Drenching sweats are often worse at night, can disturb sleep, cause severe discomfort, fatigue and affect quality of life. Patients often complain of needing to change the bedding in the middle of the night.
Differentiate from hot flushes - an intense feeling of warmth and erythema, but without sweating.
Ask about recent chemotherapy - sweats may be a sign of neutropaenic sepsis.
Especially an abscess
Caused by cancer - common with sarcoma, lymphoma, leukaemia, liver mets from any tumour
Oestrogen deficiency e.g. treatment-induced menopause for breast and ovarian cancer
Testosterone deficiency e.g. surgical or hormone treatment for prostate cancer
Diabetes and Parkinsons are the commonest causes
Non Pharmacological Treatment
- Loose cotton clothes
- Fan and tepid sponging may help
- Ensure oral hydration as a lot of fluid can be lost with sweats
- Avoid spicy food, alcohol and coffee
- With fever
- Paracetamol or NSAIDS plus antibiotics for infection
- Without fever
- Amtriptyline 10mg - 25mg
- Oxybutinin 2.5mg bd
- Hyoscine patches (Scopoderm)
- Cimetidine 400mg -800mg
- Last resort
- Gabapentin 100mg tds
- Clonidine - watch out for hypotension
- Hormones - discuss safety of hormone replacement with oncologist