Heat Stroke: Can It Happen While You Sleep?

Heat stroke is a severe form of heat illness that occurs when the body is no longer able to regulate its temperature, resulting in a dangerously high core body temperature of over 104°F. It is typically caused by prolonged exposure to high temperatures, often in combination with dehydration, and can lead to organ failure and even death. While it usually occurs during a heatwave or vigorous exercise in hot weather, one may wonder if it is possible to get heat stroke in your sleep.

Risk factors for heat stroke

While it is unlikely that you would get heat stroke in your sleep, there are still risk factors that could make you more susceptible to heat stroke. Here are some detailed explanations of the risk factors for heat stroke:

Age

Infants, children up to age 4, and adults over age 65 are at an increased risk of heat stroke. Older people are more vulnerable as they adjust to heat more slowly and may have underlying health conditions that impair their ability to regulate body temperature. Additionally, older people living in homes without proper cooling systems, such as air conditioning or good airflow, are at a higher risk.

Health Conditions

Certain health conditions can make individuals more susceptible to heat stroke. These include heart, lung, or kidney disease, obesity or being underweight, high blood pressure, diabetes, mental illness, sickle cell trait, alcoholism, sunburn, and any condition that causes a fever. People with these health issues should be cautious during hot weather and ensure they stay hydrated and cool.

Medications and Substance Use

The use of certain medications and substances can increase the risk of heat stroke. This includes the use of antihistamines, diet pills, diuretics, sedatives, tranquilizers, stimulants, seizure medications (anticonvulsants), heart and blood pressure medications, and psychiatric drugs such as antidepressants and antipsychotics. Illegal drugs, such as cocaine and methamphetamine, are also associated with an increased risk. It is important to consult with a doctor or healthcare professional if you are taking any of these medications to understand your risk and take appropriate precautions.

Environmental Factors

Living in urban areas, especially during prolonged heat waves with stagnant atmospheric conditions and poor air quality, can increase the risk of heat stroke. The "heat island effect" in cities, where asphalt and concrete store and release heat, leads to higher nighttime temperatures, making it challenging for the body to cool down.

Physical Activity and Dehydration

Engaging in intense physical activity or exercise in hot and humid weather can elevate the risk of heat stroke. This is particularly true if individuals do not properly acclimatize to the heat, are highly competitive, do not take adequate breaks, or have limited access to fluids during physical exertion. Dehydration is a significant factor, and individuals of any age who do not drink enough water or consume excessive alcohol are at higher risk.

Heat stroke symptoms

Heat stroke is a medical emergency and can be fatal. It is caused by prolonged exposure to high temperatures, usually in combination with dehydration, which leads to a failure of the body's temperature control system.

The hallmark symptom of heat stroke is a core body temperature of 104°F or higher. However, fainting may be the first sign. Other symptoms include:

• Dizziness and light-headedness
• Lack of sweating despite the heat
• Red, hot, and dry skin
• Muscle weakness or cramps
• Rapid heartbeat, which may be either strong or weak
• Rapid, shallow breathing
• Behavioural changes such as confusion, disorientation, staggering, or loss of consciousness
• Nausea, seizures, or coma

If you suspect that someone has heat stroke, immediately call emergency services or take the person to a hospital. While waiting for the paramedics to arrive, initiate first aid by moving the person to a cool, shady area and removing any unnecessary clothing. Try to take the person's core body temperature and initiate first aid to cool it to 101-102°F. Use cooling strategies such as fanning the person's skin while wetting it with water, applying ice packs to the armpits, groin, neck, and back, or immersing them in a shower or tub of cool water.

Preventing heat stroke

While it is unclear whether one can get heat stroke during sleep, there are still precautions that can be taken to prevent heat stroke, especially during hot weather or exercise. Here are some ways to prevent heat stroke:

Stay Hydrated

• Drink more cold drinks, especially if you're active or exercising. It is generally recommended to drink at least eight glasses of water, fruit juice, or vegetable juice per day.
• During exercise, drink another 8 ounces of water every 20 minutes, even if you don't feel thirsty.
• Monitor the colour of your urine. Darker urine is a sign of dehydration. Ensure you drink enough fluids to maintain very light-coloured urine.

