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You wake up at 3 a.m., the pillow is damp, the sheets are twisted, and you’re kicking the covers off and pulling them back on for the next hour. If that sounds familiar, you’re not alone, and you’re not imagining it. Night sweats are one of the most common reasons sleep falls apart in perimenopause and menopause.
There’s a lot of noise about what to do. This note sorts it into two honest piles: what actually treats night sweats, and what only helps you sleep through them. Both matter. They’re just not the same thing.
The short version
- Night sweats are hot flashes that happen while you sleep.
- Hormone therapy is the most effective treatment, and there are several non-hormone prescription options too. These are conversations to have with your doctor.
- The Menopause Society reviewed the evidence in 2023 and does not recommend supplements, herbal remedies, cooling techniques or avoiding triggers as treatments for hot flashes.
- That doesn’t make your bedroom setup pointless. A cooler room and the right fabrics won’t stop a night sweat, but they can make it easier to get back to sleep.
- New, severe night sweats, or sweats with fever or unexplained weight loss, deserve a doctor’s visit, even in midlife.
Why night sweats happen
A night sweat is a hot flash that shows up while you’re asleep. As estrogen levels shift during the menopause transition, the body’s temperature control becomes more sensitive. Small changes can trigger a sudden wave of heat, flushing and sweating as your body tries to cool down fast. During the day it’s a hot flash. At night it wakes you up, often soaked, and then you feel cold once the sweat dries.
Doctors group hot flashes and night sweats together as “vasomotor symptoms.” How often they happen, how intense they are and how many years they last varies a lot from woman to woman.
What actually treats night sweats
In 2023, The Menopause Society (formerly the North American Menopause Society) published a position statement reviewing non-hormone treatments for hot flashes. Combined with what major medical centers say about hormone therapy, here’s where the evidence points.
Hormone therapy
Estrogen-based hormone therapy is the most effective treatment for hot flashes and night sweats. It isn’t right for everyone, and the decision depends on your age, health history and how long it’s been since your last period. The usual approach is the lowest dose that controls your symptoms. This is a decision to make with your doctor, not with the internet.
Non-hormone options with evidence behind them
If hormone therapy isn’t for you, The Menopause Society’s 2023 statement recommends these options:
- Cognitive behavioral therapy (CBT), a structured talk therapy that helps you manage how symptoms affect you.
- Clinical hypnosis.
- Weight loss, for women carrying extra weight.
- Prescription medications: certain antidepressants (SSRIs and SNRIs), gabapentin, oxybutynin and fezolinetant, an FDA-approved medication made specifically for hot flashes.
- Stellate ganglion blockade, an injection procedure.
Every one of these needs a professional: a doctor, a pharmacist or a trained therapist.
What the experts don’t recommend as treatment
This is the part most “menopause hacks” articles skip. The same 2023 review looked at popular approaches and did not recommend them for treating hot flashes, mostly because there isn’t enough good evidence that they work. The list includes:
- Supplements and herbal remedies, including soy products
- Cooling techniques
- Avoiding triggers such as spicy food, caffeine or alcohol
- Exercise, yoga, mindfulness and relaxation, as a treatment for hot flashes specifically
- Paced breathing, acupuncture and cannabinoids
Exercise and good sleep habits are still great for your overall health. They just haven’t been shown to reduce hot flashes reliably. And if a supplement promises to “stop night sweats,” that’s a claim the evidence doesn’t support.
So why bother with your bedroom?
Because there’s a difference between treating night sweats and sleeping through them.
A cooling technique won’t stop a hot flash from starting. But if you’re waking up drenched, the fabric against your skin and the temperature of your room affect how uncomfortable that moment is, and how quickly you can fall back asleep. For many women, that’s the difference between losing ten minutes and losing two hours.
Think of this section as comfort, not cure.
A night-sweat-friendly bedroom
- Keep the room cool. Set the thermostat lower at night, and use a fan to keep air moving.
- Layer your bedding. Several light layers are easier to adjust half-asleep than one heavy comforter.
- Choose fabrics that move moisture. Heavy cotton flannel soaks up sweat and stays wet against your skin. Fabrics designed to wick moisture dry faster.
- Keep a backup kit by the bed: a spare top, a small towel and a glass of water. Changing quickly beats lying in damp fabric.
- Use a pillow protector so you’re not sleeping on a damp pillow for the rest of the night.
An honest look at cooling sleepwear and sheets
Several brands now make sleepwear and bedding for hot sleepers. One we’ve looked at closely is Lusomé, a Canadian brand that makes pajamas, nightshirts and sheets from a moisture-wicking fabric designed with menopausal night sweats in mind.
What the research shows, and what it doesn’t
Lusomé points to a study published in Frontiers in Sleep by researchers at Brigham and Women’s Hospital and Harvard Medical School. It followed 64 self-described hot sleepers (89% women, average age 48) for six weeks before and after they switched to the brand’s cooling sheets. People reported better sleep quality, about 26 more minutes of sleep per night, and less trouble sleeping because of heat. Among those who had night sweats at the start, 42% said they improved.
Before you take those numbers at face value, know three things:
- It was a small pilot study with no control group, so everyone knew they were testing new sheets. That can shape how people rate their own sleep.
- Participants were hot sleepers in general, not only women in menopause.
- The study was funded by Lusomé, and the researchers disclosed financial ties to the company.
So it’s an encouraging early signal, not proof. That matches everything above: these products may make nights more comfortable, but they don’t treat the underlying cause.
Who it might suit
- You sleep hot and wake up damp, and switching fabrics is something you’d like to try before or alongside talking to your doctor.
- You’d rather start with one piece, like a sleepshirt, before investing in a full set of sheets.
When we checked, single sleepwear pieces were listed from about CAD $78 to $98, and sheets from about CAD $328. Prices for U.S. shoppers are shown at checkout. Lusomé offers a 30-night comfort guarantee and free shipping on orders over $150. Check the current terms on their site before you buy.
See Lusomé’s sleepwear and sheets (affiliate link)
When to see a doctor
Menopause is the most common reason for night sweats in midlife, but it isn’t the only one. Medications, infections, thyroid problems and other conditions can cause them too. Book an appointment if:
- Your night sweats are new, severe or getting worse.
- They come with fever, unexplained weight loss or other new symptoms.
- They’re wrecking your sleep, mood or work. That alone is reason enough.
Before the visit, jot down for a week or two how often the sweats happen, how bad they are and anything that seems to set them off. It makes the conversation faster and more useful.
Frequently asked questions
How long do menopause night sweats last?
It varies widely. Some women have them for a year or two, others for many years. If they’re affecting your life, you don’t have to wait them out. Effective treatments exist.
Do supplements help with night sweats?
The Menopause Society’s 2023 review did not recommend supplements or herbal remedies for hot flashes because the evidence isn’t strong enough. Talk to your doctor or pharmacist before taking anything, especially if you take other medications.
Will cooling sheets or pajamas stop night sweats?
No product can promise that. They may help you stay more comfortable and get back to sleep faster when a night sweat happens, but they don’t treat the cause.
Sources
- The Menopause Society. 2023 Nonhormone Therapy Position Statement (press release).
- Mayo Clinic. Hot flashes: diagnosis and treatment.
- Weaver MD, Qadri S, Ejikeme C, Quan SF, Czeisler CA, Robbins R. A non-randomized pre-post pilot study of cooling bed sheets in hot sleeping people. Frontiers in Sleep, 2025.
This article is for general information only and is not medical advice. Talk to your doctor before starting any treatment. See our Medical Disclaimer.