What Are Postpartum Night Sweats

  • Lucy Luikinga Graduate Student studying MSc Women’s Health, UCL

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Introduction 

Postpartum night sweats are experienced by around 35% of women in the weeks after giving birth1. Although this is an uncomfortable experience, it is completely normal and luckily only temporary. 

So, what are they? In the first 6 weeks following childbirth, which is defined as the postpartum period, some women experience severe sweating at night. They may wake up in the night soaked in sweat or even find sleeping difficult because of this. The sweating can be an irritating experience for many and lead to disrupted sleep, tiredness, and body odour. Severe sweating at night after giving birth occurs due to the considerable change to hormone levels as they drop rapidly after childbirth1. As your body regulates itself, it can lead to various symptoms including night sweats.

Although the experience is frustrating, it usually only lasts around 2-6 weeks2. Additionally, there are various steps that can be taken to ease the sweating and improve sleep. This article will provide further information on the causes, symptoms, ways to control it, and when to be concerned.

Causes of postpartum night sweats

Although this phenomena is well documented with many women sharing their life experiences, the exact mechanisms behind postpartum night sweats has yet to be academically determined.There are however various factors that most likely lead to night sweating. 

Hormonal changes

During pregnancy, the body undergoes huge hormonal changes in order to grow the new life inside the body. 

Oestrogen and progesterone are two hormones whose levels are raised significantly during pregnancy. They then drop to pre-pregnancy levels within a few days after childbirth3. Additionally, if you make the choice to breastfeed, this will also lower oestrogen levels. 

The changes to these hormone levels are thought to change the regulation of heat by the body. This is similar to how decreased levels of oestrogen and progesterone are thought to cause hot flashes during the menopause. As a result, sweating can be brought on by small temperature changes. 

Fluid retention

At the later stages of pregnancy, water retention by the body increases due to various changes the body goes through, both physical and hormonal. A pregnant person keeps an average of an extra 6.5 litres of water4. After childbirth, it’s thought these excess fluids may be expelled through excessive sweating at night. 

Stress and anxiety 

Many women after giving birth may experience symptoms of stress and anxiety, commonly associated with the major hormonal changes. One manifestation of this may be sweating at night and consequent difficulty sleeping.

Medication

Some medications can give the side effect of night sweats. These include:5

  • Antidepressants
  • Hormone therapy 
  • Hypoglycemic medicines

If unsure if your medication can cause night sweats, contact your doctor.

Ultimately, more research is required to fully understand the causes of postpartum night sweating and why it affects certain women. 

Symptoms and characteristics 

Although sweating is a normal bodily function in order to maintain the normal core temperature, night sweats are defined by extra sweating than is required in order to cool the body.

Postpartum night sweats are similar to the nighttime hot flushes that women going through menopause may experience. You may experience intense heat in the upper body which then spreads to the whole body. This is followed by excessive sweating. Shivering and a feeling of anxiety may also come with sweating6

You are more likely to experience this in the first half of the night3. It’s normal for some people to need to change bedding when this occurs. Unfortunately, this experience is both uncomfortable and disrupts normal sleep. This can also contribute to the exhaustion most likely already felt in the weeks after childbirth and can cause feelings of irritability and unrest the following day.

Fortunately, as your body adapts to the changes following childbirth, night sweats should ease of their own accord within a couple of weeks.

Management and treatment

Unfortunately there is no way to completely prevent postpartum night sweats, but there are various ways to manage and ease the symptoms7

Home Remedies

  • Maintain a cool room:
    • Use a fan, air conditioning, or keep the room ventilated by opening windows in order to maintain a cool room
  • Pyjama choice:
    • Wear sleep clothing made from natural fibres such as cotton. This is better at allowing your skin to breathe compared to synthetic fabrics that trap heat
    • Loose fitting sleepwear is also recommended to keep cool
    • By layering your nightwear, you can remove outer layers when a hot flush occurs
    • Having a fresh change of clothes on hand can also help if needed within the night
  • Cooling bedding
    • Using cooling bedding (pillows, sheets, mattress) can help maintain your body temperature and prevent the build up of heat. Gel mattresses and those that allow plenty of airflow are best for keeping you cool at night
    • Cooling mattress toppers may be useful 
    • Again, it's best to avoid any synthetic fabrics, sticking to cotton is best
  • Use a towel
    • This can prevent the need to change bedding as frequently
    • To prevent staining, a mattress protector is also useful
  • Drink plenty of water
    • Excessive sweating may lead to dehydration so keep an eye on urine colour. If your urine is dark then make sure to increase your uptake!
    • A glass of cold water before sleeping may also help
    • Keep some on hand for during the night as well
  • Relaxation techniques
    • If you find yourself feeling anxious or stressed when waking up due to night sweats then relaxation techniques may be useful to help regulate yourself
    • Deep breathing, meditation, and mindfulness can all help ease symptoms and make getting back to sleep easier

Looking after your emotional wellbeing

The postpartum period is a stressful and tiring time with all the changes happening to you and your life. Night sweats can contribute to the overall stress commonly experienced in this period. It’s important to have emotional and psychological support. Sharing your experiences with a partner, friend, family member, or healthcare professionals can be beneficial in taking the mental load off. Sharing your experiences with other new mother’s can also help you feel less alone in your experiences and allow you to pick up new tips for dealing with this issue. 

