Everyone has a different way to get comfortable for bed. Some people like to pile on the layers and blankets and get extra cosy, while others prefer the constant breeze of a fan on their skin. But if you’ve ever stopped to wonder why your body feels a certain way at bedtime, you’re not alone. Why do your feet feel hot at night, for instance? It may be totally normal and natural, or there may be something else causing these feelings.
“Having your feet feel hot at night is a fairly common complaint,” says Dr David Cutler, a general practitioner. “While often there isn’t significant disease underlying this sensation, there are often clues that something more serious is going on.”
Read on to discover the key sensations that point to a real health issue, plus the possible causes of hot feet and how to make them feel better.
When to worry about hot feet
Preferring to sleep with your feet sticking out of the blankets is nothing to worry about. So what is? “The main sign is a feeling of burning or heat in the feet, even without a fever. This burning feeling is real and can make it hard to do daily activities or get a good night’s sleep,” says Dr Oluwatosin Ajao, an internal medicine physician. In addition to a burning sensation, Dr Ajao notes that tingling, prickling, shooting pain, redness, swelling or sensitive skin would also warrant taking a closer look at why your feet feel so hot at night. “You may have a strong desire to cool your feet, but then have your feet feel much worse when they get warm,” she adds.
If the hot feet feeling is accompanied by any of these additional symptoms, or if it’s frequent, severe or continues to get worse, Dr Cutler says you should give your doctor a call – they can run some tests to determine the cause of your hot feet. But in the meantime, here are some of the possible reasons your feet feel hot at night.
Reasons your feet feel extra hot at night
1 Peripheral neuropathy
“The most common cause of burning sensation in the feet is neuropathy, or nerve damage,” says Dr Cutler. “While burning may be the primary abnormal sensation for this condition, there can also be the feeling of cold, tingling, numbness or ‘pins and needles’ with neuropathy.” There are many different possible causes of neuropathy, though doctors aren’t always able to pinpoint which one you’re experiencing. “Doctors call this idiopathic neuropathy, which means the exact reason is unknown,” says Dr Ajao. “But it doesn’t mean the symptoms aren’t real.”
2 Diabetes
One cause of neuropathy that’s possible to diagnose? Diabetes. “Diabetes is the leading cause of nerve damage,” says Dr Ajao. “High blood sugar can injure nerves throughout the body over time. Pre-diabetes and metabolic syndrome can also cause burning feet in some people.”
3 Vitamin deficiencies
If you’re deficient in certain vitamins, it can contribute to nerve damage. Dr Ajao notes that vitamin B12 deficiency is the most common culprit, but not getting enough folate or vitamin B6 can also harm the nerves.
4 Hormonal changes
“Other causes of hot feet, such as hormonal changes with menopause, may not be related to nerve damage at all,” says Dr Cutler. In this case, the drop in oestrogen that leads to hot flushes and night sweats for many women can also contribute to feelings of heat or a burning sensation in the feet.
5 Erythromelalgia
“This is a rare condition that causes episodes of burning pain, redness and warmth in the feet,” explains Dr Ajao. “The symptoms often get worse with heat and improve quickly when the feet are cooled. It can run in families or link to certain blood disorders.” While there’s no specific test to confirm an erythromelalgia diagnosis, Dr Ajao says your doctor can run special blood tests to look for other blood disorders that can contribute to hot feet.
6 Restless legs syndrome
“People with restless legs syndrome often feel burning, crawling or uncomfortable sensations in their legs or feet, especially in the evening or when resting,” says Dr Ajao. “Moving the legs usually relieves the symptoms.”
7 Poor circulation
Decreased blood flow to the feet, which occurs in people with peripheral arterial disease, can cause feelings of heat and pain in the feet at night, says Dr Ajao. “Unlike nerve pain, discomfort often improves when the person hangs their legs over the side of the bed to increase blood flow,” she adds.
8 Other diseases and infections
There are a handful of other diseases and infections that count hot feet among their possible symptoms. According to Dr Ajao, these include thyroid, kidney and liver diseases, Sjögren’s disease, sarcoidosis, amyloidosis, vasculitis, and infections such as HIV.
9 Warm environment
“Sometimes there’s no disease condition whatsoever” that’s making your feet feel hot, says Dr Cutler. Sleeping with too many blankets or too-thick socks, or simply keeping your bedroom too warm, can make your feet hot enough that it disrupts your sleep.
How to ease the symptoms
If you visit your GP and they’re able to diagnose a medical reason why your feet feel hot at night, treating that underlying cause is the best way to ease symptoms and improve your sleep. That said, “if testing is normal and no treatable cause is found, there are still things you can do,” says Dr Cutler. He and Dr Ajao recommend the following strategies:
- Keep the bedroom cool
- Wear lightweight socks to ease abnormal sensations, or use a bed cradle to keep the sheets from touching your feet
- Moisturise and protect your feet so dryness, cracking or injuries don’t make symptoms worse
- Soak your feet in cool (not cold) water, and avoid hot baths or showers before bed
- Ask your doctor about pain-relieving creams, patches or transcutaneous electrical nerve stimulation (TENS) therapy for nerve pain
If these strategies don’t work, only work for a short time or your symptoms get worse, don’t hesitate to make another appointment with your doctor. “Even if an initial evaluation fails to reveal a treatable cause, ongoing follow-up with your treating physician should be pursued, as the underlying cause may eventually be revealed,” says Dr Cutler. Then you can get the relief you need.
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