Associations Between Night Sweats and Other Sleep Disturbances: An OKPRN Study

James W. Mold; Joseph H. Woolley; Zsolt Nagykaldi

doi:10.1370/afm.554

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Table 1.

Bivariate Associations Between Night Sweats and Demographic and Sleep-Related Variables

Variables	Number	Night Sweats n (%)	PValue
Study sample	363	123 (34)
Age
18–40 y	105	32 (30)	.19
41–55 y	127	52 (41)
56–69 y	102	30 (29)
70+ y	30	9 (30)
Sex
Female	215	75 (35)	.66
Men	147	48 (33)
Race
White	326	110 (34)	.41
Black	18	4 (22)
Other	16	7 (44)
Ethnicity
Non-Hispanic	357	120 (34)	.08
Hispanic	4	3 (75)
Sleep latency
≤15 min	188	52 (28)	.01
>15 min	174	70 (40)
Sleep duration
≤6 hr	173	54 (31)	.29
>6 hr	189	69 (37)
Awakening
≤ 2 times per night	49	8 (16)	.005
>2 times per night	313	115 (37)
Pain
No	186	45 (24)	.0001
Yes	177	78 (44)
Snoring
No	129	41 (32)	.53
Yes	234	82 (37)
Snore frequency
Less than weekly	225	72 (32)	.33
Weekly or more	138	51 (37)
Snore volume
Talking or less	236	73 (31)	.11
Louder than talking	127	50 (39)
Daytime tiredness
≤ 2 times a week	103	20 (19)	.0002
>2 times a week	260	103 (40)
Fidgety legs
No	230	63 (27)	.0006
Yes	133	60 (45)
Legs jerk
No	280	83 (30)	.002
Yes	83	40 (48)
Sour/bitter taste
No	257	71 (28)	.0001
Yes	106	52 (49)

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Table 2.

Multivariate Associations Between Night Sweats and Sleep-Related Variables

Variables	Coefficient	Standard Error	Odds Ratios	95% Confidence Intervals
*Defined as waking up with bitter taste in mouth.
Constant tiredness	−1.87	0.28
Daytime tiredness	0.69	0.29	1.99	1.12–3.53
Acid reflux*	0.66	0.25	1.94	1.19–3.18
Legs jerk in sleep	0.58	0.27	1.78	1.05–3.00
Awaken with pain	0.62	0.24	1.87	1.16–2.99

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The Article in Brief

Background Research has shown that night sweats are more common than previously thought. This study examines possible relationships between night sweats and sleep disorders.

What This Study Found Thirty-three percent of patients in this study experienced night sweats, with 16% reporting nighttime sweating severe enough to soak their bedclothes. Night sweats appear to be associated with a variety of sleep symptoms (daytime tiredness, waking up with a bitter taste in the mouth, legs jerking during sleep, and awakening with pain in the night), but it is not clear how they are associated. Sleep-related symptoms, such as waking often at night and daytime drowsiness, were also common among primary care patients.

Implications

Night sweats are commonly experienced by adults who visit primary care doctors and are associated with a variety of sleep symptoms.
Doctors should ask patients with night sweats about sleep problems.
Annals Journal Club Selection:

Sep/Oct 2006

The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.
The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions. 1
Article for Discussion

Mold JW, Wooley J, Nagykaldi Z. Associations between night sweats and other sleep disturbances: an OKPRN Study. Ann Fam Med. 2006;4:423-426.

Discussion Tips
The study featured in this article is from a practice-based research network (PBRN). PBRNs have emerged as an essential laboratory for primary care research. 2 Like many PBRN investigations, this study used data collection techniques that are practical in real-world practice and that engaged practice members in formulating the research question and interpreting the findings to generate knowledge relevant to the care of patients in general practice. In addition to discussing the specific content of the study, you may wish to consider whether and how you might like to participate in a PBRN and what research questions might emerge from your practice.
Discussion Questions

What is the research question in this study? Why does it matter? How does it fit with what already is known about night sweats?
Is the study design appropriate for the research question? Does the design take into account what already is known about the question?
Study methods�to what degree can the findings be accounted for by:
How participants were selected, particularly who might have been excluded?
How key variables were defined and measured?
Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a third factor)?
How information was interpreted?
Chance (as indicated by inferential statistics)?

Main findings�does this study advance current knowledge?
Generalizability�how transportable are the findings to other settings, particularly to my patients, practice and community?
Implications�how can the information be used to change practice or advance new hypotheses and research?

References

Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.
Lanier D. Primary care practice-based research comes of age in the United States. Ann Fam Med. 2005;3(Suppl 1):S2-S4.