WHEN TO SEE YOUR DOCTOR
* Your cold sweats happen repeatedly during the night, night after night.
* You suspect that anxiety is causing your cold sweats.
* You also have sickle cell disease or a condition that impairs your immune system.
* If your cold sweats accompany overexposure to sun or heat, treat it as a medical emergency.
What Your Symptom Is Telling You
You're an ice cube with the jitters, a snowman on a vibrating bed. You're wet, you're shivering, you're cold—and you're probably miserable.
More likely, a virus like the flu or mononucleosis has made your body its playground. Other, more serious infections, like tuberculosis and AIDS, can also cause cold sweats.
But maybe you're not under the weather—just under too much stress or feeling very anxious, two other causes of cold sweats.
Besides intense emotions, intense pain—like the pain of a migraine headache—can cause cold sweats. A surge of pain-sparked adrenaline can force open your sweat glands and shut down the blood vessels in your skin, making you sweaty and cold.
Adrenaline isn't the only hormone involved in cold sweats. Estrogen—or the lack of it—also plays a role. If you're a woman nearing menopause, you might sleep through a hot flash and wake up during the aftermath wrapped in clammy sheets. In fact, for some women, nighttime cold sweats are the only sign of hot flashes.
But the hormones aren't done yet—there's also insulin. If you're diabetic—a problem of too little insulin—you can experience cold sweats when your blood sugar drops.
Finally, cold sweats sometimes signal a medical emergency. They might be the sign of a severe heart or circulatory problem, though you'd probably notice chest pain first. (In a few rare cases cold sweats are the first sign of a heart attack.) Cold sweats might also indicate lowered blood pressure because of shock from loss of blood, perhaps from internal bleeding like a ruptured blood vessel.
Because cold sweats are almost always linked to another condition, they don't really need separate treatment, doctors say. They will go away when the underlying problem is treated. Here's a brief look at a few ways to deal with those problems.
Get tested. If your doctor thinks that an infection is causing your cold sweats, medical tests will show which microbe is responsible, says Adel Mahmoud, M.D., Ph.D., chairman of medicine at Case Western Reserve University School of Medicine in Cleveland. Your doctor will then prescribe an antibiotic to knock out the offending bacteria.
If the verdict is mononucleosis, you'll be advised to take fluids, eat a balanced diet and avoid exhausting exercise, says Oliver Cooper, M.D., professor of family and community medicine at Texas A & M University Health Science Center College of Medicine in College Station. You'll also need to boycott contact sports when you're on the mend (to avoid rupturing your mono-swollen liver or spleen).
Ease your anxiety. If you suspect your cold sweats are caused by anxiety, don't hesitate to ask your doctor for help, says Robert Wesselhoeft III, M.D., director of family medicine at Tufts University School of Medicine in Boston. (For other ways to cope with anxiety, see page 21.)
Relieve a migraine. When over-the-counter remedies like aspirin, acetaminophen or ibuprofen don't ease the pain, your doctor can prescribe medicines to ease migraines and prevent further attacks, says John C. Rogers, M.D., M.P.H., vice chairman of the Department of Family Medicine at Baylor College of Medicine in Houston.
Evaluate your estrogen. If you think hot flashes may be causing those clammy sweats, ask your doctor what treatments may be appropriate, says David Losh, M.D., associate professor of family practice at the University of Washington School of Medicine in Seattle. Hormone replacement therapy is one possible option. (For other coping techniques, see Hot Flashes on page 264.)