Quick Answer: Night sweats in men most often result from sleep environment issues (overheating), obstructive sleep apnoea, or low testosterone. Less common causes include infections, medications, and in rare cases lymphoma or other conditions. If sweating is severe, drenching, and not explained by a hot room or heavy bedding, it warrants medical evaluation , most causes are very treatable.
In This Guide
Reading Time: 8 minutes
Defining Night Sweats vs Sleeping Hot
There's an important distinction between sleeping hot (being warm and sweating mildly from an overheated room or heavy bedding) and true night sweats (drenching perspiration that soaks through bedding despite a cool sleep environment).
True night sweats are a clinical symptom , they occur even when the room is cool, the bedding is light, and the person hasn't been physically active. They can soak through a t-shirt and sheets and may require changing clothes or bedding during the night.
Sleeping hot, by contrast, has an obvious environmental cause and resolves when that cause is removed (cooling the room, removing a layer of bedding). If you're sweating because your bedroom is 25°C in summer with no air conditioning, that's sleeping hot, not clinical night sweats.
Common Causes in Men
| Cause | How Common | Key Indicators |
|---|---|---|
| Hot sleep environment | Very common | Resolves with cooler room or lighter bedding |
| Sleep apnoea | Common | Also snoring, daytime fatigue, morning headaches |
| Low testosterone (hypogonadism) | Common after 40 | Also low libido, fatigue, mood changes, weight gain |
| Alcohol before bed | Common | Sweating correlates with drinking evenings |
| Medication side effects | Common | New medication timing matches symptom onset |
| Anxiety / stress | Common | Associated with racing thoughts, worry at bedtime |
| Hypoglycaemia (low blood sugar) | Moderate | Common in diabetics; associated with shakiness on waking |
| Infections (TB, HIV, bacterial) | Less common | Also fever, weight loss, fatigue |
| Lymphoma | Rare | Also lymph node swelling, unexplained weight loss, fever |
8 min read
Low Testosterone and Night Sweats
Testosterone levels in men naturally decline roughly 1% per year after age 30-35. By 50-60, some men have testosterone levels low enough to produce symptoms , a condition called hypogonadism or late-onset hypogonadism.
Hot flushes and night sweats in men with low testosterone are less well-known than the equivalent symptoms in women during menopause, but they're real and documented. The mechanism is similar: declining sex hormone levels affect the hypothalamic thermostat, causing exaggerated temperature responses.
The Evidence for Testosterone and Sweating
A 2010 study in the Journal of Clinical Endocrinology and Metabolism found that men who had testosterone surgically or medically suppressed (e.g., for prostate cancer treatment) reported hot flushes and night sweats at rates comparable to menopausal women. Testosterone replacement therapy reliably reduces these symptoms in men with confirmed hypogonadism, though therapy requires careful management and monitoring.
If you suspect low testosterone, a simple blood test (serum testosterone, usually drawn in the morning when levels are highest) can confirm or rule it out. Talk to your family doctor , this is a straightforward assessment that's increasingly recognised in primary care.
Sleep Apnoea
Obstructive sleep apnoea (OSA) is a significant but under-recognised cause of night sweats in men. During apnoea events, the body experiences hypoxia (low oxygen) and surges of adrenaline as the brain forces a wake response to resume breathing. These adrenaline surges can trigger sweating.
Men with OSA are 2-4 times more likely to report night sweats than the general population, according to research published in Sleep Medicine (2013).
OSA risk factors in men: excess weight (particularly central obesity), large neck circumference (over 17"), smoking, alcohol use, and age over 40. The STOP-BANG questionnaire is a validated screening tool your doctor can use to assess risk.
If you also have: loud snoring, observed breathing pauses, excessive daytime sleepiness, or morning headaches, discuss OSA screening with your doctor. CPAP therapy is highly effective and typically resolves the night sweats associated with OSA.
Medications
Many medications cause night sweats as a documented side effect:
- Antidepressants (SSRIs, SNRIs) , very common cause; up to 22% of antidepressant users report excessive sweating
- Antipyretics (aspirin, acetaminophen, ibuprofen) , rebound sweating after fever-reducing effect wears off
- Antihypertensives (beta blockers, calcium channel blockers)
- Hormone therapies , including androgen deprivation for prostate cancer
- Opioid pain medications
- Diabetes medications that affect blood sugar levels
If a medication is the cause, your prescriber may be able to adjust the dose, change the timing, or substitute an alternative. Never stop a prescribed medication without medical guidance.
