Definition
Significant generalised night time sweating that soaks bedclothes or bedding.
Night sweats are a fairly common symptom and the majority of patients do not have an underlying haematological malignancy.
Medical causes are very varied and include:
- infection
- menopause
- anxiety
- endocrine causes:
- hyperthyroidism
- nocturnal hypoglycaemia in diabetics
- acromegaly
- phaeochromocytoma
- obstructive sleep apnoea
- connective tissue disorders
- neurological:
- parkinsonism
- neuropathies
- medications:
- antipsychotics
- SSRIs
- hormonal agents such as Tamoxifen and GnRH agonists
- alcohol excess or withdrawal
- drug abuse (including cannabis use / withdrawal)
- gastritis
- haematological malignancies.
Please see the Primary Care Management page for guidance on further investigation.
C.M & L.W 26-06-23
Who to refer:
Only refer patients with genuinely drenching sweats and any of:
- significant additional systemic symptoms: unexplained weight loss >10%, fever or alcohol induced pain
- associated nodal enlargement and / or splenomegaly
- abnormal FBC
Who not to refer:
- Night sweats only, otherwise well with normal FBC – these patients should be investigated in primary care as are unlikely to have lymphoma
- Patients with sweats which are not genuinely drenching
How to refer:
SCI Gateway to the Department of Haematology WGH or SJH.
Primary care investigations
- FBC
- Blood film
- CRP
- Thyroid function tests
- HIV serology (ie antigen and antibody test)
- Quantitative immunoglobulins+ serum electrophoresis
- Gonadotrophins and oestradiol where appropriate
- CXR
