Woman With Fever and Insomnia.

Can Lack of Sleep Cause a Fever? (Doctor Reveals 10 Causes)

by
Dr-Babar-Naeem.

This article was written by Dr. Babar Naeem (MBBS, MRCPCH) – a licensed and practicing medical doctor – to ensure maximum factual accuracy and unique content.

If you have a fever and you’ve not been sleeping well, then you might be wondering if your lack of sleep is causing your fever or if it’s another condition.

So can a lack of sleep cause a fever?

A lack of sleep can cause a fever by increasing the skin temperature, the temperature of the brain, and increase the risk of infections. However, sleep deprivation and fever can occur simultaneously due to several conditions like COVID-19, an overactive thyroid, arthritis, and pneumonia.

The rest of this article explains in more detail how a lack of sleep can cause a fever and then lists 10 of the leading causes of fever and sleep deprivation – along with steps to help manage the conditions.

Although this article was written by a qualified and practicing medical doctor, it’s just for information purposes and you should ALWAYS seek medical attention from a professional for the best course of treatment for your condition.

Related: 9 ways to get to sleep when you have a fever.

3 Ways a Lack of Sleep Causes a Fever

A lack of sleep can result in a fever in the following 3 ways:

1: Lack of Sleep Can Increase Skin Temperature

When we are awake, the flow of the blood to all parts of the body is not equally distributed

More blood flows to the chest and abdomen when compared to the periphery (arm, legs, hands, and feet).

Sleep redistributes blood to all parts of the uniformly, so blood flow to the skin is increased when compared to the awake state.

This increased blood flow warms the skin and increases heat loss.

Therefore, the body temperature drops during sleep.

This decrease in body temperature starts even before the onset of sleep.

Lack of sleep disrupts this ‘decrease in body temperature’ and hence increases the body temperature that is known as fever [1].

Research has demonstrated that temperature differences in the middle and lower body can be used as a marker of “sleep debt” [2].

When a sleep-deprived person is exposed to a mildly cooler environment he/she loses the temperature quickly and becomes cold.

Ability to rewarm the body is also decreased due to disturbed thermoregulatory mechanisms.

2: Lack of Sleep Can Increase the Temperature of the Brain

Sleep deprivation also increases the temperature of the brain due to enhanced blood flow and increased metabolic demands of the brain.

The hypothalamus – a temperature-controlling area of the brain – is one of the most severely affected areas.

Small changes in the temperature of the brain can result in markedly increased brain activity.

This increased temperature of the brain results in memory loss, attention impairment, and learning problems [3].

According to the Centers for Disease Control and Prevention (CDC), lack of sleep can disturb judgment, coordination, and decision-making in the same way as drinking too much alcohol.

Sleep deprivation for 24 hours is equal to a blood alcohol level of 0.10%, which is higher than the legal limit for driving i.e is 0.8% (source).

3: Lack of Sleep Can Lead to Infections

‘Sleep helps in healing’ is a very famous saying that highlights the importance of sleep in enhancing our natural defense system against diseases.

Deep sleep helps in the proper functioning of immune cells.

Sleep deprivation has a negative effect on proper immune function.

Lack of sleep decreases the number and function of the T-cells that are an important component of our immunity.

A depressed immune system predisposes the body to infections.

The occurrence of any infection is another way by which sleep deprivation can cause you to have a fever [4].

A Lack of Sleep Can Cause Fever Through Infection Caused by Microbes

Another effect that increases the chances of infection and fever is the increased entry of microbes into the body from the gut.

Lack of sleep weakens the natural barriers that inhibit the entry of microbes from the gut into the blood.

If sleep deprivation is prolonged, then overwhelming infection can result in death [5].

A barrier is also present between the brain and blood that prevents the entry of harmful substances and germs from the blood into the brain.

This natural barrier is also compromised by sleep deprivation.

Depressed immunity can increase this effect manifold.

Everson did a study in 1993 and concluded that chronic sleep loss leads to the death of rats after 19 days.

10 Conditions that Cause Fever and Lack of Sleep

Here are 10 conditions that commonly cause both a fever and sleep disturbance at the same time:

1: COVID-19

The Covid 19 virus was initially identified in the Wuhan city of China and rapidly became a global concern.

According to research conducted in 13 countries, 75% of patients with COVID reported sleep problems [6].

COVID-19 can disrupt sleep in the following ways:

  • The release of chemicals by the infected cells causes fever and sleep disturbance.
  • Depressed immune system.
  • Increased stress level.
  • Disturbed sleeping habits.

How to Manage this Condition:

COVID-19 is a global problem and the whole world is trying to find a cure for this pandemic.

