Menopause night sweats keep me awake. How can I cope?

Night sweats that wake you up around menopause are common. The main reason is that changing hormones unsettle the way your body controls its temperature. What you can do yourself is keep the bedroom cool with a fan and light bedding, keep cold water by the bed, avoid spicy food, coffee, hot drinks, alcohol and smoking, and exercise regularly. If night sweats disrupt your daily life, or come with fever or weight loss you can't explain, see a doctor.

Cleveland Clinic says as many as 3 in 4 people have hot flashes in the years leading up to menopause, and when they happen at night they are called night sweats. In Thailand, where nights stay hot and humid and many homes rely on a fan rather than running air conditioning all night, they can make it especially hard to get back to sleep.

Why do hot flushes and night sweats happen around menopause?

The NHS describes a hot flush as your face, neck and chest suddenly feeling very hot. It can make you sweat a lot, feel your heart pounding, or feel dizzy, and some people feel cold afterwards.

Changing hormones and your body's thermostat

The NIA explains that during the menopausal transition the ovaries work less, and hormones such as estrogen and progesterone fall over time. These changes are believed to cause hot flashes. Cleveland Clinic says that when estrogen drops, your body's temperature control can be thrown off, so you suddenly feel hot and start sweating. Stress, some medicines and your surroundings can also affect how often and how strongly they come.

Hot because you woke, or awake because you are hot?

The NIA notes that recent research suggests waking from sleep may itself trigger a hot flash, not only the other way round. That is why it helps to look after both the heat in your bedroom and your sleep habits at the same time.

When do they start, and how long do they last?

So experiences differ widely, from a few mild flushes to soaking your nightwear. The NIA suggests noting when they happen, what you did beforehand and how much they bother you, to help decide what to change first.

What kind of bedroom helps in Thailand's heat?

The NHS recommends keeping your bedroom cool at night. The NIA suggests lowering the bedroom temperature, layering your bedding so it can be adjusted, and turning on a fan.

If you don't run air conditioning all night

• Point a fan at the bed and open a window for airflow if you can.
• Close the curtains from the afternoon so the room doesn't store up the day's heat.
• If you can run air conditioning for part of the night, time it for before bed and the small hours, when you are most likely to wake.
• Cleveland Clinic lists hot weather and warm rooms as a trigger, so a cooler room removes one of them.

Clothing and bedding

If you share a bed with someone who likes a thick blanket, try separate covers so each of you can choose your own weight.

Things to keep by the bed

• A glass of cold water. The NIA also suggests sipping a little cold water before bed.
• A cool, damp cloth. Cleveland Clinic suggests keeping cool compresses ready for hot flashes.
• A spare top and a small towel.
• A small fan. The NIA suggests a portable fan for when a hot flash strikes.

What tends to set off hot flushes?

The NHS, the NIA and Cleveland Clinic list similar triggers, and many are part of everyday life in Thailand.

Triggers differ from person to person. Noting which nights you sweat most and what you ate or did that day can show what to cut back first. Some people find a late spicy curry or a few beers with friends is often followed by waking up soaked.

The NIA also says alcohol won't help you sleep: even small amounts make it harder to stay asleep. It recommends avoiding caffeine, found in coffee, tea and chocolate, late in the day.

I woke up soaked in sweat. What should I do next?

The NIA says hot flashes, especially night sweats, can contribute to poor sleep. The aim is to cool down first and then settle back to sleep.

Cool down first

1. Turn on the fan or point it at yourself.
2. Sip the cold water by your bed. The NHS lists a cold drink as something that can help during a hot flush.
3. Wipe your face, neck and arms with a cool cloth.
4. If you are very sweaty, take a quick cool shower, which the NHS also suggests.
5. Change out of damp clothes and pull off a layer of bedding.

Get back to sleep without waking yourself up more

• Keep the light dim and use only as much as you need.
• Leave your phone alone. The NIA says light from phones and computers can make it harder to fall asleep.
• Try not to keep checking the clock. Counting how many hours are left tends to make you more anxious.

If you have cooled down but your mind won't settle, see Can't sleep because your mind won't stop thinking?

What can I do during the day to sleep better at night?

The NIA suggests trying lifestyle changes first, and the NHS gives similar advice.

Exercise regularly

Cleveland Clinic suggests exercising for at least 20 minutes on most days, ideally somewhere cool. In Thailand that points to early morning or after the sun has softened, such as a brisk walk in the park. The NIA suggests exercising at regular times but not close to bedtime, and the NHS recommends including weight-bearing exercise to build strength.

Keep to a healthy weight

The NIA says women who are overweight may have more frequent and stronger hot flashes. The NHS and Cleveland Clinic also recommend keeping to a healthy weight, with a varied, balanced diet.

Manage stress with breathing and relaxation

Cleveland Clinic suggests managing stress with breathing exercises, yoga or meditation, and the NHS mentions yoga, tai chi and meditation. Try a few minutes of slow, deep breathing before bed, or when you feel the heat starting to build.

Keep regular sleep times

For more sleep habits, see Want to sleep better? Which habits can you change?

Before starting any product or medicine, the NHS and the NIA advise talking to a doctor first, especially if you take regular medicines.

When should I see a doctor?

The NHS says night sweats don't usually need treatment, but a doctor will want to check whether you have any other symptoms. See a doctor if:

• night sweats regularly wake you up or worry you (NHS)
• you also have a very high temperature, feel hot and shivery, or have a cough or diarrhoea (NHS)
• your weight drops for no reason (NHS)
• you have a pounding heart, or your periods change a lot (NHS)
• hot flashes interfere with your life, for example you are too tired to work (Cleveland Clinic)
• you have hot flashes but are not near menopause, which may have another cause (Cleveland Clinic)

The NHS also notes that some medicines can cause night sweats. If they started after a new medicine, don't stop it on your own. Talk to the doctor or pharmacist who gave it to you.

Note these down before your appointment

• how often night sweats happen, how many nights a week and how many times a night
• whether you can get back to sleep, and how sleepy or tired you feel in the day
• the date of your last period and how your recent cycles have been
• whether you have fever, weight changes or any other symptoms
• all the medicines and supplements you take

If night sweats affect your daily life, talk to a doctor. Don't start any medicine on your own.