What Is the Connection Between Stress and Night Sweats?

Stress and orthostatic hyperhidrosis refers to the sweating response caused by the change of body position and the side of the body under pressure when lying sideways, which is a manifestation of hyperhidrosis. Hyperhidrosis is a disease caused by excessive excretion of sweat glands due to excessive excitability of sympathetic nerves.

Stress and orthostatic sweating

Stress and orthostatic hyperhidrosis refers to the sweating response caused by the change of body position and the side of the body under pressure when lying sideways, which is a manifestation of hyperhidrosis. Hyperhidrosis is a disease caused by excessive excretion of sweat glands due to excessive excitability of sympathetic nerves.

Affected area

whole body

Related diseases

Malaria hyperhidrosis cortical hyperhidrosis chromhidrosis compensatory hyperhidrosis, etc.

Related symptoms

Trauma, night sweats, sweating, cyanosis, high fever, muscle atrophy, severe pain, etc.

Affiliated Department

Department of Internal Medicine

Related inspections

Thyroxine (T4) thyroid iodine test cerebrospinal fluid endothelin, etc.

Causes of stress and orthostatic sweating

Generalized sweating can be an abnormal physiological reaction or one of the symptoms of certain diseases such as hyperthyroidism, diabetes, and the like. Local hyperhidrosis can be due to sympathetic nerve damage or abnormal response, increased choline acetate secretion, causing the small sweat glands to secrete excessive sweat.

(I) Causes of Onset

Examination and diagnosis of stress and orthostatic sweating

Hyperhidrosis is mainly based on a history of hyperhidrosis, typical clinical manifestations, and a combination of objective examinations, and is usually not difficult to diagnose.

1. According to sweating

(1) Localized hyperhidrosis: It usually starts in children or adolescence, and can occur in both sexes. Some have a family history that can last for several years, and there is a natural tendency to reduce after 25 years of age. The most common areas of localized hyperhidrosis are the palmar plantar and friction surfaces, such as underarms, groin, and perineum. Followed by forehead, nose and chest. Sweating of palms and palms can be continuous or transient. It is caused by emotional fluctuations. There is no seasonal difference. Hand, foot, or chills often occur. It can be accompanied by keratinization of hands and feet. Axillary sweating can be induced by heat or mental activity. Axillary hyperhidrosis is caused by excessive movement of the small sweat glands, unlike the axillary odor, which is mainly caused by the large sweat glands.

(2) General hyperhidrosis: generalized generalized hyperhidrosis caused by other diseases, such as infectious hyperthermia, due to the regulation of the nervous system or oral antipyretic agents to emit heat by sweating. Other damage to the central nervous system, including the cortex and basal ganglia, spinal cord, or peripheral nerves, can cause sweating throughout the body.

2.Different according to the cause of excessive sweat

(1) Neurohidrosis:

Cortical Hyperhidrosis:

A. Emotional hyperhidrosis: Due to emotional stimulation, acetylcholine secretion increases and hyperhidrosis occurs. Cortical or emotional sweating that occurs after sexual stimulation is a special type.

B. Palmar hyperhidrosis: It can be seen in various ethnic groups without obvious gender differences. Most patients have a positive family history and often begin to develop in infancy or childhood. Palmar hyperhidrosis does not occur during sleep and quiet. Patients with hyperhidrosis in palms and palms may experience abnormal electrocardiograms, tachycardia, or sharp waves, which may be related to vasomotor instability. There are generally no local or systemic companions.

C. axillary hyperhidrosis (axillaryhyperhidrosis): Axillary hyperhidrosis in addition to heat source stimulation, but also emotional stimulation and hyperhidrosis, often with palmar and palm sweating, but axillary sweating without odor, men sweat than women large.

D. Other diseases with cortical hyperhidrosis (otherdiseasewithcorticalhyperhidrosis): palmoplantar keratosis, congenital pachyparathyroidism, recessive hereditary bullous epidermolysis, congenital ichthyosis-like erythroderma, and nail nail synthesis Coronary hyperhidrosis can occur. It often appears after excitement or eating, but sometimes heat source stimulation can cause disease, indicating that the subcortical center is particularly hot (the hypothalamus also plays a certain role).

hypothalamic hyperhidrosis (hypothalamichyperhidrosis): The hypothalamus is the main autonomic nervous center in the central nervous system, which controls and regulates sweating. Hyperhidrosis caused by the hypothalamus can be seen in the following diseases:

A. Hodgkinrsquo; disease: It is characterized by the triad of fever, night sweats, and weight loss. Night sweats occur early in the disease, body temperature suddenly drops and a lot of night sweats during sleep, and fluctuating fever later.

B. Diabetic hyperhidrosis (diabetesmellitus): There are 3 types; hyperhidrosis that occurs during the onset of severe hypoglycemia; compensatory hyperhidrosis in the upper body during peripheral neuropathy, and no sweat in the lower body; mainly occurs in the face and neck Tasteful sweating.

C. Pressure and postural hyperhidrosis (pressure and postural hyperhidrosis): Refers to the sweating response caused by changes in body position and side body pressure when the side is lying.

D. Idiopathic unilateral circumscribed hyperhidrosis: It is a kind of episodic localized sweating commonly found on the face or upper limbs. Heat, mental, and taste stimuli can all be triggered, but the former are common and the sweat mechanism is unknown.