Based on my professional experience as a doctor, I recommend the following steps:

  • Vaccination offers the best chance of prevention. There are different types of vaccines available and all are effective at reducing the incidence of getting an infection. Don’t fall into the trap of social media propaganda about the side effects of vaccines.
  • Take Paracetamol for the fever.
  • Follow good sleep hygiene.
  • Take every measure to minimize the level of stress.
  • Use fruits and vitamins to boost your immunity.
  • Consult a healthcare professional if you have any signs of COVID-19 infection like fever, flu, breathing problems, and a cough.

2: Asthma Exacerbation

Fever and sleep disturbance can be caused by the worsening of asthma and are relieved when optimal control of the asthma is achieved.

Asthma is a chronic allergic disease that causes inflammation of the airways and presents with fever, cough, chest tightness, and difficulty breathing.

Sleep disturbances are very commonly associated with asthma.

A recent study done in 10 European countries demonstrated that respiratory and nasal symptoms cause a short sleep span of <6 hours [7].

The severity of asthma is also determined based on the number of night-time symptoms experienced in the last month [8].

How to Manage this Condition:

Sleep disturbance and fever associated with asthma will resolve once the condition is under control.

Unlike other conditions, vigorous efforts to improve sleep are usually not required as sleep disturbance is mainly caused by disturbed breathing and associated inflammation.

You should only treat asthma after consultation with a healthcare professional.

I will advise following these steps to have optimum control of the disease:

  • Stay away from trigger allergens. The best treatment for any type of allergy is to recognize the trigger allergen and stay away from it. For example, sleeping on a hypoallergenic mattress can help to avoid dust mite exposure (click here to see the best options).
  • Learn to use the inhaler properly. Incorrect inhaler technique is a frequent cause of poor asthma control. Although this seems obvious, a study shows that only 31% use inhalers properly.
  • Cold air, smoke, air pollution, and fragrance can trigger an asthma attack and should be avoided.
  • Keep your vaccination schedule updated.
  • Don’t smoke and avoid the company of smokers.
  • Take your asthma medications as prescribed by your doctor.
  • Minimize exposure to dust and always wear a mask when cleaning your home or workplace.

3: Overactive Thyroid

Another condition that can cause fever and insomnia is overactive thyroid also called hyperthyroidism.

The thyroid gland is a small gland that is located in front of the neck but has a very important role in metabolism, growth, and development.

It produces two very important hormones T3 and T4 (also called thyroxin) that control the functions of the heart, muscle, brain, and digestive system.

When this gland becomes hyperactive, it causes many problems like fever, sleep deprivation, fatigue, weight loss irregular heartbeats, etc.

How to Manage this Condition:

The mainstay of the treatment of hyperthyroidism is anti-thyroid drugs, radioactive iodine, and surgery.

The only person that can choose the best treatment option is a healthcare professional.

Nevertheless, here are some very important recommendations that should be considered:

  • Take the medicines as prescribed by your healthcare professional.
  • Control your stress level by using relaxation exercises, meditation, yoga, biofeedback, and other methods.
  • Hyperthyroidism results in weak bones; therefore, it is very important to eat a diet that is rich in calcium like milk, cheese, vegetables, etc. You can also use calcium and vitamin D supplements.
  • An overactive thyroid can cause eye problems. Eyecare is recommended with wearing sunglasses, artificial tears and lubricating eye drops to prevent dryness and irritation.
  • Smoking also makes this condition worse, therefore smoking cessation is advised.
  • The head side of the bed should be elevated to decrease blood flow to the brain (use pillows or an adjustable bed).
  • Seek immediate medical attention if you develop a fast heartbeat, sweating, vision problems, or restlessness.

4: Arthritis

Arthritis is an inflammatory disease of the joints that causes pain and stiffness in the affected joints.

There are many different types of arthritis like osteoarthritis (age-related wear and tear), rheumatoid arthritis (genetically increased tendency to have inflammation of joints), Psoriatic arthritis (associated with skin problems), etc.

Pain and inflammation associated with arthritis can result in fever and sleep disturbance.

Management of sleep is vital as sleep loss lowers the pain threshold and pain tolerance for any person.

About 80% of people with arthritis have problems sleeping.

Medication used for arthritis can also interfere with the normal sleep cycle.

Sleep problems worsen arthritis in many ways like increasing stress, lowering pain threshold, and lowering pain tolerance [9].

I always recommend working on good sleep hygiene as it helps you better manage your pain and allows the body to repair the damaged tissues.

How to Manage this Condition:

I have arthritis in both of my knees and shoulders so I know how painful this condition can be at night.

Personally, the most effective way to stop the pain in my shoulders was to switch to the back sleeping position and trade in my old spring mattress for the Puffy Lux Hybrid mattress that has much better pressure relief – click here to see my full review.