When to See a Doctor
Night sweats warrant medical evaluation when they are:
- Drenching , soaking through clothing and bedding in a cool environment
- Accompanied by fever, unexplained weight loss, or swollen lymph nodes (possible infection or lymphoma)
- Associated with chest pain, cough, or shortness of breath (possible cardiac or pulmonary cause)
- Accompanied by extreme fatigue, mood changes, or reduced libido (possible hormonal cause)
- Persistent for more than a few weeks without an obvious environmental explanation
- Accompanied by symptoms suggesting uncontrolled diabetes (excessive thirst, frequent urination)
In the vast majority of cases, the cause turns out to be benign and treatable. But the overlap in symptoms with serious conditions makes a GP visit the right move when sweats are severe or persistent.
Fixing the Sleep Environment
Even when there's an underlying medical cause, optimising the sleep environment reduces discomfort and improves sleep quality during evaluation and treatment:
Cooling the Sleep Environment
- Bedroom temperature , keep between 16-19°C; this is the optimal range for sleep thermoregulation
- Bedding layers , natural fibres (cotton, linen, bamboo) are significantly more breathable than polyester; use lighter layers you can push off rather than one heavy duvet
- Moisture-wicking sheets , bamboo and Tencel (lyocell) sheets absorb moisture and dry faster than standard cotton; percale weave is more breathable than sateen
- Cooling pillow , gel-infused memory foam or latex pillows retain less heat than standard memory foam
- Fan or air circulation , moving air assists evaporative cooling even if room temperature stays constant
- Alcohol elimination , alcohol raises body temperature and vasodilates peripheral blood vessels, contributing directly to night sweats
How Your Mattress Affects Temperature
The mattress itself significantly affects how much you overheat during sleep. Dense memory foam mattresses retain body heat in a way that worsens night sweats. Innerspring, latex, and hybrid mattresses have better airflow and heat dissipation.
If night sweats are a persistent issue and you're sleeping on a dense foam mattress, this is worth considering. A breathable innerspring or hybrid mattress combined with natural fibre bedding can meaningfully reduce the severity of sleep sweating even when there's an underlying medical cause that's being addressed.
Brad, Owner since 1987: "Men in their 40s and 50s often come in saying they've started waking up drenched and their wife is complaining about the heat. The first question I ask is what they're sleeping on , if it's a dense foam mattress, that's often a big contributor. Restonic's pocketed coil systems with natural fibre covers breathe much better than foam. And if they need something more specific, we can talk about bed cooling systems. But often just the right mattress and cotton sheets makes the difference."
Cooling Mattresses at Mattress Miracle
We carry Restonic and Sleep In mattresses in Brantford, including hybrid and innerspring models that sleep significantly cooler than dense foam. Our sleep specialists can help identify whether your current mattress is contributing to night sweats and find an alternative. Call (519) 770-0001 or come in at 441 1/2 West Street , we've been helping families in Brantford and area sleep better since 1987.
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Call 519-770-0001At what age do night sweats start in men?
There's no fixed age , night sweats in men can occur at any age depending on the cause. Testosterone-related hot flushes typically begin in men over 45-50, when androgen decline becomes more pronounced. Sleep apnoea becomes more common with age and weight gain. Medication-related sweating can occur at any age. If you're under 40 with severe night sweats and no obvious cause, infections and other systemic conditions are worth ruling out.
Do night sweats in men mean low testosterone?
Not necessarily, but low testosterone is a significant and common cause in middle-aged men. A blood test for serum total testosterone (drawn in the morning) is a simple way to assess this. Normal testosterone ranges vary by laboratory but are typically 300-1000 ng/dL (10-35 nmol/L in SI units used in Canada). Levels below the reference range, particularly with symptoms, warrant further evaluation by an endocrinologist or GP with an interest in men's health.
Can anxiety cause night sweats in men?
Yes. Anxiety activates the sympathetic nervous system, which triggers the sweat response as part of the fight-or-flight mechanism. Men who experience anxiety or stress at bedtime , including racing thoughts, worry, or replaying events from the day , can experience night sweats as part of the anxiety response. Addressing the underlying anxiety (CBT, stress management, exercise, therapy) typically reduces the sweating as well.
Is it normal for men to sweat a lot at night?
Mild perspiration during sleep is completely normal , the body uses slight sweating as part of normal thermoregulation. Drenching night sweats that soak through bedding in a cool room are not typical and suggest an underlying cause that's worth identifying. The distinction: if reducing blankets and cooling the room stops the sweating, it's environmental. If the sweating continues in a cool room with light bedding, further assessment is warranted.
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