Night Sweats as a Symptom of HIV

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Perspiration is the body's natural response whenever it's overheated, emotionally or physically stressed, or affected by a disease-causing agent such as HIV.

In some people, this can occur spontaneously and without apparent reason (a condition called hyperhidrosis). In others, it occurs specifically and profusely at night. This is something we call "night sweats," or, more specifically, sleep hyperhidrosis.

feet kicked out from under bed covers
 Burak Karademir / Getty Images

What Are Night Sweats?

Night sweats frequently occur in people living with HIV, most often in later stages of untreated disease (when the CD4 count is below 200 cells/milliliter).

They cause profuse, drenching perspiration for no apparent reason and, while they themselves are harmless, night sweats can be indicative of an underlying medical condition that may be serious. 

Night sweats differ from regular perspiration in that they occur without exercise and almost entirely when sleeping. Furthermore, they can be extremely profuse, soaking through bedclothes, sheets, and even blankets.

Causes

Night sweats have numerous possible causes, ranging from common hormonal changes in women to more severe manifestations of HIV infection.

It's important to note, however, that night sweats alone—without other symptoms such as fever, weight loss or diarrhea—are not a common manifestation of HIV.

Night sweats do, however, warrant investigation, as well as an HIV test should you be at risk of infection or have other symptoms.

Causes of night sweats can, among other things, include:

HIV especially causes night sweats during the acute illness that takes place with seroconversion (the period during which an antibody becomes evident in the blood).

Night sweats in HIV are almost always accompanied by other symptoms, including fever, diarrhea, weight loss, enlarged lymph nodes, and joint pain. They rarely (if ever) occur as a lone symptom of HIV.

Pinpointing the Cause

Night sweats aren't something that's treated directly; rather, the underlying cause has to be addressed. To help your healthcare provider identify the underlying cause, ask yourself:

  • Are you having sleep problems, such as breathing difficulties or night terrors? Sleep disorders can often contribute to drenching night sweats.
  • What medicines are you taking? Are there any you're taking (or combinations you've started taking) that coincide with the night sweats?
  • Are you a heavy drinker? While this is a subjective question in some ways, heavy drinking can be roughly defined as having more than two drinks per night.
  • Do you have any condition that might cause a hormonal imbalance, either diagnosed or suspected? Pregnancy or menopause? Low blood sugar? Hyperthyroidism?
  • When did the night sweats start? Do they happen frequently or just occasionally? Is your entire body soaked or just parts of your body?
  • Are there any other physical or emotional signs or symptoms you may have noticed recently, even minor ones?

Be sure to share these thoughts with your healthcare provider.

While you're at it, consider taking an HIV test if you haven't already. All Americans age 13 to 64 are recommended to get a once-off HIV test as part of a routine healthcare provider's visit. 

Rapid in-home HIV tests are also available for purchase at most major chain drug stores.

Finding Relief

The worst thing about night sweats is they can be incredibly uncomfortable and unnerving. If you awaken in the middle of the night soaked in perspiration, here are a few things you can do:

  • Take a cool bath or shower and change into fresh bedclothes.
  • Change your bedding. If the night sweats are persistent, use a waterproof pad to protect your mattress from being saturated.
  • Adjust the room temperature. If the weather permits, open a bedroom window or use a fan to circulate air.

Be careful, however, to avoid a chill. While you should make every effort to keep yourself comfortable, you shouldn't try to "treat" your night sweats by sleeping in an overly chilled, air-conditioned environment.

If your night sweats are severe or increasing in frequency, they may be indicative of a life-threatening illness. Be sure to contact your healthcare provider right away so testing and treatment can begin.

The presence of night sweats has no direct correlation to disease progression or life expectancy in people with HIV. Rather, night sweats may suggest an underlying condition that may have poor health outcomes.

A Word From Verywell

If you have unexplained night sweats, talk to your healthcare provider right away.

Do not self-diagnose or dismiss your symptoms, as there is no such thing as "normal" night sweats. Get it checked as soon as possible, if only for peace of mind.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. About HIV/AIDS.

  2. National Sleep Foundation. Four common causes of night sweats.

  3. Arnardottir ES, Janson C, Bjornsdottir E, et al. Nocturnal sweating--a common symptom of obstructive sleep apnoea: the icelandic sleep apnoea cohort. BMJ Open. 2013;3(5):e002795. doi:10.1136/bmjopen-2013-002795

  4. Centers for Disease Control and Prevention. HIV testing.

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.