Night sweats (nocturnal hyperhidrosis) that occur with anxiety can disrupt sleep and worsen worry. Causes include stress, menopause, medications, infections, and endocrine problems. Start with sleep hygiene and relaxation; evidence-based options include CBT and, when appropriate, medications such as SSRIs or menopausal hormone therapy for vasomotor symptoms. See a clinician for new, severe, or unexplained symptoms. Some herbal remedies are popular but have limited evidence and can interact with drugs.
Why anxiety and night sweats matter
Night sweats (nocturnal hyperhidrosis) - heavy sweating during sleep - are common and often distressing. When they occur alongside anxiety or panic, they can disrupt sleep, increase daytime fatigue, and intensify worry. Treating both the sweating and the underlying anxiety improves sleep and quality of life.
Common causes and contributors
Anxiety and stress can activate the sympathetic nervous system, producing sweating, a racing heart, and a sense of panic that sometimes happens at night. But night sweats have many possible causes: menopause (vasomotor symptoms), infections, some medications (including certain antidepressants), endocrine problems such as hyperthyroidism, low blood sugar, and less commonly, cancers or autonomic disorders.
If night sweats are new, severe, or accompany unexplained weight loss or fever, see a clinician for evaluation.
What history and doctors look for
Clinicians ask about timing, triggers, medications, alcohol and drug use, and other symptoms (fever, weight loss, palpitations). They may check vitals, consider blood tests (thyroid function, glucose), review current medicines, and recommend further tests only if indicated.
Self-care and lifestyle strategies
Start with sleep-focused measures: keep the bedroom cool, use breathable bedding, avoid heavy meals, alcohol, caffeine, and spicy foods close to bedtime, and wear moisture-wicking sleepwear. Relaxation routines - diaphragmatic breathing, progressive muscle relaxation, or a short wind-down meditation - can reduce evening anxiety and lower the chance of nocturnal panic.
Cognitive-behavioral therapy for insomnia (CBT-I) or for anxiety is effective at reducing nighttime symptoms and improving sleep quality.
Medical and evidence-based options
Treatments depend on cause. For menopausal hot flashes and night sweats, menopausal hormone therapy is the most consistently effective medical option for people without contraindications. If anxiety or panic disorder is the driver, evidence-based therapies include CBT and medications such as SSRIs or SNRIs; some patients benefit from short-term benzodiazepines under close supervision.
If a medication is causing sweating, adjusting the prescription may help. Always discuss medication changes with your prescriber.
Some people try natural or over-the-counter approaches (e.g., warm milk before bed, dietary sources of tryptophan, herbal supplements). Evidence for these is limited and variable; herbal remedies can interact with medications (for example, St. John's wort affects many drug pathways) so check with a clinician or pharmacist before use.
When to seek urgent care
Seek prompt medical attention for night sweats that begin suddenly with fever, unexplained weight loss, or signs of heart problems (chest pain, severe shortness of breath). Panic episodes feel frightening and can mimic cardiac symptoms; if you have cardiac risk factors and new chest pain, treat it as urgent. 1
Bottom line
Night sweats linked to anxiety are common and treatable. A combination of sleep hygiene, behavioral therapies, and targeted medical care - guided by a clinician - will usually reduce symptoms and restore restful sleep.
- Check evidence and recommended guidance on St. John's wort for anxiety and its interaction profile (drug interactions, contraindications).
- Verify guidance on when anxiety-related symptoms mimic cardiac events and clarify when to seek emergency care for potential cardiac causes.