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What is Hyperhidrosis

Hyperhidrosis is situational excessive sweating (i.e., brought on when the patient is nervous or agitated), and generally occurs in limited areas of the body (such as hands, face, feet, groin, and armpits). Hyperhidrosis is most commonly diagnosed as a primary illness, meaning it is its own disorder, and not a symptom of another disease or condition.

What is Sleep Hyperhidrosis

Sleep hyperhidrosis is excessive sweating which is brought on during sleep and tends to effect more than one area of the body. It is rarely a primary illness, almost always it is a symptom and other conditions are looked for, such as HIV, cancer, lymphoma, tuberculosis, septicemia, or thyroid disorders. However, it can and does occur on its own. As a primary condition, sleep hyperhidrosis usually begins during the early adult years and the symptoms are generally quite severe.

Symptom Severity Classification

The severity of the illness is graded on the following scale:

  • Mild: the patient isn't sweating so excessively as to warrant a change of bedclothes, however they may turn their pillow over, or change their position under blankets to gain more comfort. Sweating is usually limited to areas of the body which don't cause overall discomfort.
  • Moderate: the patient isn't sweating so excessively as to warrant a change of bedclothes, however they may get up during the night to wash their face, hands, or other affected areas. Sweating is usually limited to areas of the body which don't cause overall discomfort.
  • Severe: the patient sweats so excessively and extensively that the bedclothes and blankets are changed, and the patient requires a bath. Sweating is general, all glands are producing excessively.

Treatment Options

Primary Sleep Hyperhidrosis

The first line of treatment a doctor may recommend is simply an over-the-counter antiperspirant on all of the problematic areas ('Raise your feet! Raise your feet if you're Sure!'). However, by the time a patient brings the problem to their doctor, they've tried that. If regular antiperspirants don't provide relief, the doctor may recommend a prescription solution of aluminum chloride, which is applied nightly to the spots which are troublesome. In most cases, prescription strength antiperspirants do well at reducing the sweating to tolerable levels.

In extreme cases where topical solutions don't provide adequate relief, surgery can be performed to remove the problematic sweat glands or sever the nerves to them, or Botox injections can be used to paralyze the nerves which trigger the glands.

Secondary Sleep Hyperhidrosis

The treatment for sleep hyperhidrosis as a secondary condition involves finding the primary cause, and treating that disease.

The Stigma

People without hyperhidrosis may not understand why sweating is such a big deal. However, in serious cases, sleep hyperhidrosis is almost like wetting the bed every night, causing the sheets and blankets to become uncomfortably wet. At the very least it's a horrible inconvenience, requiring a change of bedsheets every night and constant laundering and bathing. Many patients must get rubber or plastic mattress protectors to keep sweat from soaking into it and causing it to smell or grow mildew. Beyond the mere inconvenience, it can cause social isolation due to embarrassment, constant worries about sweat and odor, loss of self-esteem, continual tiredness due to sleep disruption, dehydration, and skin irritation from being so constantly moist.

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