Lyme disease is an infection caused by the bacterium Borrelia burgdorferi, transmitted to humans through the bite of an infected blacklegged tick. This condition produces a wide array of non-specific symptoms that can often be mistaken for other illnesses. Among these systemic manifestations, night sweats stand out as a symptom that can be disruptive for patients.
Night Sweats as a Symptom of Lyme Disease
Night sweats are a recognized feature of Borrelia burgdorferi infection. These episodes involve excessive perspiration during sleep, often drenching clothing and bedding, and they are not simply a result of a warm sleeping environment. The presence of sweats and chills is a common constitutional symptom in the early stages of Lyme disease, sometimes presenting alongside the characteristic erythema migrans rash and flu-like complaints.
In one study examining adults with early Lyme disease, approximately 60% of patients reported experiencing sweats and chills. Night sweats are also frequently reported in the later, disseminated phases of the infection. When the bacterium spreads throughout the body, the resulting systemic inflammation can lead to cyclical temperature fluctuations that manifest as fevers, chills, and sweats. This pattern of sweating often occurs as the body’s temperature naturally drops from a fever peak, which can happen repeatedly overnight.
The Body’s Response: How Lyme Triggers Systemic Symptoms
The underlying cause of systemic symptoms like fever and night sweats in Lyme disease is the host’s robust inflammatory response to the invading Borrelia burgdorferi. When the immune system detects the presence of the spirochetes, specialized cells release signaling proteins known as inflammatory mediators. These mediators are the chemical messengers that orchestrate the body’s defense mechanism. Specifically, the immune system releases pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and various interleukins. These powerful molecules act as endogenous pyrogens, meaning they effectively reset the body’s internal thermostat to a higher temperature. This thermal adjustment happens in the hypothalamus, the brain region responsible for regulating body temperature.
When the cytokine-driven set point is raised, the body generates heat to reach the new, higher temperature, resulting in a fever. The subsequent drop in the body’s temperature, which can occur naturally or in response to a waning fever or medication, triggers a cooling mechanism to return to the original set point. This rapid cooling process is what results in the drenching night sweats and accompanying chills experienced by patients.
Differentiating Lyme-Related Sweats from Other Causes
Night sweats are a non-specific symptom, meaning they are associated with numerous conditions beyond Lyme disease, making differentiation challenging. Common alternative causes include hormonal fluctuations, such as those related to menopause or thyroid disorders, certain medications, anxiety, and other infectious diseases. The context of the sweating is what helps point toward Lyme disease.
Lyme-related sweats are often accompanied by a constellation of other symptoms, including migratory joint pain, chronic fatigue, and neurological issues like brain fog or facial palsy. The presence of a recent tick bite or the classic bull’s-eye rash, known as erythema migrans, makes Lyme disease a much stronger possibility. It is particularly important to consider tick-borne co-infections, especially Babesiosis, a malaria-like parasite that can be transmitted alongside Borrelia. Drenching, cyclical night sweats are a hallmark feature of Babesiosis, and their severity can sometimes be more pronounced with this co-infection than with Lyme disease alone. If night sweats are severe, persistent, or accompanied by other concerning symptoms, a healthcare provider should be consulted for a comprehensive evaluation.