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Written by Emily McVicker Dietetic Intern, Reviewed by Shena Jaramillo, MS, RD
Eating disorders often trigger a mix of hormonal and metabolic changes. Changes in the body associated with malnutrition can result in night sweats.
You will know you are experiencing night sweats if:
- You wake up with damp bedding
- Your sleep is interrupted because you feel too hot
- You have to change your sleeping location as a result of sweating
- You require cold temperatures for sleeping
The good news is that night sweats are a sign you’re working through recovery! While this can be reassuring, it can also be scary to experience the physical effects of recovery you may not have been warned about, and feel embarrassed to talk about.
Night sweats are a common symptom people in eating disorder recovery experience, and does not mean there is something wrong with you. Let’s break night sweats down and understand why they happen and what you can do to make this symptom of eating disorder recovery easier to manage.
What are Night Sweats
Night sweats refer to excessive sweating during sleep, often leading to soaked bedclothes and disturbed rest.
Medical conditions that may cause night sweats include:
- Hypermetabolism
- Heart disease
- Depression
- Cancers
- Autoimmune disorders
- Infections
- Excessive alcohol consumption
While commonly associated with other medical conditions, night sweats can also be experienced by those with anorexia during the recovery process. It is also important to consider that an eating disorder can cause shifts in the body that mimic the chronic conditions listed above.
Night Sweats Caused by Anorexia
Anorexia nervosa is an eating disorder characterized by distorted body image, severe food restrictions and fear of gaining weight. During recovery, hypermetabolism can occur.
When your body is learning to use this new energy intake, it can cause the energy you are feeding yourself to quickly turn into heat instead of directly into building new tissues. This is called an increased thermic effect of food.
Increased thermic effect of food can be higher during night time when the body is usually at a lower temperature. The results of these metabolic changes can lead to night sweats.
Anorexia causes night sweats because of both hormonal and metabolic changes in the body.
Metabolic Changes Leading To Night Sweats
Changes in the metabolism can lead to excessive sweating at night.
- Calorie restriction can change the way the body metabolizes food.
- The body might enter a state of conservation trying to save energy by altering its thermoregulation resulting in night sweats
- Shifts in gut microbiome can delay the digestive processes leading to night sweats
- Decreased gut motility resulting from muscles not being used causes prolonged digestion interrupting sleep
- Inflammation resulting from the eating disorder alters absorption and digestive processes
- Decreased enzyme production to slow down metabolism
Hormonal Changes Leading To Night Sweats
Hormonal Imbalances that occur during anorexia disrupt hormonal balance, affecting the hypothalamus and pituitary gland in the brain, which both regulate various hormones throughout the body. These changes can impact the body’s ability to regulate temperature and contribute to night sweats.
Stress and Anxiety increases will also result in changes in hormone levels which can lead to night sweats in eating disorders.
Hormonal changes in the body that contribute to night sweats include:
- Shifts in parathyroid hormone which impact thyroid function and can lead to night sweats
- Increases in cortisol (a hormone often associated with stress)
- Decreased estrogen levels (causing shifts in body temperature)
- Changes in progesterone levels (causing shifts in body temperature)
Women who have not gotten their period back from an eating disorder are more likely to experience night sweats. When a woman does not have a period, symptoms often mimic those of a post-menopausal woman.
Physical Changes Leading To Night Sweats
Some physical changes in the body that can be correlated with night sweats include:
- Decreased brain size
- Structural changes in the heart leading to difficulty regulating blood pressure
- Decreased bone mineral density causes calcium shifts and changes in thyroid and heart function
Anatomical changes in the brain, the bones, the digestive tract, and the heart can influence digestion, absorption, and ultimately body temperature.
Symptoms of night sweats
Night sweats during anorexia can look different for each person. Night sweats in recovery are common and normal and can vary from a slight drip of sweat to having to change bed sheets completely covered in sweat.
Some events that may occur are:
- You’ll wake up multiple times throughout the night,
- You feel a rush of heat going to your head and your skin is red
- The sweat can cause your clothes to be damp
- Sometimes sweating will get onto your sheets, pillows, and blankets, making them feel damp
- This can happen daily or weekly and will resolve after a few months after hypermetabolism has decreased
Treatment for Night Sweats In Eating Disorders
To figure out what is causing the night sweats, first talk with a healthcare provider and/or the professional you see for recovery treatment. If the cause of your night sweats is due to the recovery process, eating less is not the solution. This can cause your recovery timeline to take many steps backward and fall back into the eating disorder mindset.
Continue to focus on your path in recovery and eating according to your meal plan set by you and your healthcare provider. While night sweats may be unavoidable, here are a few things you can do to encourage your body to sweat less at night:
- Avoid caffeine and alcohol
- Use cooling fabrics for your sheets and pillowcases such as cotton or linen
- Wear loose-fitting, lightweight breathable pajamas
- Rotate having sheets stored in the freezer an hour before bedtime
- Focus on eating less spicy foods
- Keep a fan next to your bed to blow on you throughout the night
- Keep cold water near you to drink
- Include complex carbohydrates and foods with fiber such as whole grains, fruits and vegetables in your dinner and evening snack
- Try to eat 2-3 hours before bedtime
Coping with night sweats
Recovering from anorexia can be difficult both mentally and physically. When learning to have a positive relationship with food and yourself, having night sweats can make it even harder and be discouraging.
Some things that can help you cope emotionally with night sweats include:
- Journaling about emotional challenges
- Finding an eating disorder support group
- Keeping a list of positive mantras that will help you in recovery
- Follow the recovery journeys of others for inspiration, but know everyone’s journey is unique
- Practice nurturing your body daily
Know that this is a temporary symptom that shows you are moving one step forward in recovery. Focus on finding ways to keep yourself cool during these couple of days to weeks, and have someone you can talk to about the struggles of recovery such as a therapist, close friend or family member.
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