For the third time that night, John Browne woke up when his bed was wet with sweat. Reluctantly he hauled himself up to take a shower and change the sheets.
He had no bad dream and was not particularly hot in his bedroom: he had a night sweat again.
The problem started in 2014, a few months after the relationship broke up. Sporadic initially, the sweat occurred once a week, and within six months it was every night.
"I started to sweat when I slept, I had to change my sheets halfway through the night," says the 39-year-old Wembley cook.
Hormones: John Browne, 39, from London, often woke up when his bed was wet with sweat
"They soon disturbed my sleep every night. I had no energy and focused on sugary foods and coffee to stay alert. I felt terrible.
"At first I put her under stress, but as they worsened, I began to worry about what might cause them. I searched the Internet for night sweats and found they could be a symptom of prostate cancer, which panics me. But I just pushed the fear in the back of my mind – I did not want to believe that something serious could be wrong. "
In May 2015, John's night sweats awoke three times at night, and he got other disturbing symptoms like hair loss and a drop in libido. When he realized that it was no longer a problem he could ignore, he arranged a doctor's visit.
A blood test showed that his night sweats were actually the result of falling testosterone levels – most likely, said his family doctor, caused by stress. The test also showed that his stress hormone cortisol was in the sky.
John's experience is by no means unusual. Night sweats (defined as the recurrence of profuse sweating during sleep) affects at least 41 percent of adults, many of whom are males. This emerges from a 2002 study by the University of Oklahoma Health Sciences Center in the US.
Although most people perceive night sweats as something that only menopausal women experience, they also affect a significant number of men – "and can be just as distressing," says dr. Clare Morrison, a doctor in Havant. Hampshire.
The problem started in 2014, a few months after the relationship broke up. Sporadic initially, the sweat occurred once a week, and within six months it was every night
"Men often find it embarrassing to seek help with nocturnal sweats, but they should do so as this is often due to hormonal changes or stress, but this can be a symptom of an underlying problem that needs urgent attention . "
Night sweats may be present in viral infections as a result of increased temperature, but they are also common in overactive thyroid glands, as the excess thyroid hormone increases metabolic rate and results in additional heat production, "adds Dr. Morrison also added medical consultant to the online medical service MedExpress.
In rare cases, night sweats may be a sign of Hodgkin's lymphoma, a type of cancer that develops in the lymphatic system (which removes waste from the tissue).
"Night sweats can occasionally be a sign of prostate cancer because the immune system is responding to cancer that is similar to an infection," adds dr. Morrison added.
Night sweats can occasionally be a sign of prostate cancer as the immune system responds to cancer that acts like an infection
"This leads to a slight increase in body temperature and an increased metabolic rate. However, it is not too common for prostate cancer to be so presented. "
But as with women, one of the most common causes is a drop in hormones. However, in men, this can happen at any age and can even be caused by stress, says dr. Richard Quinton, adviser to endocrinologists of the Royal Victoria Infirmary in Newcastle.
"In any physical or psychiatric illness, including depression and stress, it is the normal physiological response that testosterone levels drop, sometimes below the lower limits of normal," he says.
This is because stress reduces the release of a hormone, GnRH, which ultimately controls testosterone secretion by the testes.
When this happens, night sweats are one of the first symptoms. This is because low hormone levels (which naturally fall off at night due to changes in the body clock) cause the area of the brain that regulates temperature to think that the body is overheating. This triggers sweating to cool the body.
Other symptoms of low testosterone include poor mood, motivation, libido loss and a reduction in muscle mass.
"It is common knowledge that overweight patients are at increased risk of night sweats – about half of them – although the reason is unclear," adds Quinton added.
Night sweats are also a common side effect in men undergoing cancer treatment. Studies have shown that up to 80 percent of men who have received deprivation therapy – usually a drug treatment to lower hormone levels such as testosterone – may experience night sweats.
Dr. Quinton says some men need a testosterone treatment ("pill, patch or gel") to control their sweat.
Lifestyle changes can help too. There is some evidence that the breakdown of sugar can help to reduce night sweats in men when the cause is hormonal.
In 2013, researchers from the Massachusetts General Hospital in Boston, USA, found that only 75 grams of sugar (about two slices of chocolate cake or four pints of cider) lowered testosterone levels by 25 percent for up to two hours after consumption.
At least ten of the 66 male participants had normal levels of testosterone at the beginning of the experiment, but dropped to a low level after the sugar.
A healthy weight and regular exercise make the difference. Overweight men are more prone to sleep apnea (breathing pauses during sleep due to the collapse of tissues in the throat), which in turn are associated with night sweats.
"Regular exercise also improves sleep quality and can help soothe an active mind to reduce anxiety and depression," says Dr. Morrison.
Reducing or even eliminating spicy foods, alcohol and caffeine can make a significant difference, she adds. "This is because they all stimulate the body's central nervous system and can trigger sweating as a result."
Dr. Alanna Hare, consultant for respiratory medicine at the Royal Brompton and Harefield NHS Foundation Trust, explains that the bedroom is well ventilated and that it is less valuable to reduce the weight or even the bedding material.
"Moving to natural, breathable fibers like silk and cotton is a good first step," she adds. "And if anxiety is a problem, seek professional advice or use meditation apps like Headspace 30 minutes before bedtime that use mindfulness to calm the mind."
Seeing John's night sweats as a by-product of stress, his doctor suggested he try to manage his testosterone levels with stress management techniques and lifestyle changes.
So John cut out sugar, caffeine and alcohol and started meditating before going to bed. He also changed his synthetic duvet cover to silk and took up yoga.
Six months later, a subsequent blood test showed that his testosterone was back to normal and his cortisol had dropped.
Now John rarely suffers from night sweats and his other symptoms have subsided – although he finds he returns when he gets very scared or over-junk food.