What causes cold sweats? Related conditions and treatments

Overview: What do cold sweats feel like?

Unlike normal sweating, cold sweats are the feeling of being chilled or shivering while sweaty at the same time. It’s sometimes described as feeling “clammy.” Many people with cold sweats experience them at night while sleeping and describe waking up drenched in sweat and freezing cold. Cold sweats are a strange and uncomfortable feeling that can interrupt sleep and daily activities, yet the causes of cold sweats are treatable.

People can feel cold sweats anywhere on the body and, depending on the cause, may experience other symptoms simultaneously, like nervousness, fever, or exhaustion. 

There are many causes of cold sweats, including menopause, stress and anxiety, panic attacks, fever or infection, sepsis, low blood sugar (hypoglycemia), hyperhidrosis, night sweats, heat exhaustion or heatstroke, hormone disorders or hormone changes, alcohol or drug use, and some medications. A fever breaking can also cause cold sweats. 

There are more serious medical conditions that cause cold sweats, including heart attack, some types of cancer, and Crisponi syndrome. One rare cause of cold sweats is cold-induced hyperhidrosis, sometimes called cold-induced sweating syndrome. 

Some medications are known to cause night sweats, which can lead to cold sweats. For instance, antidepressants and steroids like prednisone may cause one to sweat while sleeping and then wake up feeling chilly or cold.

What causes cold sweats?

There are many underlying conditions, plus some behaviors and environments, that can cause cold sweats. Most of them are non-life-threatening.

Common causes of cold sweats include:

• Menopause

• Stress or anxiety

• Panic attacks

• Fever or infection

• Low blood sugar or hypoglycemia

• Hyperhidrosis, or excessive sweating, which is the result of an overactive sympathetic nervous system

• Night sweats, which can be the result of consuming alcohol, a sleeping environment that’s too warm, some medications, menopause, hyperthyroidism, mood disorders, gastroesophageal reflux disease, and obesity

• Heat exhaustion or heatstroke

• Hormone disorders or hormone changes

• Alcohol or drug use 

• Some medications, including antidepressants and some steroids like prednisone, cause sweating as a side effect (called diaphoresis) 

• Heart attack

Less common causes of cold sweats include:

• Sepsis, or septic shock, which is a life-threatening medical emergency

• Crisponi syndrome, which is a rare genetic condition typically diagnosed in infants

• Cold-induced sweating syndrome, also known as cold-induced hyperhidrosis

• Some cancers, including leukemia and lymphoma, as well as some cancer treatments 

Should I be worried about cold sweats?

Usually, the cause of cold sweats is not life-threatening. Many causes, like menopause, hormonal changes, and hyperhidrosis, are not dangerous and can be effectively treated or managed at home or under the care of a primary care provider. 

If left untreated, heart attack, sepsis, bacterial or viral infections, heatstroke, and cancers can be deadly, and low blood sugar is dangerous for those who have diabetes.

Usually, cold sweats will resolve within an hour. If the feeling persists or worsens, contact a medical provider. Seek immediate medical help at an emergency room if the following are also experienced:

• Dizziness or light-headedness 

• Confusion

• Nausea or vomiting 

• Cyanosis, which is when the skin, lips, or nails turn blue

• Crushing pain across the chest

• Racing heart

• Difficulty breathing or shortness of breath

• Arm pain

• Jaw stiffness

• Shoulder pain

If cold sweats make it difficult to sleep or interrupt normal daily activities, or if there is unexplained weight loss, seek advice from a healthcare provider. They can offer advice on possible causes and the best treatments. 

How are the causes of cold sweats diagnosed?

There are several conditions that can cause cold sweats, and only a healthcare provider can accurately diagnose them. 

To determine the cause of cold sweats, a healthcare provider may begin by asking questions about symptoms, lifestyle and habits, and health history. For example:

• When did the cold sweats start?

• How often do cold sweats occur?

• Do they happen at a specific time of day or during a specific activity?

• What other symptoms are happening? 

• What medications do you take?

• If alcohol is consumed, how much?

• Do you feel depressed or anxious??

They may also conduct a physical exam to rule out some conditions. To evaluate for infection, for instance, they may:

• Take your temperature

• Check blood pressure and heart rate

• Palpate the neck to check for swollen lymph nodes 

• Listen to the heartbeat and breathing with a stethoscope 

• Look at the throat and ears with an otoscope

• Conduct blood tests 

• Conduct rapid diagnostic tests 

A doctor may also choose to evaluate one for signs of a heart attack by:

• Conducting an electrocardiogram (EKG)

• Ordering blood tests

• Ordering heart imaging tests

• Conducting a physical exam

The provider will also consider age, sex, and family medical history when diagnosing.

To rule out the possibility of cancers, they may order lab tests and imaging, like CT scans, X-rays, ultrasounds, or MRIs.

If the provider believes the cause of cold sweats may be related to menopause or a hormonal change, they may refer patients to a gynecologist or endocrinologist. If anxiety, stress, or panic attacks are causing cold sweats, the doctor may recommend a visit to a psychotherapist or psychiatrist.

Are cold sweats contagious?

