What could cause night sweats in a middle-age man?

Q. A couple months ago I started sweating a lot at night. It wakes me up. I need to towel off and change bedclothes. I consider myself a relatively healthy 55-year-old man. What can it be?

A. Night sweats are very common. And the cause is often not serious.

Here's my approach to someone with new night sweats. I first ask about the temperature in the bedroom, and how many blankets you sleep with. Next, I want to know if you are having fevers during the day, and if you have been losing weight without trying. If you haven't already checked your temperature several times over a couple days, you should.

If you are experiencing fever or weight loss, then the cause could be serious. You could have an infection, a noninfectious inflammatory disorder, or cancer.

If you feel well during the day and don't have any fever or weight loss, then a serious cause is less likely. But you should still consider these important possibilities:

• sleep apnea, especially if you snore, get sleepy during the day, or both
• anxiety
• a side effect of a medicine; you should review all herbs, supplements, and medicines you take with a pharmacist
• low blood sugar (though this is not likely unless you have diabetes)
• an overactive thyroid (hyperthyroidism); usually there would be additional symptoms, such as weight loss despite a good appetite, rapid heartbeat, sweating during the day, and feeling jittery
• other rare hormonal disorders.

You should definitely see your doctor to discuss the night sweats. In the meantime, here are some things you can try to decrease the sweats.

• Keep the bedroom cool and open a window.
• Avoid spicy food, especially at night.
• Don't drink alcohol for a while.
• Get up, towel off, and change bedclothes immediately as needed.

Quite often, doctors can't find a specific cause for night sweats. In these cases, the sweats often go away on their own.

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