Postpartum depression (PPD) is a completely normal thing which many new mother’s experience. Night sweats have been linked to PPD3.If you are experiencing feelings of low mood, anxiety, numbness, or guilt and these are continuing for more than two weeks, talk with your doctor. It’s important to know you are not alone and there are many ways of treating and managing PPD.

When to seek medical attention 

Postpartum night sweats are generally harmless and resolve by themselves. However, if you find that your sleep is severely compromised and night sweating is greatly affecting your day to day life, it may be useful to discuss your symptoms with your healthcare provider. 

Furthermore, night sweats may be a symptom of other diseases such as infection, hypothyroidism, or diabetes. Look out for the following and if these accompany your night sweats, then contact your doctor:

  • Fever
  • Diarrhoea or vomiting
  • Headache
  • Rapid weight loss
    • Above what is expected postpartum
  • Intense itching
  • Enlarged lymph nodes
  • Joint or back pain
  • Severe depression or anxiety 
  • Severe cramping
  • Pain when urinating 
  • Warm red areas on the breasts
  • Breathlessness
  • Dizziness
  • Fainting
  • Large clots or red bleeding for over 3 days post delivery

These could be symptoms of something more severe so don’t hesitate to contact your doctor if you are concerned. 

It also may be useful to discuss your medical history with your doctor to rule out any other causes of night sweating.

You also should have a 6-week postpartum appointment after childbirth to ensure you are in good health. This is a great opportunity to discuss any less pressing matters with your doctor and to look into family planning options.

Summary

In conclusion, postpartum night sweats, while an uncomfortable and sometimes disruptive experience, are a common and temporary phenomenon affecting approximately 35% of women in the weeks following childbirth. The root causes are believed to be linked to significant hormonal changes, fluid retention, stress, and, in some cases, medication side effects.

The symptoms, characterised by excessive sweating, heat sensations, and potential associated feelings of anxiety, usually peak in the first half of the night but tend to resolve on their own within about two weeks as the body adjusts to postpartum changes. While there is no foolproof way to prevent these night sweats, various home remedies such as maintaining a cool sleep environment, choosing appropriate sleepwear, using cooling bedding, and practising relaxation techniques can help manage the symptoms.

Emotional well-being during the postpartum period is crucial, and seeking support from loved ones or healthcare professionals can be beneficial. Night sweats have been linked to postpartum depression. If you experience persistent feelings of low mood, anxiety, or guilt, then don’t be afraid to seek help.

While postpartum night sweats are generally harmless and resolve on their own, it's important to monitor for any signs of severe complications or underlying health issues. If night sweats significantly impact your daily life, or if additional symptoms like fever, rapid weight loss, or severe depression accompany them, it's advisable to consult with your healthcare provider. Regular check-ups, open communication with your doctor, and addressing any concerns promptly contribute to a holistic approach to postpartum care.

References

  1. Thurston RC, Luther JF, Wisniewski SR, Eng H, Wisner KL. Prospective evaluation of nighttime hot flashes during pregnancy and postpartum. Fertility and Sterility. 2013;100(6):1667–72. doi:10.1016/j.fertnstert.2013.08.020
  2. Postpartum Night Sweats: Causes & Treatments. Cleveland Clinic [Internet]. [cited 2023 Nov 9]. Available from: https://my.clevelandclinic.org/health/symptoms/24631-postpartum-night-sweats.
  3. Postpartum night sweats: Causes Management. Sleep Foundation [Internet]. 2023 [cited 2023 Nov 9]. Available from: https://www.sleepfoundation.org/night-sweats/postpartum-night-sweats 
  4. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Maternal Physiology. In: Williams Obstetrics [Internet]. 25th ed. New York, NY: McGraw-Hill Education; 2018 [2023 Nov 9]. Available from: https://www.accessmedicine.mhmedical.com/content.aspx?aid=1160772082. 
  5. Night sweats Causes. Mayo Clinic [Internet]. 2022 [cited 2023 Nov 9]. Available from: https://www.mayoclinic.org/symptoms/night-sweats/basics/definition/sym-20050768
  6. Introduction to Menopause [Internet]. 2019 [cited 2023 Nov 9]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause.
  7. Postpartum Night Sweats: Causes and Treatments; [cited 2024 Apr 14]. Available from: https://tidewaterobgyn.com/postpartum-night-sweats-causes-treatments/. 

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Lucy Luikinga

Graduate Student studying MSc Women’s Health, UCL

Lucy is a graduate student currently completing here MSc at UCL. In her undergrad she completed her industrial placement in a pharmaceutical lab. Now she is moving towards a career in Science Communications. Having assisted in a Research Project on the Menopause and worked in a Pharmacy during the COVID-19 pandemic, Lucy has experience across the field of healthcare.

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