Are Night Sweats a Sign of HIV?

Understanding Why They Happen and What They Mean to People Living with HIV

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Photo Credit: Ryan Hyde

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

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

What Are Night Sweats?

Night sweats occur frequently in people with HIV, most often in later stages of untreated disease (when the CD4 count is below 200 cells/mL). They manifest with profuse, drenching perspiration with no apparent cause and, while they themselves are harmless, night sweats can be indicative of an underlying medical condition which may or may not be serious. 

Night sweats differ from regular perspiration in that they

  • occur without exercise;
  • occur primarily while sleeping, and;
  • can be extremely profuse, often soaking bedclothes, bed sheets and blankets.

What Causes Night Sweats?

There are numerous possible causes for night sweats, ranging from common hormonal changes in women to more severe manifestations of HIV infection.

It's important to note, however, that night sweats are not alone a sign of HIV. They do, however, warrant investigation, as well as an HIV test should you be at risk of infection.

(Learn more about whether you should get an HIV test and when.)

Causes of night sweats include:

HIV itself does not cause night sweats. However, if you have advanced or untreated HIV and are experiencing intermittent or localized night sweats (limited, say, to the head and neck), then they are most likely related to an HIV-associated illness.

What Should I Do If I Have Night Sweats?

While there is no way to eliminate night sweats without treating the underlying cause, certain steps can be taken to identify the problem. Start by asking 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 that you are taking (or combinations you've started taking) which the 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 and menopause in women? Low blood sugar in diabetics? 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 doctor, some of which may help pinpoint the likely cause of the night sweats.

And while you're at it, consider taking an HIV test if you haven't done so. Currently in the U.S., it is recommended that all Americans age 15 to 65 be given a once-off HIV test as part of a routine doctor's visit. Rapid, in-home HIV tests are also available for purchase at most major chain drug stores.

What Can I Do If I Awaken with Night Sweats?

The worst thing about night sweats is they can be so 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 underpad 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 contact your doctor without delay so that investigations can be performed to identify and treat the underlying cause.

The bottom line is this: any person with unexplained night sweats should seek medical care. Do not self-diagnosed or dismiss your symptoms as there is no such thing as "normal" night sweats. Get it checked today if only for peace of mind.

Edited by James Myhre and Dennis Sifris, M.D.


U.S. Preventive Services Task Force (USPSTF). "Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement." Rockville, Maryland; April 2013; accessed February 7, 2014.

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