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Q: In the last three months, my husband has started sweating profusely when he is asleep. His sweat has a strong cheesy smell and I can no longer tolerate it. His hygiene is perfect. He is in his fifties. I'm afraid this could be a sign of something serious. What can it be?

A: Night sweats are very common and most often the cause is not serious. The cheesy smell also is not unusual. Some Swiss researchers actually studied the smell of sweat in men and women. Sweaty men tended to smell like cheese, while sweaty women smelled like onions or grapefruit.

When a patient comes to me with new night sweats, I start by asking about the temperature of the bedroom and number and type of blankets. Assuming that this is not the issue, I would next want to know if your husband is having fevers during the day, and if he has been losing weight without trying. If he hasn't already checked his temperature several times over a couple days, he should.

If he is experiencing fever or weight loss, then the cause could be serious. He could have an infection, a non-infectious inflammatory disorder, or cancer.

If he feels well during the day and has no fever or weight loss, then a serious cause is less likely. But some important possibilities should be considered:

  • Sleep apnea—especially if he snores, is sleepy during the day, or both

  • Anxiety

  • A side effect of a medication. He should review any medications, herbs, or supplements he takes with a pharmacist

  • Low blood sugar (though this is not likely unless he has diabetes)

  • An overactive thyroid (hyperthyroidism). Usually there would be additional symptoms, such as weight loss despite a good appetite, rapid heart beat, sweating during the day, and feeling jittery.

  • Other rare hormonal disorders

He should see a medical professional to discuss his night sweats. In the meantime, here are some things he can try to decrease the sweats:

  • Keep the bedroom cool, and open a window

  • Avoid spicy food, especially at night

  • Avoid alcohol for a while

  • Get up, towel off, and change bedclothes and sheets immediately as needed

Quite often, no specific cause for night sweats is discovered. In these cases, the sweats usually go away on their own.

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Howard LeWine, M.D. is a clinical instructor of medicine at Harvard Medical School and practicing internist with Harvard Vanguard Medical Associates and Brigham and Women’s Hospital in Boston, Massachusetts. He serves as Chief Medical Editor of Internet Publishing at Harvard Health Publications.

Copyright © 2009 by the Presidents and Fellows of Harvard College. Used with permission of StayWell. All rights reserved. Harvard Medical School does not approve or endorse any products on the page. Harvard is the sole creator of its editorial content, and advertisers are not allowed to influence the language or images Harvard uses.

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