Generally speaking, management of arthritis is dependant upon the type of arthritis and involves taking painkillers and special medications.

By using my years of medical knowledge and experience, I have developed a list of recommendations to help you treat this disease in a better way:

  • Take your arthritis medication regularly as advised by your doctor.
  • Take painkillers before going to sleep in line with your doctor’s advice.
  • Use non-drug based pain management interventions like massage, use of heat, relaxation exercise, and guided imagery.
  • Stress reduction techniques like progressive relaxation exercises are helpful for pain and sleep.
  • Distraction activities like watching TV or playing games can take your mind off the pain and helps in relaxation.
  • Practice good sleep hygiene habits.
  • Hypnotics can also be used for a short time after consultation with a doctor.

5: Heat Exhaustion and Heat Stroke

Heat exhaustion results from working in a hot environment with excessive sweating and limited water – the core body temperature is below 104F.

Serious injury can be prevented if fever is controlled within 30 minutes.

Heatstroke is an emergency that results when core body temperature is above 104 F.

Such a high temperature can result in organ damage and even death.

A night of good sleep is essential to speed up the recovery and manage the pain.

However, affected skin, pain, and associated problems result in difficulty sleeping.

How to Manage this Condition:

Urgent medical attention is required for heat exhaustion and heatstroke.

I have compiled a list of tips to help you sleep better with sunburn – click here to see it.

The most important step to managing these conditions is to bring the temperature down to prevent further damage and seek immediate medical attention.

I also recommend following these tips:

  • When you experience any sign of heat exhaustion immediately move to a cooler place.
  • Drink plenty of water to stay hydrated.
  • Remove excess clothing.
  • Get a shower with cool water or use tepid sponging.
  • Seek immediate medical attention.
  • Use protective measures to prevent heat injury like avoiding sun exposure for a prolonged period, applying sunblock, wearing protective clothing and increasing fluid intake.
  • Apply moisturizing cream or Alovera over the burnt area.
  • Follow good sleep hygiene practices.

6: Pneumonia

Pneumonia is caused by infection of the lung tissue.

Patients with pneumonia usually develop fever, chest pain, a cough, and difficulty breathing.

These patients also have difficulty in sleeping due to pain, shortness of breath, and associated inflammation. 

How to Manage this Condition:

Pneumonia is treated with antibiotics, paracetamol or ibuprofen, and nebulization.

Sleeping problems resolve spontaneously once the disease settles.

7: Mental Health Disorders

Stress, anxiety, depression, and other mental health problems can cause serious sleeping problems.

These disorders can also result in low-grade fever called psychogenic fever that is without any underlying inflammatory process [10].

How to Manage this Condition:

Mental health problems are treated with psychotherapy (including group and family therapy), behavioral therapy, cognitive therapy, peer support, and self-help.

Medications are needed in some cases.

Treatment of insomnia is also required – which may be addressed through medications like quetiapine that can treat both insomnia, anxiety, and depression.

Click here for 8 ways to get to sleep when battling OCD thoughts and anxiety at night.

8: Medications

Many prescription medications can disrupt sleep and cause fever.

Examples of such drugs include anti-depressants, antihypertensives, painkillers, flu medications, caffeine, medication to treat Parkinson’s disease, and other stimulants.

Drugs can cause sleeping problems by inhibiting melatonin secretion, releasing chemicals that disrupt sleep, or causing breathing problems.

Some medications cause sleeping problems when a person stops using them.

Medication-associated fever results when a drug upsets the body’s temperature-regulating center – the hypothalamus.

Click here to discover 6 ways to take melatonin safely with a fever.

How to Manage this Condition:

The only effective treatment is the cessation of the culprit medicine.

However, this is not as simple as it seems if that drug is being used for some other disease like asthma.

So another option is to decrease the dose or use an alternate medicine for that person after consultation with a healthcare professional.

Click here to find out how to get to sleep when coming off benzodiazepines.

9: Ear Infection

Ear infection can cause fever and difficulty sleeping but it is usually self-limiting.

Ear infections are very common, especially among children.

Ear infections can affect every part of the external or internal ear but infection of the middle ear is most common and is called otitis media.

A patient with otitis media develops a fever, ear pain, irritability, and ear discharge.

Sleep disturbance is caused by pain, irritability, and associated inflammation.

How to Manage this Condition:

Ear infections are usually self-limiting and antibiotic treatment is usually not required.

