It’s Not Your Imagination: Hot Flashes Are Worse at Night — Here’s Why + the Easy Fixes

There’s never a good time to have a hot flash — the intense heat, flushed skin and sweating are unpleasant any time of day. But hot flashes can feel even more intense when they happen in the middle of the night and you suddenly wake up in a pool of sweat. If this sounds familiar, it’s because hot flashes are the most common symptom of menopause, affecting up to 75% of women. So why are hot flashes worse at night? And how can you keep your cool when they flare up? Here’s what you need to know.

What are hot flashes?

Hot flashes are a sensation of sudden and intense heat that radiates through the upper body. “Women will describe it as an internal heat that starts in the belly and works its way up through the chest and into the neck — it feels like they’re on fire from the inside out,” says Terri DeNeui, DNP, a board-certified nurse practitioner and founder of EVEXIAS Health Solutions. Some women may also experience a rapid heart rate, sweating and anxiousness.

Most women will start to experience hot flashes during perimenopause, the period of transition to menopause. (Drew Barrymore recently made headlines when she had her first perimenopausal hot flash during a live interview.) A hot flash typically only lasts a few minutes. But they can be a daily occurrence for some menopausal women, and they may persist until you’re post-menopausal. 

Related: The 9 Best Foods That Fight Hot Flashes, According to MDs — No Medication Required

The 4 phases of hot flashes

“Most clinical research indicates that a hot flash occurs when estrogen levels decrease and cause your body’s natural thermostat, the hypothalamus, to become more sensitive to changes in body temperature,” explains Michael Krychman, MD, a board certified OB/GYN, certified sex counselor and medical director of Women’s Health Services at MemorialCare Saddleback Medical Center in Laguna Hills, CA . “The hypothalamus is tricked into thinking you are hotter than you are, and a cascade of events occur to try and cool you down.”

According to Lauren Streicher, MD, medical director of education for Midi Health, this usually happens in four phases:

• Phase 1: Your core body temperature goes up. Blood vessels in your skin dilate, your skin gets warmer and your heart rate speeds up.
• Phase 2: The heat becomes more intense, with flushing of the skin on the upper body.
• Phase 3: Your heart rate peaks and you may experience profuse sweating.
• Phase 4: The heat wave is followed by chills and shivering as your body tries to cool off.

While hot flashes are primarily caused by fluctuating hormones, there are a few factors that can trigger them or make them worse. “Some triggers may include anxiety, mood changes, eating spicy food and drinking alcohol,” Dr. Krychman says. Hot weather, caffeine, tobacco use and obesity can also increase the likelihood of having hot flashes, he adds.

Race can also play a role. Research suggests Black women are 50% more likely than white women to have vasomotor symptoms like hot flashes during menopause. The exact reason is still unknown, but experts suspect it’s a combination of factors, including chronic stress and disparities in treatment.  

Related: This Ancient Peruvian Herb Tames Hot Flashes + Boosts Your Libido — And It Tastes Like Caramel

Hot flashes vs. night sweats

Night sweats are — you guessed it — episodes of heavy sweating while you sleep. Nocturnal hot flashes are one of the most common causes of night sweats. When that’s the case, hot flashes and night sweats are essentially one and the same.

However, it’s important to note that not all night sweats are caused by hot flashes. Night sweats can also happen due to:

• Your sleep environment. If it’s too warm in your house, or you sleep under a mountain of blankets, you may wake up sweaty.
• Medications. Certain medications used to manage depression and diabetes may cause night sweats.
• Underlying medical conditions. Night sweats can be a symptom of various health issues, including anxiety disorders, sleep disorders and certain thyroid issues.

Why are hot flashes worse at night?

In most cases, it’s not so much that your hot flashes are worse at night, it’s that they’re more disruptive. Not only is it frustrating to have your blissful Zzz’s interrupted, but the temperature change in your body is also more drastic at night.

“Your body temperature usually drops a tiny bit at night so you can sleep,” explains Erica Montes, MD, a board-certified OB/GYN and advisor for PHD Feminine Health. “Therefore, hormone changes that affect your body temperature could become more noticeable or seem worse at night — especially if it’s waking you from sleep or preventing you from going back to sleep.”

If your night sweats are only happening at night, and you’re not having hot flashes during the day, it’s possible that a different hormone could be to blame. Most women experience a decline in testosterone and progesterone levels in their 30s, Dr. DeNeui says, which can lead to night sweats. (Click through to learn how sweet potatoes balance menopause hormones to tame hot flashes.)

How to ease hot flashes that are worse at night

If you’re experiencing hot flashes, you’re probably wondering how to get relief — especially if they’re worse at night. While there’s no surefire way to avoid hot flashes altogether, these tricks curb your risk and minimize discomfort.

1. Set your thermostat to the ‘sweet spot’

Your warm-and-cozy bed may suddenly feel like a sauna if a hot flash strikes in the night. To keep your bedroom cool, Dr. Krychman recommends lowering the temperature, using a ceiling fan and layering your bedding so you can quickly peel off covers if needed. Sleep experts say the ideal temperature range for sleep is 65° to 68°F.

2. Trade your nightcap for tea

Alcohol and stress are both common triggers for hot flashes that may feel worse at night. “Alcohol is known to raise internal body temperature, which can trigger more hot flashes,” Dr. Montes says. “And stress can worsen hot flashes due to similar physiological changes that occur to your body during stressful times.” So if you usually unwind with a glass of wine at night, replace it with a stress-busting tea like chamomile or lavender — two birds, one stone! (Click through to learn more about the sleep benefits of lavender tea and to see how chamomile can help stop someone from snoring.)

3. Cut back on canned foods

“We have so many endocrine disruptors in our food,” Dr. DeNeui says. “There are so many things we eat as a society daily that cause us to have these hormone deficiencies at a much younger age.” Endocrine disruptors interfere with the endocrine system’s ability to regular reproductive hormones. And this shift in hormones can spur hot flashes at night.

The one of the easiest ways to limit your exposure to these troublesome endocrine disruptors? Scale back on your consumption of canned foods when possible. Instead, include more dry beans (cup-for-cup, they actually cost less than canned beans!), fresh produce and homemade soups in your daily diet when you can. (Click through for a delicious Caldo des Res homemade Mexican soup recipe.)

When to talk to your doctor

While hot flashes are common, they’re still worth discussing with your doctor. Finding the root cause can help you manage your hot flashes as effectively as possible. Plus your doctor can help rule out any other underlying conditions. “Seek medical attention if you have bothersome hot flashes,” Dr. Krychman adds. “There’s no need to suffer in silence — and there are safe, effective treatments available.” These options may include lifestyle changes, hormone therapy or non-hormonal medications.

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For more ways to soothe menopause hassles:

Seed Cycling Is the TikTok Trend That May Help Ease Menopause Symptoms Naturally

MDs: Menopause Wreaks Havoc on Your Oral Health — 5 Ways to Keep Your Smile Healthy

Yoga for Menopause Helps Tame Hot Flashes, Irritability, Fatigue and More, Experts Agree

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.