Night Waking With Internal Intense Body Heat?

I have been waking in the night with intense body heat at about 12 or 1 AM every night. This is not night sweats, as I am not sweating and have had night sweats before. I am just extremely hot and cannot sleep anymore.

Also I have been taking Advil PM to help with my insomnia and I am able to sleep well until the heat kicks in. It is awful. I am so sleep deprived, I am dopey during the days and feeling exhausted.

I am a 45 year old woman, and unwilling to think this is menopause related as I am on hormone replacement and have been for 5 years. This awful heat thing has been going on for a full year. Also, I am a bit more hot than most during the days, but nothing compares to the midnight inferno.

Also, sometimes I feel like my heart is pounding out of my chest. Help, I am really frustrated and would love to know what to do to make this all go back to normal.

Thanks for your response.

---

Kevin: Hey there,

Thanks a lot for asking about this and sharing your situation. The internal heat you describe definitely sounds like symptoms of menopause that some women report, but as you say you are already taking the hormone replacement that is traditionally used to treat this, so perhaps it is not in your case.

While I can't go into that aspect too much deeper myself, I can point to some simple environmental and behavioral aspects of sleep hygiene that could help you out.

But before I do that, I would first really recommend going to see a sleep physician and describing your situation to him or her. While you are already on hormone replacement, a sleep specialist may be able to recognize other factors that may be holding you back from consistent restful sleep (and hopefully get to the bottom of this internal heat conundrum!), and help you to pinpoint what needs to be done.

Okay, let's turn to some possible environmental factors...

The first question I would ask myself in this situation is when I wake up in the middle of the night and can't get back to sleep, do I feel alert or do I feel utterly exhausted still? If I felt that my brains alertness, in addition to the internal heat, was contributing to me having trouble getting back to sleep, I may look towards my body's circadian rhythms for an answer.

If your clock-dependent alerting hormones are turned on at all in the middle of the night, possibly due to an irregular pattern of sleep, this could play a role in keeping you awake after the internal heat has first awakened you.

(If you'd like to know a bit more how this would work, I wrote a little bit about it recently in response to another question.)

In fact, the hormones related to menopause or perimenopause are modulated by the exact same mechanism in your body as the hormones that govern your wake/sleep cycles--what's commonly known as your biological clock, which is in the suprachiasmatic nuclei (or SCN) of your brain's thalamus. There's a wonderful Reader's Digest article Update 2015: The link to the article has broken. It used to be at http://www.rd.com/living-healthy/menopause-and-sleep-problems/article54699.html about this connection, and it seems other aspects of what you're describing.

An excerpt from that article reads: "'The SNC is where you have the axis for the sleep/wake cycle and the axis for all the endocrine glands that affect monthly reproductive rhythms,' says Dr. Yan-Go. 'They’re all linked together like an orchestra,' so when one cycle is out of whack, it tends to sideswipe the others as well."

In addition to those considerations, there's certainly no harm in trying to make your sleeping environment as conducive to staying cool as you can, which I would guess you may already be doing. I often sleep with a fan or two on, or the window open, to this end. Another possible strategy (one adopted by Benjamin Franklin, interestingly enough) is to prepare a second sleeping area/bed for yourself, so that when you wake up hot you can move to a spot that hasn't already adjusted to your own body heat.

Now, those are clearly strategies more geared towards addressing external heat, but I'd wager that being cool on the outside has to be better than being warm on the outside when you're already burning up inside.

But again, I would definitely seek the advice of a doctor. Chronic sleep deprivation is serious business, and it's no fun living with the consequences it brings. It really would be well worth it to pull all the stops and take the time to seek professional medical advice.

Best of luck. I wish I could give you a magic solution, but unfortunately in life that rarely exists. I have faith that you can get to the bottom of this though!

If you have any more follow-up questions or comments, please feel free to ask them using the "Post comments" link below.

Warmly,
Kevin

(Please keep in mind that I am a student of sleep science and not a medical doctor. Please take any thoughts I give with my background in mind.)