Understanding Why Hot Flushes Occur Predominantly at Night

Hormonal Changes and Their Impact

Key Point: One of the primary reasons for experiencing hot flushes and night sweats is the fluctuation in hormone levels during the menopause transition, in particular the hormone oestrogen. Hot flushes and night sweats are known as vasomotor symptoms. You may feel an intense heat spread over your body and become flushed and red. In addition, you may become sweaty or drenched in sweat. They can vary in severity, frequency and duration, so for some women they happen regularly while others only experience the odd one here and there. They generally last for a few minutes, sometimes shorter and sometimes longer. Some women experience them during the day, some just at night and some experience both. Night sweats can occur with or without daytime flushing.

Body Temperature Regulation During Sleep

The regulation of body temperature during sleep is intrinsically linked to our circadian rhythm, which is like an internal clock that dictates our physical, mental, and behavioural changes throughout a 24-hour cycle. As part of this natural cycle, the body’s temperature tends to decrease during the night. There are a number of factors which influence body temperature, one being release of melatonin, a hormone that signals to our bodies that it’s time to rest.

However, during menopause, there is a significant disruption in the body’s hormonal equilibrium. This can lead to difficulties in maintaining stable body temperature, a condition known as thermoregulatory instability. As a result, many experience hot flushes in the cooler hours of the night, which can significantly impact sleep quality.

Lifestyle Factors That Trigger Nighttime Hot Flushes

Many individuals experience hot flushes and or sweats during the night, and certain lifestyle choices can significantly exacerbate these symptoms. Understanding and modifying these factors may help reduce the frequency and intensity of nighttime hot flushes.

• Dietary Choices: Consuming certain types of food and beverages in the evening can lead to an increase in body temperature, which may trigger hot flushes. Spicy foods are particularly notorious for this. Additionally, caffeinated drinks consumed close to bedtime can not only increase body temperature but also disrupt sleep patterns, thereby worsening hot flushes.
• Alcohol Consumption: Alcohol has a profound impact on the body, particularly on the central nervous system and the body’s ability to regulate temperature. Drinking alcohol can dilate blood vessels and increase the likelihood of experiencing hot flushes during the night.
• Smoking: Stopping smoking can help as smoking can make hot flushes and night sweats worse. The NHS is a great place to start if you need help quitting.
• Stress and Anxiety: Emotional stress and anxiety can disrupt one’s sleep and exacerbate the severity of hot flushes. The body’s response to stress can increase core body temperature and heart rate, making it difficult to stay cool during the night.

By addressing these lifestyle factors, individuals may find some relief from the discomfort of nighttime hot flushes, leading to better sleep quality and overall well-being.

Impact on Sleep Quality

Experiencing hot flushes during the night can significantly impair one’s ability to get a good night’s rest. These sudden and intense feelings of heat can lead to multiple awakenings throughout the night, making it challenging to fall back asleep. As a result, individuals may suffer from sleep deprivation, which in turn can adversely affect their functioning during the day. The frequent interruptions in sleep patterns can have a profound impact on overall health and well-being, as a lack of restful sleep is linked to various health issues. It is helpful to understand and address these sleep disturbances to maintain optimal health and quality of life.

Management and Treatment Options

Key Point: While lifestyle adjustments can help manage symptoms, medical treatments are often recommended for persistent hot flushes. These may include:

• HRT (hormone replacement therapy) is an oestrogen replacement is the most effective treatment for vasomotor symptoms for most women who take it. The correct dose and how long you should take it for will depend on your symptoms.
• Non-hormonal medications, such as certain antidepressants, antihypertensive medication clonidine, and anti-seizure drugs, have been found to be effective in some cases.
• Veoza is a new, non-hormonal medication that is designed to help manage moderate to severe vasomotor symptoms (hot flushes and night sweats) that occur as a result of the menopause.
• Herbal remedies can help some women. If you’re considering this route, we recommend looking for the THR mark, which stands for Traditional Herbal Registration. Registration to this scheme means that there is a guarantee that the goods bearing the mark meet certain defined standards or possess particular characteristics, as defined by the owner of the mark.
• Relaxation techniques such as yoga, relaxation breathing, meditation or anything else that helps you slow down. There are lots of great videos and apps out there that can help.
• There’s good evidence that cognitive behavioural therapy (CBT) can help decrease the severity and frequency of hot flushes. It can be a good alternative if you have been advised not to take HRT.

What next?

As always, see your GP if you are concerned about hot flushes or night sweats. You can also book an appointment with our specialist menopause clinic.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.