Night Sweats Anxiety: Yes, It’s Real.

September 28, 2020.

As if having night sweats isn’t bad enough, you can also get anxiety about having night sweats. That’s right; not only do women struggle with anxiety during menopause, but they can develop anxiety about their menopausal symptoms. Anxiety can cause night sweats, and night sweats can cause anxiety. It truly is a vicious cycle. Let’s talk about night sweats anxiety and what you can do to calm your nerves, cool your body, and get some sleep.

Can anxiety cause night sweats?

One of the leading causes of sleeplessness and insomnia among all individuals is anxiety. For many of us, our worries, fears, troubles, to-do lists, oops-I-forgot-this, and emotions all come out as we are lying quietly in bed, awaiting sleep. Yet, when our mind is difficult to still, it can make us feel anxious about the night ahead, the loss of sleep, and the consequences when the sun comes up. Add to the mix off-balance hormones in menopause and a predisposition for hot flashes, and you have the perfect cocktail of night sweats anxiety. 

Night sweats anxiety occurs in perimenopausal and menopausal women as a response to the unpredictable nature of hot flashes and night sweats. These vasomotor symptoms can be extremely debilitating, and when they happen at night, they can derail your rest. Essentially, women become anxious about having night sweats, knowing that the repercussion could mean that they can’t get back to sleep, will be tired and moody the next day, and will struggle to perform the next day’s tasks. And they get to repeat the same fears and symptoms the next night.   

Let’s talk about night sweats for a moment.

Night sweats are the same as hot flashes in that they are a vasomotor symptom that often accompanies the menopause transition. The only difference is that night sweats occur while you are sleeping, and hot flashes are at any other time during the day. 

The exact cause of hot flashes and night sweats is not well understood. However, most theories suggest that fluctuating estrogen levels affect how the hypothalamus interprets information from thermoreceptors in your skin. (The hypothalamus is your body’s internal thermostat). Likely, the hypothalamus overreacts to subtle changes picked up by thermoreceptors, causing you to experience a hot flash. 

Characteristics of hot flashes (or night sweats) include: 

  • An intense feeling of heat
  • Flushing or redness, especially on the face, neck, and chest
  • Lightheadedness
  • Tingling in the extremities
  • Perspiration
“Essentially, women become anxious about having night sweats, knowing that the repercussion could mean that they can’t get back to sleep, will be tired and moody the next day, and will struggle to perform the next day’s tasks. And they get to repeat the same fears and symptoms the next night.”   

How is night sweats anxiety managed?

Night sweats can be a normal manifestation of your changing hormones in menopause. And, feeling anxious about them is understandable – they are an absolute pain! However, it helps to separate the two symptoms (anxiety and night sweats) and treat them individually. 


According to the North American Menopause Society, hormone replacement therapy (HRT) is the most effective treatment for hot flashes and night sweats. While not all women can take HRT, it is helpful to check with your doctor to see if HRT is an option for you if you are open to using medication. 


Some women also try supplements that contain black cohosh, red clover, Dong Quai, ginseng, kava, or evening primrose oil. Some studies suggest that these natural remedies may help with hot flashes, anxiety, and moodiness. While nature often provides the best medicine, the FDA does not strictly regulate herbal supplements for safety and efficacy. Thus, it is best to consult your doctor before using menopause supplements. 

Lifestyle changes

Do you remember having a bedtime routine as a child or perhaps setting one for your children? If you have night sweats anxiety, there has never been a better time to implement a bedtime routine. Start it at the same time each night, make the temperature in your room just right, put on cool pajamas (or nix them altogether), do something to relax your body and mind, and keep a cold glass of water next to your bed. It is also helpful to limit or avoid things that can worsen anxiety, night sweats, and insomnia, including alcohol, caffeine, and smoking.

Cognitive-behavioral therapy

You can do CBT at home or with a therapist. Essentially, CBT helps retrain your brain to cope differently. For example, it trains you to manage anxiety differently and even talk yourself through things that usually make you anxious. 

When to be concerned about night sweats

It is important to note certain health conditions or infections can cause that night sweats. It can be hard to differentiate between night sweats related to hormones versus a health condition. Look for signs that may indicate it is caused by something more serious. For example, if you have diarrhea, fever, pain, a cough, or other symptoms that may suggest you are sick, it may be something more than hormones. Similarly, if the night sweats are persistent or you begin to notice weight loss, see your doctor. 

In general, if you are struggling with night sweats and do not think they are related to the menopause transition, you should see your doctor. A medical evaluation may help you get to the bottom of what is causing the night sweats and help you treat and manage this disruptive symptom. Similarly, if night sweats anxiety is depleting your quality of life during menopause, don’t sit back and wait for the ride to be over. Talk to your doctor about ways to manage this annoyance. 

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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