Adjust Your Environment

• If you're inside on a very hot day, close the curtains and windows if it's hotter outside than in your home.
• Turn off electrical equipment and lights that get hot.
• If you live in an apartment or house without fans or air conditioning, try to spend at least 2 hours each day in an air-conditioned environment.
• At home, open windows at night on two sides of your building to create cross-ventilation.
• If you can, reschedule or cancel outdoor activities during hot weather. If you must go outdoors, shift your time outdoors to the coolest times of the day, either early morning or after sunset.

Clothing and Sun Protection

• Wear light-coloured, loose clothing.
• When going outdoors, wear a wide-brimmed hat and use sunscreen with a sun protection factor (SPF) of 30 or more.

Other Precautions

• Avoid extreme exercise and excess alcohol.
• Monitor your weight before and after physical activity. Tracking lost water weight can help you determine how much fluid you need to drink.
• Avoid fluids containing caffeine or alcohol, as they can make you lose more fluids and worsen heat-related illnesses.
• Check with your doctor before increasing your fluid intake, especially if you have epilepsy, heart, kidney, or liver disease, are on fluid-restricted diets, or have a problem with fluid retention.

Heat stroke treatment

Heat stroke is a medical emergency that requires immediate treatment. If you suspect that someone is experiencing heat stroke, call the emergency services and give first aid until paramedics arrive.

• Move the person to a cool place, ideally air-conditioned, or at least a cool, shady area.
• Remove any unnecessary clothing.
• If possible, take the person's core body temperature and try to cool it down to 101–102 °F (38.3–38.9 °C).
• Try various cooling strategies, such as fanning air over the patient while wetting their skin with water, applying ice packs to the person's armpits, groin, neck, and back, or immersing them in a shower or tub of cool water.
• If the person is young and healthy and suffered heat stroke while exercising vigorously (exertional heat stroke), an ice bath can be used.
• Do not use ice for older patients, young children, patients with chronic illnesses, or anyone whose heat stroke occurred without vigorous exercise, as this can be dangerous.

While waiting for emergency services, it is crucial to monitor the person's condition and watch for any changes. If there is a delay in the emergency response, contact the hospital emergency room for further instructions.

At the hospital, the person will be rehydrated and receive electrolytes through an IV to restore fluid balance and support the body's temperature regulation.

It is important to note that heat stroke prevention is crucial, especially for individuals at high risk, such as the elderly, children, and those with chronic health conditions. Staying hydrated, wearing appropriate clothing, avoiding excessive sun exposure during the hottest parts of the day, and being cautious during exercise or outdoor work can all help prevent heat stroke.

Heat stroke vs heat exhaustion

Heat exhaustion and heat stroke are both heat-related illnesses that can be serious or even life-threatening if not treated promptly and properly. Both are caused by the body's inability to cool itself, often due to prolonged exposure to high temperatures and dehydration. However, heat stroke is more severe and requires immediate medical attention.

Heat exhaustion occurs when the body loses excess water and salt, typically through sweating. The early warning signs of heat exhaustion include nausea, light-headedness, fatigue, muscle cramping, and dizziness. If someone is showing signs of heat exhaustion, they should be moved to a cool place, given fluids, and their skin should be cooled with methods such as spraying or sponging with cool water, or using cold packs. Heat exhaustion is typically not considered an emergency if the person can cool down within 30 minutes.

On the other hand, heat stroke is a medical emergency and requires immediate medical attention. It occurs when the body's internal temperature control system fails, often due to prolonged exposure to high temperatures and dehydration. The hallmark symptom of heat stroke is a core body temperature above 104°F (40°C). Other symptoms include fainting, dizziness, lack of sweating despite the heat, red, hot, and dry skin, muscle weakness or cramps, rapid heartbeat, rapid shallow breathing, and behavioural changes such as confusion, disorientation, or staggering.

If someone is suspected of having heat stroke, it is crucial to call for emergency medical help immediately. While waiting for medical assistance, move the person to a cool and shaded area, remove unnecessary clothing, and initiate cooling strategies such as fanning them while applying cool water to their skin or using ice packs.

To prevent heat-related illnesses, it is important to stay hydrated, wear lightweight and light-coloured loose-fitting clothing, limit sun exposure, and avoid strenuous activities during the hottest parts of the day.

Frequently asked questions