I recommend that my patients use the following home care plan if symptoms are mild:

  • Use paracetamol or ibuprofen to control pain and fever.
  • Drink more water.
  • Rest.
  • Do not insert anything in the ear to remove wax. We deal with many patients that present with a cotton bud or stick inside their ear that they used to clean the ear.
  • NHS recommends placing a cold or warm flannel on the ear.
  • Immediate medical consultation should be done if the fever is high grade, pus is coming out of the ear, or hearing loss is suspected.

10: Cancer

Cancer is a condition in which normal cells of the body start growing at an abnormal rate and places.

Cancer patients experience a lot of problems including lack of sleep and fever.

It can involve any tissue of the body and symptoms are different for every cancer.

According to a study conducted by John Hopkin medicine, one in four patients with childhood cancer experience sleep problems (source).

Sleep problems can be caused by cancer itself, by the side effects of the medication used for treatment, or by associated conditions.

Cancer also secrets chemicals that can cause fever and insomnia.

How to Manage this Condition:

Sleep problems and fever associated with cancer are very difficult to manage.

Treatment of cancer with surgery, chemotherapy or radiotherapy will provide a lot of relief.

Following interventions can be helpful to manage these problems:

  • Sleep hygiene is considered as the best practice strategy for the management of insomnia by the NHS.
  • Cognitive-behavioral therapy is also helpful.
  • A short course of hypnotics or sedating antihistamines can also be used for short-term insomnia.
  • Take a bath before going to bed.
  • Avoid exercising just before bed.
  • Set a fixed routine for sleep and waking up.
  • Join a support group or counseling session to manage your stress.

Conclusion: Seek Medical Attention

Although a lack of sleep can cause a fever, it’s difficult to tell if this is the exact cause because both a fever and a lack of sleep can present simultaneously due to a separate condition like COVID-19, asthma, an overactive thyroid, arthritis, heat stroke, pneumonia, mental health disorders, cancer, and reactions to some medications.

Therefore, if you – or your child – are experiencing both a fever and insomnia then you should seek immediate medical attention.

Up next: 9 ways to get to sleep when you have a fever.

Sources and References

[1] Vishwakarma, L. C., Sharma, B., Singh, V., Jaryal, A. K., & Mallick, H. N. (2021). Acute sleep deprivation elevates brain and body temperature in rats. Journal of sleep research, 30(2), e13030. https://doi.org/10.1111/jsr.13030

[2] Romeijn, N., Verweij, I. M., Koeleman, A., Mooij, A., Steimke, R., Virkkala, J., van der Werf, Y., & Van Someren, E. J. (2012). Cold hands, warm feet: sleep deprivation disrupts thermoregulation and its association with vigilance. Sleep, 35(12), 1673–1683. https://doi.org/10.5665/sleep.2242

[3] Te Lindert, B., & Van Someren, E. (2018). Skin temperature, sleep, and vigilance. Handbook of clinical neurology, 156, 353–365. https://doi.org/10.1016/B978-0-444-63912-7.00021-7

[4] Besedovsky, L., Lange, T., & Born, J. (2012). Sleep and immune function. Pflugers Archive: European journal of physiology, 463(1), 121–137. https://doi.org/10.1007/s00424-011-1044-0

[5] Krueger, J. M., & Opp, M. R. (2016). Sleep and Microbes. International review of neurobiology, 131, 207–225. https://doi.org/10.1016/bs.irn.2016.07.003

[6] Jahrami, H., BaHammam, A. S., Bragazzi, N. L., Saif, Z., Faris, M., & Vitiello, M. V. (2021). Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 17(2), 299–313. https://doi.org/10.5664/jcsm.8930

[7] Björnsdóttir, E., Janson, C., Lindberg, E., Arnardottir, E. S., Benediktsdóttir, B., Garcia-Aymerich, J., Carsin, A. E., Real, F. G., Torén, K., Heinrich, J., Nowak, D., Sánchez-Ramos, J. L., Demoly, P., Arenas, S. D., Navarro, R. C., Schlünssen, V., Raherison, C., Jarvis, D. L., & Gislason, T. (2017). Respiratory symptoms are more common among short sleepers independent of obesity. BMJ open respiratory research, 4(1), e000206. https://doi.org/10.1136/bmjresp-2017-000206

[8] Kavanagh, J., Jackson, D. J., & Kent, B. D. (2018). Sleep and asthma. Current opinion in pulmonary medicine, 24(6), 569–573. https://doi.org/10.1097/MCP.0000000000000526

[9] Davis G. C. (2003). Improved sleep may reduce arthritis pain. Holistic nursing practice, 17(3), 128–135. https://doi.org/10.1097/00004650-200305000-00003

[10] Glazer J. L. (2005). Management of heatstroke and heat exhaustion. American family physician, 71(11), 2133–2140.

Medical Disclaimer

No part of this article or website offers medical advice – seek such guidance from a qualified medical professional.

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