Wellness and Lifestyle

Fever at Night Gone in Morning: An Expert’s Guide

One of the most common symptoms of a fever is feeling cold, but this is misleading. Fever can cause your body temperature to spike at night and then dip in morning, leading to what’s known as “fever at night gone in morning.”

Why are you getting fever at night gone in morning?

“Every night I have a fever and when I wake up the next morning, the fever is gone. I can’t understand what is happening to me?” Very common query most of the doctors get. Fevers are often worse at night and give a disturbing morning.

The same is often said about asthma, arthritis, and the flu. And although heart attacks commonly occur in the morning, researchers believe they are frequently triggered by night-time happenings in the body.

Doctors have known this about illness for many years, anecdotally. But science is offering some explanation and validation for the theory. There’s even a field of study devoted to understanding how time of day affects our health chronobiology.

What is fever?

The primary symptom of fever is abnormally high body temperature. 

Normal body temperature for an adult can range anywhere from 97 F to 99 F. Children have a slightly higher range, approximately 98 F to 100 F. However, adults are much more tolerant of temperature spikes than children and have more fully functional immune systems. With children, especially babies, even a slightly elevated temperature can signal something more serious.

Besides a high temperature, symptoms of fever can include shivering and sweating, headache, muscle ache, loss of appetite, and general fatigue. Sometimes, children under 5 may suffer seizures during high fever spikes alarming for parents, but not usually life-threatening. 

It’s important to remember that fever itself is not a disease. In fact, it’s the exact opposite a sign that the body’s immune system is fighting off a bacterial or viral infection although it can be a cause for serious concern in certain circumstances: for example, urgent medical evaluation is needed if an infant less than two months of age is running a fever greater than 100.4 degrees Fahrenheit, or if anyone with a compromised immune system spikes a fever.

Is night fever really worse?

There are some fairly obvious explanations for “night fever” the tendency for fever symptoms to be magnified during the evening hours. 

First, it’s normal for body temperature to creep up at night, adding proverbial fuel to the fire. This is often compounded by well-meaning parents or caregivers swaddling their infant under piles of blankets. Incidentally, it’s precisely because of this natural ebb and flow of body temperature that health care professionals don’t declare a fever broken in the morning just because someone suddenly seems symptom-free. Instead, they often wait until fever has been absent for 24 hours to celebrate.    

There’s also the undeniable boredom effect. During the day, even if you have a fever, you are more active or at least distracted by visitors, making sure you’re drinking lots of fluids and getting enough rest. At night, it’s just you, the four walls, and your fever, so you have more time to think about how miserable you feel. And, guess what, that makes you feel more miserable. 

But probably the main reason fever seems worse at night is because it actually is worse. The inflammatory response mechanism of the immune system is amplified. Your immune system deliberately raises your body temperature as part of its strategy to kill the virus attacking you. That’s what triggers the alternating hot flashes and chills the classic fever effect. 

There’s one other element that we don’t fully understand, but it seems to be important. We know that two key hormones, cortisol and adrenaline, are suppressed when we sleep. From extensive studies on asthma management, we have learned that when the level of these hormones is reduced at night, it’s harder for asthmatics to breathe. Researchers believe this restriction also exacerbates fever symptoms at night.

When you or your family members have a troubling fever, trust your instincts if you think something is wrong and call your paediatrician or family doctor for advice. And remember, always call a doctor if a young infant has a fever of over 100.4. 

13 Causes of Fever at Night

In case you are suffering from fever at night, you need to check on the symptoms first. The symptoms may be a loss of appetite, irritability, general weakness, dehydration, sweating, headache, chills and shivering, etc. There are obvious causes that you can avoid to get rid of the fever that visits in the night. What causes high fever is only in the night, let’s know.

  1. External Pyrogens – Pyrogens that travel from outside and try to penetrate your body cause high fever only at night. These pyrogens produce toxins that can be harmful to your health. Within the body, these pyrogens are produced because of monocytes and macrophages. When external pyrogens enter the body, they induce the body to produce its own pyrogens, thus resulting in feverish conditions. This is one of the major causes of fever at night.
  2. Upper Respiratory Tract Infections – Cold and other respiratory tract infections are probable causes of fever in the night. Sometimes, it is just a common cold that affects your body to cause fever in the night. Sometimes, it can also be an infection of the larynx, bronchi or the trachea that can cause major respiratory tract infections and it can cause a fever that occurs in the night. Common cold lasts for a few days while other infections depend on the patient’s immunity and general time period.
  3. Urinary Tract Infections – You may also experience fever only in the night when you have urinary tract infections. Very sharp pain in the urinary tract, along with the presence of toxins, can lead to fever. You would need to consult a doctor in this case. In case you have urinary tract infection, it can be cured with some medication and a proper checkup.
  4. Skin Infection – most times, fever at night is because of skin infections. If there are major infections present on your skin that have been persistently bothering you, you will need to get it checked. This could be one of the major reasons for fever at night.
  5. Inflammations – In case there is inflammation in your body because of allergic reactions to the medicines, you will get a fever in the night. It could be a plain allergy that can cause major reactions. Make sure you get it checked as soon as possible.
  6. Infection – An infection caused by bacteria or fungi. It can be infective endocarditis, tuberculosis, or other occult long-term infection.
  7. Connective tissue disorders – These could include rheumatoid arthritis, giant cell arteritis, systemic lupus erythematosus, polyarteritis nodosa, polymyositis, and dermatomyositis.
  8. Connective tissue disorders – These could include rheumatoid arthritis, giant cell arteritis, systemic lupus erythematosus, polyarteritis nodosa, polymyositis, and dermatomyositis.
  9. Inflammatory – Inflammatory diseases include Crohn’s disease, pancreatitis, phlebitis, thyroiditis, ulcerative colitis, etc.
  10. Endocrine and metabolic disorders like thyroid disease
  11. Blood disorders like aplastic anaemia and leukaemia
  12. Allergic reactions
  13. Drug reactions
Blood Test for Fever at Night

You need to inform the doctor about the duration of fever and the associated symptoms, if any. Get tested for malaria (malaria antigen), Dengue (NS1ag/IgM antibody) and Typhoid (typhoid IgM) as these are the most common illnesses in our country causing fever apart from viral illnesses.

Blood tests are used by doctors to detect what causing the fever and other conditions. Following are initial blood test advised if you have fever at night gone in the morning.

  • Complete Blood Count
  • ESR
  • NS1 Antigen Test For Dengue Fever
  • Rapid Malaria Test
  • Typhidot Test For Typhoid Fever

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