Causes and Treatment of Cold Sweats

When to Act and When to Go Back to Sleep

woman with night sweats
Often an infection like the flu can cause cold sweats. EXTREME-PHOTOGRAPHER / Getty Images

"Cold sweats" refers to sudden sweating that doesn't come from heat or exertion. The medical term for cold sweats is diaphoresis. It comes from the body's response to stress, called the fight or flight response. It's very important to recognize cold sweats when providing first aid, which can be a sign of significant injury or illness.

Symptoms

What sets cold sweats apart from regular sweating is what the patient is doing when they start.

You would expect to sweat after doing a few jumping jacks or push-ups, but cold sweats come on suddenly and at any temperature.

Sometimes the sweating happens at night when the patient is trying to sleep. This is often referred to as "night sweats" but there isn't any actual difference between night sweats and cold sweats. It's all diaphoresis and it could be pointing to a larger problem.

Treatment

There is no specific treatment of cold sweats. To make them go away, you must treat the underlying cause. For example, if shortness of breath is causing sweats, helping the patient to breathe better and get more oxygen should help dry the skin.

diaphoresis is not the problem; it is the sign or symptom of the problem. Recognizing cold sweats when they happen can help identify a problem before it gets too bad.

Causes of Cold Sweats

Anything that causes a fight or flight response in the body can cause cold sweats.

What you do to fix the cold sweats depends on the cause.

  • Shock is dangerously low blood flow to the brain and other vital organs. The lack of blood flow delivers less oxygen and nutrients to the brain, which causes stress. Shock is a life-threatening condition and recognizing cold sweats is an important key to identifying shock. Other things to look for if you suspect shock would be a rapid pulse (over 100 beats per minute), rapid breathing (over 20 breaths per minute), pale skin, and feeling weak or woozy when sitting up or standing. Shock doesn't just happen, either. Cold sweats after a mechanism of injury like a car accident or a fall is enough of a concern to call 911. In the meantime, let the patient lie flat on his or her back and elevate the feet about 8-12 inches.
  • Any infection that causes a fever can lead to cold sweats. It's common for cold sweats to come on as a fever "breaks" or starts to go back down. Really bad cases of infection, called sepsis, can lead to shock and therefore also to cold sweats. If the cold sweats come on without any preceding fever, or they are accompanied by the symptoms listed with shock above, call an ambulance. 
  • Another drop in blood pressure called syncope, which often causes fainting, can lead to diaphoresis. Many people will start sweating with severe or sudden nausea or vertigo. This is very similar to shock and lying flat on the back with the feet elevated also works for this. Call an ambulance for syncope.
  • Intense pain from severe injuries like fractures or amputations, can lead to cold sweats. If a patient with a broken ankle is sweating, it's a good bet he or she is in excruciating pain and could use something to ease the pain. If the patient is already taking something for pain, call the doctor to explain the situation and discuss alternatives or changes to dosages.
  • heart attack can lead to cold sweats. Call an ambulance if cold sweats also come with chest pain or pressure, or pressure in the neck or arm. Have the patient take a chew-able aspirin while waiting for the ambulance to arrive.
  • Severe shortness of breath can lead to a lack of oxygen in the bloodstream. When the patient's brain begins to crave oxygen, a stress response is triggered, causing cold sweats, among other things. Look for other signs of shortness of breath in a patient with cold sweats, like fatigue with very little exercise or pursed-lip breathing. If the patient has oxygen, make sure it is on and call an ambulance.
  • Too little sugar in the bloodstream (hypoglycemia) is a fairly common complication in diabetic patients. The brain regards a lack of sugar as just as serious an emergency as a lack of oxygen. The response is the same, including cold sweats. If a diabetic patient is confused, call an ambulance and provide the patient with glucose if it is available. If the patient can drink, try fruit juice if glucose isn't nearby.

    Lastly, fear and anxiety are definite causes of stress for anyone. Anything from intense panic to everyday anxiety can lead to a fight or flight response and all the signs that go with it, including cold sweats.

    There are other causes of cold sweats that aren't necessarily emergencies, such as the hormonal changes that come with menopause or chronic conditions like cancer. It's important to discuss common signs and symptoms of chronic medical problems with your doctor. Most importantly, if you're concerned about cold sweats—especially the first time it happens—see a doctor.

    Source:

    Kyaw TH, Sullivan L, Klingsberg RC. A 45-Year-Old Woman With 3 Weeks of Cough and Night Sweats. Chest. 2016 Mar;149(3):e87-90. doi: 10.1016/j.chest.2015.08.014.

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