Many people with inflammatory bowel disease (IBD) experience night sweats. These tend to happen consistently, but may also be intermittent. Night sweats may occur more frequently during a disease flare-up when switching medications, or changing the dosage of an existing medication.
Adequate sleep helps regulate the immune system and potentially reduce inflammation. Chronic sleep disturbances may affect the quality of life of people with IBD by worsening their symptoms and increasing stress. However, there are several ways to help manage night sweats and improve sleep quality.
Causes
It may be difficult to pinpoint the exact cause of IBD night sweats. However, some causes may include:
- Inflammation: May cause changes in body temperature
- Medications: May cause a fever, leading to chills and sweating
- Infection: Causes fever (e.g., perianal disease)
- Comorbid conditions (other conditions that occur with IBD): Anxiety and migraines
A fever is one of the many symptoms of an IBD flare-up. Chronic gastrointestinal inflammation can affect body temperature, causing night sweats. A fever may spike several times over the night, causing your body temperature to rise and fall.
Certain IBD medications may cause a fever as one of their side effects. These include:
- Sulfasalazine (Azulfidine)
- 6-mercaptopurine (Purinethol)
- Infliximab (Remicade)
- Azathioprine (Imuran)
Switching medication or adjusting to a new medication may cause night sweats.
You may also experience night sweats if you have an infection, such as perianal disease, which affects 17% to 43% of people with Crohn's disease.
If you are experiencing night sweats, consult with your healthcare provider. They can help by adjusting medication or providing new treatments, as needed.
Additional Symptoms
You may notice additional symptoms that occur with night sweats. Some of these may include:
- Fever/chills
- Diarrhea
- Pain
- Skin rash
How Common Are Night Sweats?
Night sweats are slightly more common in Crohn's disease than in ulcerative colitis. A year-long survey of 704 people with IBD found that 24% of those with Crohn's disease experienced fever or night sweats in any three months, vs. 15% of those with ulcerative colitis.
Sleep and IBD
Sleep is intimately connected to the disease course of IBD. While this is a topic that is still being studied, it's accepted that people who have IBD need quality sleep to help keep their symptoms in check.
A 2018 study found that sleep disturbances are related to disease activity. Overall, 70% of participants with IBD said they had poor sleep quality, and it was more prevalent in those with symptoms (78%) vs. those in remission (35%). However, the researchers concluded that more evidence is needed to confirm that sleep disturbances are a risk factor for IBD.
Some older studies have shown that disturbances in sleep can be the first sign of a flare-up. Waking in the night, being unable to fall asleep, or insomnia may start before other hallmark symptoms, such as diarrhea, occur.
Poor sleep quality may also be associated with clinical relapse. One study found that participants with IBD who self-reported poor sleep quality during remission had a higher likelihood of a clinical relapse within six months.
Using a sleep tracker may help measure your sleep and its quality, including how many times you are awake during the night. Even if you are feeling well, discuss sleep disturbances with your healthcare provider before the situation worsens and potentially affects your symptoms.
Tips for Managing Night Sweats
Temperature changes from gastrointestinal inflammation can be unpredictable and frustrating to manage.
The best way to deal with night sweats is to be prepared for them. Minimizing discomfort and getting back to sleep as quickly as possible is key.
Some tips for dealing with night sweats include:
- Stay in the dark: Don't turn too many lights on when you get up as this will only wake you up further. Adjusting the lighting in the bedroom and the bathroom to minimize bright light will help you to fall back asleep faster.
- Change it up: Have a change of clothes and bedding close at hand so you can dry off and get back to bed as quickly as possible. Keep three sets of bedding so there's one on the bed, one clean, and one being laundered.
- Plan: Keep some cold water by your bedside to help cool you off when you wake up.
- Stack 'em up: Try sleeping on thick towels or an extra blanket to avoid getting your bedding wet. If the towel or blanket becomes saturated, you can remove them and your bedding underneath will still be cool and dry.
- Keep it clean: Use a mattress protector under your sheets to keep your mattress clean and dry.
- Cool it: A cooling mattress, sheets, and pillows may help, as well as choosing breathable materials like bamboo and cotton.
- Fresh air: Air circulating in the room with a ceiling fan, a window fan, or even an open window may help keep the room from feeling stuffy and too warm.
Maintaining a regular sleep schedule—waking up and going to bed at the same time daily may help improve your sleep quality.
If your night sweats persist or worsen, consult your healthcare provider.
Summary
People with IBD are especially prone to poor sleep quality, which is associated with the risk of worsening symptoms (flares) and may negatively affect the quality of life. Night sweats can further impact sleep quality, modify disease-coping abilities, and increase stress.
Adjusting your sleeping environment and having a plan may help alleviate night sweats. However, discussing sleep with your healthcare provider is an important aspect of IBD that should be managed.