Background: Much of primary care involves helping patients manage symptoms. Nighttime sweating is a symptom linked to menopause, malignancies, autoimmune diseases, and infections. However, in primary care settings, night sweats are commonly reported by persons without these conditions.
Results: Prevalence estimates ranged from 10% among older primary care patients to 60% among women on an obstetrics inpatient unit. Life expectancy of primary care patients reporting night sweats did not appear to be reduced. Although many clinical causes have been suggested, most are not well supported. Algorithmic approaches to evaluation are not evidence-based. Alpha adrenergic blockers may reduce night sweats in patients taking serotonin reuptake inhibitors. Thalidomide and thioridazine may benefit some terminal cancer patients with night sweats.
Table 6. Case Studies of Treatments Reported to Be Effective for Patients with Night Sweats
| Population | Treatment (Route of Administration Cited Only Where Provided) | Effectiveness |
| Patients with advanced cancer, referred for palliative care | Nabilone at 1 mg at bedtime or twice a day | 4/4 patients’ night sweats improved (mean 5.75 points on the ESAS)134 |
| Patients with terminal cancer | Thalidomide at 100 mg at bedtime | 6 /7 patients improved an average of 4 points on a 5-point scale; recurred off of drug and improved again with reinstitution of drug135 |
| Patients with advanced local or metastatic cancer | Thioridazine at 10–30 mg at bedtime nightly | 15/17 patients reported improvement, poorly quantified136 |
| Patients with myelofibrosis | Etanercept at 25 mg subcutaneously twice weekly for up to 24 weeks | 6/8 (75%) improved with treatment128 |
| Patients treated for narcotic addiction with methadone | Desloratadine at 5 mg per day | 2/2 (100%) reported relief from night sweats within 1 day137 |
| Patients taking SSRIs | Mirtazapine at 15–60 mg per day | One case: dose-dependent reduction in night sweats138 |
| Patients taking SSRIs | Benztropine at 0.5 mg at bedtime | One case: temporary relief from night sweats84 |
| Patients taking SSRIs | Terazosin at 1 mg per day to 2 mg at bedtime | Significant reduction in night sweats in
2/2 (100%), one after a day, the other after 4 weeks139 |
| Patients taking SSRIs | Terazosin | Significant reduction in night sweats in 20/ 20 (100%)140 |
| Patients taking SSRIs | Clonidine at 0.1 mg twice daily | One case: significant relief of night sweats after 3 week |
SSRIs, selective serotonin reuptake inhibitors; ESAS, Edmonton Symptom Assessment System (scored 0 –10).