Few cold sweats causes are contagious. However, if the source of the symptoms is related to an infection, the infection itself may be contagious.

To prevent the spread of infection:

• Wash hands with soap and water

• Cover the mouth when coughing

• Stay home if you have a fever or are feeling unwell

• Keep vaccinations up to date

How long do cold sweats last?

Cold sweats or the feeling of being clammy typically lasts for an hour or less and resolves without treatment.

People who are experiencing menopause, perimenopause, or other hormone changes, and those with conditions like hyperhidrosis or anxiety disorders, may experience cold sweats regularly.

If cold sweats make it hard to sleep or interrupt normal day-to-day activities, contact a healthcare provider. 

People whose symptoms worsen or who have cold sweats that last more than an hour should seek emergency medical care. If dizziness, light-headedness, confusion, nausea, vomiting, arm or chest pain, racing heart, difficulty breathing, or jaw stiffness is experienced, or if the skin or nails turn blue, visit the nearest emergency room.

How to stop cold sweats

Cold sweat treatments depend on the source of the problem. Many common causes of cold sweats don’t require emergency medical help and can be effectively treated at home.

Home remedies 

How to get rid of cold sweats depends on the cause, but making some lifestyle adjustments can help stop them from happening.

• Reduce alcohol consumption or discontinue drug use

• Adjust the sleeping environment by wearing lighter clothes, using fewer blankets or lighter bedding, using a fan, or turning on an air conditioner

• If the cause is hypoglycemia, eat small snacks and don’t skip meals to maintain proper blood glucose levels

Medications

The doctor may recommend medication for the cause of cold sweats.

• Hyperhidrosis is typically treated with antiperspirants, Botox, and other medications, including Drysol (aluminum chloride hexahydrate), Qbrexza (glycopyrrolate), and Ditropan (oxybutynin) that can help treat the affected sweat glands.

• Anxiety can be treated with psychotherapy and medications like selective serotonin reuptake inhibitors (SSRIs), including Zoloft (sertraline), Prozac (fluoxetine), Lexapro (escitalopram), and Paxil (paroxetine).

• Sepsis and other serious infections are treated with antibiotics.

• Menopause symptoms are sometimes treated with hormone therapy or non-hormonal treatments such as Paxil (paroxetine) and Veozah (fezolinetant). 

The doctor is the best source for guidance on how to treat cold sweats. Sometimes, medications can be used to treat the underlying cause. If one suspects cold sweats may be a side effect of a medication being taken, talk to the doctor about adjusting prescriptions or dosage.

Living with cold sweats 

People with certain conditions may experience cold sweats regularly, which can be uncomfortable and disrupt daily life. The best way to manage cold sweats long-term depends on the cause, but people with recurrent episodes may find it helpful to:

• Create a cool sleeping environment with a fan or air conditioner

• Wear light-weight clothing, especially to sleep, and use breathable blankets and sheets

• Manage stress and anxiety by reducing alcohol and tobacco use and by maintaining wellness with meditation, yoga, exercise, psychotherapy, eating healthy, getting plenty of sleep

Always take medications as directed by the doctor, and consult their advice before changing medication regimens or dosage.

What’s next? Additional resources for people with cold sweats

Test and diagnostics

• Persistent night sweats: diagnostic evaluation, American Family Physician

• Causes of sweating, Cancer Research UK

• Common causes of night sweats: A guide to identification and investigation, British Medical Journal 

• Can you recognize a heart attack or stroke? What to do when every moment counts, NIH News in Health 

• Heart attack: diagnosis, National Heart, Lung, and Blood Institute 

Treatments

• Successful treatment of cold-induced sweating in Crisponi syndrome and its possible mechanism of action, Developmental Medicine & Child Neurology 

• Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention, World Journal of Diabetes 

• Why you should seek care from a menopause specialist, Duke Health 

• Menopause treatments and medications, Singlecare 

• Anxiety treatments and medications, Singlecare

• Sepsis treatments and medications, Singlecare 

• Hyperhidrosis treatments and medications, Singlecare 

• Cancer treatment: dealing with hot flashes and night sweats, MedlinePlus

Scientific studies and clinical trials

• Cold-induced sweating syndrome: a report of two cases and demonstration of genetic heterogeneity, Journal of Neurological Science

• Night sweats: A systematic review of the literature, Journal of the American Board of Family Medicine 

• A systematic evidence-based review of treatments for primary hyperhidrosis, Journal of Drug Assessment

More information on related health conditions

• Acquired idiopathic cold-induced hyperhidrosis in a case of dementia with Lewy bodies, Neurology: Clinical Practice

• Hyperhidrosis, Cleveland Clinic 

• Hyperhidrosis, Cedars Sinai 

• Diaphoresis, Cleveland Clinic

• 10 causes of night sweats—and when to worry, Singlecare

• Night sweats, American Osteopathic Association 

• Night sweats, NI Direct UK

• What causes sepsis? Diagnosis, prevention, and treatment, Singlecare

• The Difference Between Heat Exhaustion and Heat Stroke: When to Sweat It and Seek Care, Comanche County Memorial Hospital

• Cyanosis, Cleveland Clinic

• 5 warning signs of a heart attack that you may not know, The Heart Foundation