Can Hydroxychloroquine Cause Night Sweats? 7 Possible Reasons for Night Sweats | MyLupusTeam

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Can Hydroxychloroquine Cause Night Sweats? 7 Possible Reasons for Night Sweats

Medically reviewed by Florentina Negoi, M.D.
Posted on July 25, 2023

Night sweats are a common symptom that MyLupusTeam members discuss. One member shared, “I have night sweats that seem like someone poured water on me. I wake up freezing cold.” Night sweats can have a big impact on your sleep, as another member lamented, “This awful sweating is robbing me of sleep.”

Even though night sweats are a common complaint, it can be hard to find the cause. If you’re taking hydroxychloroquine (Plaquenil) to treat lupus — including systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE) — you may wonder if this medication could be causing your night sweats.

What Are Night Sweats?

Night sweats are episodes of excessive sweating during sleep that can soak your clothes and bedding.

Night sweats are more than just sweating at night. While sweating is a normal part of your body temperature regulation, night sweats can happen even when you aren’t hot. If you sweat at night because you’re too hot or have too many blankets, it’s not the same as night sweats.

Does Hydroxychloroquine Cause Night Sweats?

Hydroxychloroquine is an antimalarial drug commonly used to treat lupus. More than 47,000 MyLupusTeam members report taking hydroxychloroquine. Several of them have reported that they experience night sweats while taking hydroxychloroquine. One member said, “I take hydroxychloroquine, and I still have excessive sweating and hot flashes, where I am constantly asking others if it is warm in the room.”

Another member agreed, commenting, “I’ve been on hydroxychloroquine for years and have sweating issues.”

Although several members report experiencing night sweats while taking hydroxychloroquine, it isn’t a common side effect of this drug. Continue reading to learn how lupus and the medications used to treat it might contribute to your night sweats.

7 Possible Reasons for Night Sweats With Lupus

Several factors related to lupus and lupus treatment can contribute to night sweats. Additionally, other conditions and factors unrelated to lupus may cause the symptom as well.

1. Lupus Disease Activity

If you take hydroxychloroquine to treat lupus, you may be experiencing night sweats as a symptom of lupus. Night sweats are a known symptom of autoimmune diseases like lupus.

Lupus may affect sweating if it causes inflammation that damages your autonomic nervous system. This system controls processes in your body that you don’t consciously think about, like sweating, breathing, heart rate, and blood pressure.

A MyLupusTeam member shared, “I had issues with night sweats as one of my first symptoms of SLE. I was soaking through three sets of pajamas a night three times a week! After I was diagnosed and put on meds, I still got them, but not as often.”

2. Medication Side Effects

Although you won’t find night sweats on the side effect list for hydroxychloroquine, cold sweats are a side effect of another antimalarial medication called chloroquine (Aralen).

Night sweats are a known side effect of other medications used to treat lupus, including:

  • Corticosteroids such as prednisone and methylprednisolone
  • Methotrexate
  • Pain medications such as acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin)

Other medications that can cause night sweats include:

  • Hormonal medications
  • Antidepressants
  • High blood pressure medications
  • Diabetes medications

3. Anxiety

Anxiety is a possible cause of night sweats. Anxiety is common in people with lupus. About 37 percent of people living with lupus experience anxiety.

You may have an increased risk of anxiety or depression if you take hydroxychloroquine. Some MyLupusTeam members report nightmares while taking this medication, which may result in short-term anxiety.

A MyLupusTeam member shared, “I have bad nightmares on hydroxychloroquine. I started on that medication many years ago but eventually stopped it due to experiencing nightmares every night. It would be so bad that I’d wake up in a panic and my heart feeling like it was beating out of my chest.”

Nightmares are a known side effect of hydroxychloroquine, though it’s unclear how common they are.

4. Hormonal Changes

Among the most common causes of night sweats are the hormonal changes that happen during the menstrual cycle, pregnancy, and menopause. A MyLupusTeam member shared, “I also started having hot flashes shortly after starting hydroxychloroquine. I am 47 and thought I might be starting menopause.”

5. Low Blood Sugar

If your glucose (blood sugar) levels get too low at night — known as nocturnal hypoglycemia — it could cause night sweats. This condition usually only affects people with diabetes who use insulin.

A MyLupusTeam member shared, “If my sugar levels are low at night, I do sweat more.”

Hydroxychloroquine can cause low blood sugar in some people, even if you don’t have diabetes. Talk to your doctor right away if you’re experiencing night sweats along with other signs of low blood sugar, such as:

  • Extreme hunger
  • Shaking
  • Confusion
  • Increased heart rate
  • Light-headedness

Corticosteroids, another common lupus treatment, also can affect your blood sugar levels — but by increasing them, not lowering them. If you’re living with diabetes, talk to your doctor if you start or stop your corticoid treatment, as you may need adjustments in your diabetes treatment.

6. Infections

You might also experience night sweats if your body is fighting off an infection. It can happen with common viral infections like a cold or the flu or more serious bacterial infections like tuberculosis.

You may have an increased risk of infection due to lupus or immunosuppressant drugs used to treat lupus. Although hydroxychloroquine isn’t considered an immunosuppressant, it can still make you more likely to get an infection. This is because it can decrease the number of white blood cells in your body, which normally help protect you from infection.

7. Other Health Conditions

Night sweats can be caused by a number of different conditions that might not be related to lupus, such as:

  • Thyroid disease
  • Some types of cancer
  • Sleep disorders
  • Stroke
  • Gastroesophageal reflux disease (GERD) — A condition in which stomach acid flows back in your esophagus, which connects your stomach and mouth
  • Hyperhidrosis (increased sweating)

When Should You See a Doctor for Night Sweats?

Make sure you talk to a health care provider right away if you’re regularly experiencing night sweats, especially if you also have any of the following symptoms:

  • Unexplained weight loss
  • Fever
  • Diarrhea
  • Unexplained pain

Managing Night Sweats

If you think that any of your medications are causing night sweats that affect your quality of life, talk to your doctor or rheumatologist right away.

MyLupusTeam members have shared ways they’ve coped with night sweats. One member recommended, “I try to always keep ice water nearby. This seems to help me.”

Another member commented, “It has become routine to have several sets of nightclothes and bed pads to change throughout the night.”

Waterproof pillow covers are another popular suggestion, with one member sharing, “I used to wash my pillows every other day. These pillow protectors were a great investment for me. I also sleep on a beach towel at night.”

Other tips for managing night sweats include:

  • Wearing pajamas made of cotton or linen
  • Using lightweight bedding
  • Lowering the temperature of your bedroom with a fan or air conditioning
  • Keeping a cold pack under your pillow
  • Avoiding other sweat triggers before bed, such as spicy food, alcohol, caffeine, and smoking
  • Exercising daily, but not right before bed

Talk With Others Who Understand

On MyLupusTeam — the social network for people with lupus and their loved ones — more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you get night sweats? What have you tried that helps your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on July 25, 2023
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    Florentina Negoi, M.D. attended the Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and is currently enrolled in a rheumatology training program at St. Mary Clinical Hospital. Learn more about her here.
    Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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