Wednesday, January 21, 2015

Does nocturnal sweating suggest sleep apnea?

Does nocturnal sweating suggest sleep apnea?

This was the question of
today about sweating in sleep...

In clinical context, nocturnal sweating can be a  sensitive sign of sleep apnea.  But, its not specific.

Sweating often improves with OSA treatment.



 1993 Aug;16(5):409-13.

Clinical symptoms associated with brief obstructive sleep apnea in normal infants.


Relatively little data exist concerning the manifestations of repeated obstructive sleep apnea in normal infants. A questionnaire concerning daytime and sleep habits was completed by the parents of 4,100 healthy infants before they underwent a 9-hour night monitoring study. One hundred infants with an obstructive apnea index above 1.2 were randomly selected. They formed the "apnea" group. From the initial population, 300 infants with noapnea were also selected to form the "no-apnea" group. Both groups were matched for sex, gestational age, post conceptional age, birth weight, mother's age, parity and a family history of sudden infant death. Five variables from the questionnaires significantly differentiated the two groups of infants. When awake, the infants with apnea were characterized by a greater frequency of breathholding spells (22% of apnea infants) and episodes of fatigue during feeding (28%) than the non-apnea infants. During sleep, they exhibited a greater frequency of profuse sweating (15%), snoring (26%) or noisy breathing (44%). Multiple symptoms were present in some infants. A stepwise logistic regression resulted in two significant independent variables: profuse sweating during sleep (p = 0.008) and noisy breathing (p = 0.002). The predictive value of these two symptoms was tested on a new group of 650 healthy infants. The two independent variables led to the correct classification of 60 of the 67 infants with apnea (89.67%) and 382 of the 583 non-apnea infants (65.5%). A positive history alone had a positive predictive value of 0.21.(ABSTRACT TRUNCATED AT 250 WORDS)
[PubMed - indexed for MEDLINE]


 2012 May;97(5):470-3. doi: 10.1136/adc.2010.199638. Epub 2011 Mar 22.

Night sweats in children: prevalence and associated factors.



The authors aimed to examine the prevalence and factors associated with night sweats (NS) in primary school children.


Cross-sectional design.


Among 6381 children (median age 9.2 (7.7-10.7) years) with complete information on NS, 3225 were boys (50.5%). 747 children (11.7%) were reported to have weekly NS in the past 12 months. Boys were more likely than girls to have NS (p<0 .0001="" children="" class="highlight" have="" likely="" more="" nbsp="" ns="" span="" to="" were="" with="">sleep
-related symptoms and respiratory and atopic diseases. In addition, they were more likely to be hyperactive and have frequent temper outbursts. Using an ordinal regression model, NS was found to be significantly associated with male gender, younger age, allergic rhinitis, tonsillitis and symptoms suggestive of obstructive sleep apnoea, insomnia and parasomnia.


NS is prevalent among school-aged children and is associated with the presence of sleep-related symptoms and respiratory and atopic diseases.

  • Respiratory medicine

Nocturnal sweating—a common symptom of obstructive sleep apnoea: the Icelandic sleep apnoea cohort

  1. Thorarinn Gislason1,2
+Author Affiliations
  1. 1Department of Respiratory Medicine and Sleep, Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
  2. 2Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
  3. 3Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala Universitet, Uppsala, Sweden
  4. 4Department of Otolaryngology, Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
  5. 5Division of Sleep Medicine/Department of Medicine, Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  6. 6Department of Medicine, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
  1. Correspondence toDr Thorarinn Gislason;
  • Received 26 February 2013
  • Accepted 10 April 2013
  • Published 14 May 2013


Objectives To estimate the prevalence and characteristics of frequent nocturnal sweating in obstructive sleep apnoea (OSA) patients compared with the general population and evaluate the possible changes with positive airway pressure (PAP) treatment. Nocturnal sweating can be very bothersome to the patient and bed partner.
Design Case–control and longitudinal cohort study.
Setting Landspitali—The National University Hospital, Iceland.
Participants The Icelandic Sleep Apnea Cohort consisted of 822 untreated patients with OSA, referred for treatment with PAP. Of these, 700 patients were also assessed at a 2-year follow-up. The control group consisted of 703 randomly selected subjects from the general population.
Intervention PAP therapy in the OSA cohort.
Main outcome measures Subjective reporting of nocturnal sweating on a frequency scale of 1–5: (1) never or very seldom, (2) less than once a week, (3) once to twice a week, (4) 3–5 times a week and (5) every night or almost every night. Full PAP treatment was defined objectively as the use for ≥4 h/day and ≥5 days/week.
Results Frequent nocturnal sweating (≥3× a week) was reported by 30.6% of male and 33.3% of female OSA patients compared with 9.3% of men and 12.4% of women in the general population (p<0 .001="" 11.5="" 33.2="" adjustment="" after="" age="" and="" cardiovascular="" change="" compared="" decreased="" demographic="" difference="" disease="" factors.="" for="" frequent="" from="" full="" hypertension="" in="" insomnia="" nocturnal="" non-users="" of="" p="" pap="" prevalence="" related="" remained="" significant="" sleepiness="" sweating="" symptoms.="" the="" this="" to="" treatment="" was="" with="" younger="">
Conclusions The prevalence of frequent nocturnal sweating was threefold higher in untreated OSA patients than in the general population and decreased to general population levels with successful PAP therapy. Practitioners should consider the possibility of OSA in their patients who complain of nocturnal sweating.

Article summary

Article focus

  • Previous studies have suggested a possible relationship between obstructive sleep apnoea and frequent nocturnal sweating. However until now, studies comparing the prevalence of frequent nocturnal sweating in untreated sleep apnoea patients compared with the general population as well as changes with sleep apnoea treatment have been lacking. Our study focuses on the role of nocturnal sweating in sleep apnoea.

Key messages

  • Our study indicates a possible role of frequent nocturnal sweating as a marker for untreated sleep apnoea. One-third of adults with sleep apnoea experience this symptom and they are three times more likely to report it compared with adults in the general population. The symptom is responsive to treatment in the majority of sleep apnoea patients.
  • Clinicians should include sleep apnoea in the differential diagnosis of patients presenting with a complaint of nocturnal sweating and further investigate that possibility.

Strengths and limitations of this study

  • The strengths of this study include the detailed assessment of a large number of sleep apnea patients studied with a two year follow-up and the comparison with a general population cohort.
  • Our study was an observational study, not a randomised controlled trial, which may be considered a limitation. Other limitations include the use of subjective measures of sweating and the smaller number of women with sleep apnea than men, due to lower prevalence.

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