If you can’t sleep with hot feet, from a Chinese medicine point of view, you are suffering from fire, usually due to excessive fire in the lower jiao, which causes hot feet and sleeplessness. From the perspective of Western medicine, the most common factor is infectious. The feet are particularly susceptible to bacterial and viral infections, especially fungal infections, which can lead to redness, swelling, heat and pain in both lower extremities, along with cellulitis in the surrounding tissues, and even dermatitis, all of which can have clinical symptoms and clinical manifestations of hot feet and sleeplessness. Patients with previous gout, for example, may also have clinical symptoms and manifestations of sleeplessness with very hot feet, especially in the metacarpophalangeal and first metatarsophalangeal joints, when there is a transient increase in blood uric acid. Non-infectious diseases such as rheumatism, dermatomyositis and soft tissue diseases may also present with foot fever. In addition, immune system disorders and endocrine disorders, such as hyperthyroidism, can also present with hot feet and sleeplessness.