Myelodysmia: Since effervescent stimuli often involve taste receptors, myelodysmia is also known as gustatorysweating, which can be divided into physiological and pathological myelopathy. Two types of hyperhidrosis.

A. Physiological medullary hyperhidrosis (physiologicmedullaryhyperhidrosis): Many people experience localized sweating after eating spicy and scented foods and beverages, which are more common on the face, especially the upper and lower lips and cheeks on one or both sides, and the scalp And knee, usually appear within a few minutes, the site often accompanied by vasodilation, occurs in young people, hot weather is more frequent, there is a family genetic tendency.

B. Pathological medullary hyperhidrosis (pathologicmedullaryhyperhidrosis): It often affects the area of the ear before or below the ear, varying in degree. There are 3 clinical types: caused by local trauma or disease of the parotid gland; caused by central nervous disease; such as Syringomyelia or encephalitis; caused by thoracic sympathetic nerve injury. The nucleus pulposus functions in all three types, but there are certain variations in the afferent and efferent arcs, resulting in different clinical manifestations:

a. Auriotemporal syndrome (Auriculotemporalsyndrome): also known as Kreyrs syndrome (Kreyrsquo; ssyndrome) occurs in the parotid or preauricular surgery, trauma and cysts and other lesions of the ear-temporal nerve after 1 month to 5 years, diet, chewing stimulation When saliva is secreted, localized pain in the auriculotemporal nerve distribution area, vasodilation, and sweating occur. The reason is that the large auricular nerve and the parotid gland are involved at the same time, and the parasympathetic fibers regenerated in the damaged parotid gland migrate to the distal end of the nerve, dominating the sweat glands in the subauricular area. Tympanicplexus surgical destruction can eliminate taste sweating in patients with this disease.

b. Chordatympanicsyndrome: Due to the damage of peripheral autonomic nerves near the submandibular gland, the clinical manifestations are similar to that of auricular-temporal syndrome, and the site of occurrence is at the iliac and mandibular margins.

c. Crocodiletearsyndrome: It is a disease similar to gustatory hyperhidrosis, which often occurs after facial nerve injury. The difference is that patients have gustatory tears; they originate from peripheral autonomic nerves that regulate tearing and salivation. Misleading or shorting the path.

d. Sweating due to syringomyelia or encephalitis: May be caused by vagus and glossopharyngeal nerve stimulation, which destroys the nucleus pulposus that controls sweating and salivation; the clinical manifestations are quite different and there is widespread sweating reaction.

e. Hyperhidrosis in the nucleus pulposus after thoracic sympathetic trunk injury: seen in patients with sympathectomy, lung cancer, spinal osteoma, subclavian aneurysm, and thyroidectomy. Because the sympathetic chain in the upper mediastinum is adjacent to the vagus nerve, after the sympathetic nerve is injured, the vagus nerve sends cholinergic fibers to the adjacent presynaptic fibers of the sympathetic nerve. Patients often face, neck, trunk and upper limbs after eating or swallowing Sweating response.

(2) Non-neural hyperhidrosis: It is not controlled by the sympathetic nervous system, but the gland is sweat-sensitive and dominant sweating; and drugs such as cholinergic and adrenergic can directly cause sweat glands Dominant sweating, and some organoidnevus and nevus-like hemangioma damage, Maffucci syndrome, arteriovenous tumor, Hippdl-Trenaunay syndrome, hemangiomas, blue vesicular nevus syndrome, localized Sweating may be related to hemangiomas in the affected area. In addition, cold erythema (colderythema) has localized erythema, severe pain and central sweating, vascular atrophy, and muscle atrophy after cold stimulation. The disease may be caused by the release of serotonin by platelets.

(3) Compensatory hyperhidrosis (compensatory hyperhidrosis): After the sweat glands in one part of the body are treated with a certain factor, the sweat glands in another part are compensated to maintain body temperature. There are several common diseases.

Diabetes: No sweat or hypohidrosis in the lower body secondary to diabetic peripheral neuropathy and modern compensatory hyperhidrosis. Upper body (mainly torso) heat-stimulated hyperhidrosis, common at night. Face and neck taste hyperhidrosis.

After sympathectomy, pathological and taste hyperhidrosis occurred after neck and chest sympathectomy.

Night sweat, in addition to the above-mentioned causes of hyperhidrosis, can also be due to cardiovascular endocarditis, lymphoma, hyperthyroidism, systemic vasculitis, pheochromocytoma, carcinoid syndrome, withdrawal drug response, autonomous function Night sweats can occur out of control and other chronic infectious diseases.

Differential diagnosis of confusing symptoms of stress and orthostatic sweating

This disease has outstanding characteristics, is very easy to diagnose, and is difficult to confuse with other diseases. The main cause is the identification of secondary hyperhidrosis, and judgments should be made based on different clinical manifestations. If diabetes has abnormal blood glucose and urine glucose tests, brain organic lesions should have localized symptoms and signs.

Secondary hyperhidrosis: A small number of people have increased sweating due to a physical illness. This condition is called secondary hyperhidrosis, such as hyperthyroidism, endocrine disease, mental illness, and endocrine imbalance in menopause. .

How to prevent stress and orthostatic sweating

There are no better measures, mainly to prevent related diseases. If there is a background of hereditary syndrome, preventive measures include the implementation of genetic counseling, carrier genetic testing and prenatal diagnosis and selective abortion to prevent the birth of children. Relax, pay attention to personal hygiene, take a shower and change clothes frequently.