe sleep-disrupting symptoms that impact daytime functioning.

In addition to excessive sweating, menopause-related night sweats or hot flashes are often accompanied by red skin blotches, shivering, and a rapid heartbeat. They usually last between half a minute and ten minutes, though their frequency can range from multiple times an hour to multiple times a month.

Night sweats can also occur during post-menopause, the period after menopause. They usually become less severe over time but can last for five to seven years or longer in some women.

If you are concerned about night sweats or they are impacting your quality of life, it is important to speak to your doctor. They can help determine the underlying cause and recommend treatment options such as medication, hormone therapy, or cognitive behavioural therapy (CBT).

Alcohol consumption

Alcohol affects the nervous system, the circulatory system, and almost every other part of the body. It can increase your heart rate, widen the blood vessels in your skin, and trigger perspiration. It can also disrupt your body's ability to regulate temperature.

Alcohol can cause a deeper-than-usual sleep in the first half of the night, followed by disrupted sleep in the second half. It delays the first REM sleep episode and may reduce the total amount of REM sleep. REM sleep is important for physical and mental restoration, memory consolidation, and other cognitive processes.

People who drink heavily or regularly may experience night sweats several hours or days after consuming alcohol. Night sweats are a common symptom of alcohol withdrawal, which often affects people with alcohol use disorder (AUD).

If you experience night sweats due to alcohol consumption, it is recommended to minimize drinking or seek help from a doctor or treatment program.

Stress and anxiety

An overactive mind revs up your brain and body, which can result in sweating. This can be caused by an agitated mind preoccupied with worry or thoughts of the coming day.

Stress can also be a cause and effect of nightmares, which may lead to night sweats. People with post-traumatic stress disorder (PTSD) may experience nightmares, sleep disturbances, flashbacks, and other anxiety-inducing symptoms, resulting in daytime sweating and night sweats.

For people nearing or in menopause, night sweats and anxiety are prevalent and often co-occurring conditions. Evidence suggests a relationship between the severity of hot flashes and the severity of anxiety during the years before and after menopause.

If you are experiencing stress and anxiety, there are some tips to help you manage night sweats:

• Practise paced breathing exercises to calm the nervous system and improve sleep quality.
• Improve bedroom ventilation, use cold compresses, and opt for breathable sleepwear.
• Avoid caffeine and alcohol before bed.
• Maintain a cool sleeping environment.
• Practise relaxation techniques.
• Engage in pleasurable activities to improve mental health.
• Learn skills to reduce anxiety, such as mindfulness and meditation.

Sleep environment

The sleep environment is a critical factor in understanding why individuals sweat during REM sleep. Here are some key considerations regarding the sleep environment that can contribute to sweating:

• Room Temperature: Sleeping in a room that is too warm can lead to night sweats. Keeping the bedroom cool is essential. Lowering the thermostat, using air conditioning, or leveraging fans can help maintain a comfortable temperature.
• Bedding and Sleepwear: Bedding, sleepwear, and mattresses that don't "breathe" can trap heat and disrupt the body's natural temperature regulation. Choose lightweight and breathable bedding, such as lightweight cotton or moisture-wicking materials. Avoid fleece, flannel, down, and synthetic fibres that may retain heat.
• Mattress: The type of mattress can also impact sleep temperature. Foam materials, for example, tend to limit airflow and can make it difficult for the body to cool down. Opt for a mattress that promotes cool sleeping.
• Sleepwear: Wearing lightweight and loose-fitting sleepwear can help prevent overheating. Choose moisture-wicking materials that allow the skin to breathe and regulate temperature effectively.
• Footwear: Consider sleeping with one foot outside the covers. Exposing the feet can help the body maintain a cool sensation, as the bottom of the feet have important temperature-sensing functions.
• Head and Neck: Keeping the head and neck cool can aid in temperature regulation. Try to keep these areas outside of the comforter or use a cool washcloth on the head to help lower body temperature.
• Winding Down: Creating a relaxing atmosphere before bedtime can help reduce stress levels and promote better temperature regulation. This includes keeping the lights low, limiting sound, and ensuring the room is cool.
• Screen Time: Avoiding screens and electronic devices before bed can help promote a calmer state and reduce stimulation, which may contribute to overheating.
• Exercise: While exercise is important, it is recommended to avoid energetic activities too close to bedtime. Intense exercise can "throw off" the body's thermoregulation processes, making it difficult to cool down for sleep.
• Diet: Consuming certain foods and drinks before bed can impact body temperature and contribute to night sweats. Caffeine, alcohol, and spicy foods can increase the likelihood of night sweats. It is recommended to avoid these substances a few hours before bedtime and opt for a light snack instead.
• Weight: Maintaining a healthy weight can also influence sleep temperature. Excess body weight can act as added insulation, making it more challenging for the body to cool down.

By making thoughtful adjustments to the sleep environment and addressing potential triggers, individuals can effectively manage night sweats and improve their sleep quality.

Medication

• Antidepressants, such as Effexor XR (venlafaxine), Prozac (fluoxetine), Paxil (paroxetine), and Brisdelle® (paroxetine)
• Immunosuppressive drugs, such as Cellcept (mycophenolate mofetil), Prograf (Tacrolimus), and Arava (Leflunomide)
• Pain medication (both OTC and prescription)
• Blood pressure drugs
• Nutritional supplements like calcium and niacin
• Antibiotics and antivirals
• Prilosec (omeprazole)
• Sudafed (pseudoephedrine)
• Hormone replacement therapy
• Diabetes medications
• Steroids
• Acetaminophen
• Aspirin
• Clonidine
• Gabapentin
• Pregabalin

In addition, the new prescription drug, fezolinetant, has been approved by the FDA to treat hot flashes and night sweats. However, it is not as effective as the standard treatment of estrogen or estrogen coupled with progestin.

If you experience night sweats after taking a medication, speak with a healthcare professional. They may modify your treatment plan by recommending an alternative drug or modifying the dosage. It is important not to stop taking a medication without speaking to a doctor first, as this may lead to side effects and complications.

Frequently asked questions