FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

READER NEEDS TO RETURN TO DOCTOR FIND CAUSE OF "NIGHT SWEATS"

Question: Do you know of a solution to my problem of heavy night sweats? They are so severe that at times I have to change my pajamas as many as three times a night. I've had this trouble for the past three years, and other than the night sweats I have been fine. My doctor has given me Noroxin, Sumycin and ampicillin, and I have also taken aspirin and Tylenol. None of these have helped. I'm sure I'm not the first person to be troubled by night sweats that disturb my rest. What should I do?

Answer: Nighttime sweating is a general symptom that can be produced by many different conditions. From other information in your letter I know you are not a woman in her 40s or 50s. This is important because the fluctuation of hormone levels near the time of menopause may cause night sweats for some women, but that certainly is not the cause of your sweats. One common cause of night sweats that at one time or another affects most adults is emotional stress. This can occur in women and men of any age. The individual is usually aware that they are worrying over a matter of importance to them when they awaken sweating in the middle of the night. As the period of stress subsides, normal sleep patterns return. It is unusual for stress levels to remain sufficiently high to disturb sleep for three years, so I am concerned that you may have another problem. There are a number of infectious illnesses that cause night sweats. Malaria is a classic cause of this complaint, but individuals with malaria usually feel sick during the rest of the day, too. Even though you said you feel fine except for the night sweats, it would still be a good idea to ask your doctor to check for malaria.

Chronic infection in the sinuses, urinary tract, lungs or teeth can cause night sweats, so have your doctor and dentist check for these as well. The medications Noroxin, Sumycin and ampicillin you have taken are antibiotics that are effective at clearing some -- but not all -- infections. If your doctor still suspects an infection, I would recommend that you have tests to identify the specific type of organism that may be causing the condition and its location before you take more antibiotics. More serious causes of night sweats include some life-threatening diseases. These include severe heart disease and severe kidney disease. I don't think you are afflicted by either of these problems because you would have other symptoms produced by the failing organ and wouldn't report that you otherwise feel fine.

Another serious disease that can produce the symptoms you describe is cancer. For instance, stomach, bowel and lung cancer can all produce night sweats before other symptoms are apparent. While I think that cancer may be a relatively likely cause of your night sweats, you shouldn't panic. Even though you have had three years of night sweats, it's entirely possible that any cancer you may have is still curable.

It is important for you to see your doctor again very soon for a thorough physical examination. Your doctor will help you identify the specific cause of the night sweats you experience, and then recommend the proper treatment for your condition.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.