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hello. I’m Dr. Sangchul Hwang, an autonomic nervous system researcher and therapist. Hyperhidrosis is basically a symptom caused by too much heat in the body. Chinese medicine has long explained that heat rises to the top, dries up the fluid, and causes sweating, and in fact, there are many people who are prone to fever when they have a high constitution or are stressed. However, in clinical practice, the biggest factor that determines when this fever becomes severe and when it is controlled is sleep.
Why sleep deprivation makes hyperhidrosis worse
“I didn’t sleep well last night, and this morning I’m sweating profusely,” is something I hear a lot in my clinic. It’s not just about fatigue, it’s about how sleep directly affects our autonomic nervous system and thermoregulation. We need our deep core body temperature to naturally drop right before we fall asleep, and it’s the parasympathetic nerves that help us do that. If you toss and turn or wake up frequently, your sympathetic nervous system stays on and doesn’t allow your body temperature to drop, and eventually the accumulated heat is released as sweat, which is why sleeplessness is associated with increased sweating.
The relationship between CSF and deep sleep
CSF is an important fluid that flows between the brain and spinal cord, protecting the brain, flushing out waste, and stabilizing the autonomic nervous system. Recent studies have shown that CSF flow is most active during deep sleep, when its ability to stabilize the autonomic nervous system is maximized. Shallow sleep or frequent awakenings reduce CSF flow and prevent the sympathetic nerves from being turned off, creating a structure that favors heat stasis and hyperhidrosis.
Night sweats, or ‘hyperhidrosis’, while sleeping
If you wake up with a sweaty back, wet pillow, or night sweats while sleeping, it’s called night sweats. In traditional Chinese medicine, it’s seen as yin he or cardiovascular deficiency, and in modern medicine, it’s understood as an autonomic dysregulation during sleep. This symptom is especially severe at night and is more common after stress or sleep deprivation.
Why is hyperhidrosis more common in small people?
The Oxymoron has a well-developed upper body, heat tends to travel upward, sympathetic nerves are easily triggered, and sleep is sensitive. Chinese medicine describes them as dreamy and often awake, and when they do wake up, their sympathetic nerves don’t shut down and heat builds up, making them prone to symptoms such as night sweats, hot flashes, heart palpitations, and night sweats. However, this isn’t just a problem for Siberians; anyone can suffer from sleep deprivation.
Sleep is the starting point for treating hyperhidrosis
Hyperhidrosis is caused by fever, but how bad it gets and how well it’s controlled depends on the quality of sleep, so when I treat hyperhidrosis, I look at sleep first, rather than just lowering the fever. I look for things like frequent nighttime awakenings, tossing and turning at dawn, and feeling refreshed after sleeping, and combine treatments to control sympathetic nervousness, restore sleep rhythm, and balance body temperature at the same time.
Recapping today’s content
Hyperhidrosis is basically caused by having too much heat, but the biggest key to controlling this heat is sleep. When you sleep deeply, your autonomic nervous system stabilizes, your body temperature drops, sweating decreases, and the effects of treatment last longer. With recent studies showing that CSF circulation is most active during deep sleep, it’s even clearer that sleep quality affects both autonomic nerves, body temperature, and sweating, which is why the first question in hyperhidrosis treatment should always be, “How are you sleeping lately?”
