What should you know about morning chills?

A cool bedroom, damp clothing, poor sleep, or waking after sweating can make the first part of the day feel cold. Shivering can also happen when the body is raising its temperature during an infection, even before a thermometer shows a fever. Influenza commonly presents with chills alongside fever, body aches, cough, or marked tiredness. Chills can also occur with urinary tract or kidney infections, pneumonia, malaria, or dengue fever, but the symptom alone cannot tell these conditions apart.

Note when the episode starts, how long it lasts, whether you feel feverish, and whether it returns during the day. Record associated symptoms such as cough, breathing difficulty, pain when passing urine, back or side pain, vomiting, diarrhoea, rash, or confusion. This information helps a clinician decide whether an examination or tests are appropriate.

Warm yourself gradually with dry clothing, a blanket, and a comfortable room temperature. Drink fluids if you can, rest, and check your temperature with a reliable thermometer rather than judging fever by touch alone. Avoid very hot baths or heating devices if you are drowsy, because burns can occur. Do not start antibiotics or antimalarial medicines without medical advice. If the chills keep returning, are becoming stronger, or continue with fever or other symptoms, arrange a clinical assessment.

Seek urgent medical help for morning chills with trouble breathing, chest pain, fainting, new confusion, severe weakness, blue or grey lips, a seizure, or difficulty staying awake. Prompt assessment is also needed for a very high or persistent fever, severe headache with a stiff neck, repeated vomiting, a widespread rash, severe abdominal or back pain, or much less urine than usual. Sepsis can begin with chills and a rapidly worsening overall condition, so do not wait for every warning sign to appear. If you have recently travelled to a malaria area, are pregnant, have a weakened immune system, or care for a young child or older adult, seek advice sooner.

Ask whether your temperature pattern and other symptoms suggest an infection, whether you need urine or blood testing, and which changes should trigger urgent review. Tell the clinician about recent travel, new medicines, exposure to illness, urinary symptoms, cough, rash, and any condition or treatment that affects your immune system.