Why your cough gets worse at night and how to find relief

A persistent cough that worsens at night can be a frustrating experience, impacting your ability to relax, sleep, and recover from illnesses. Understanding the reasons behind this phenomenon and exploring effective remedies can significantly improve your sleep quality and overall well-being.

Why Does Coughing Get Worse at Night?

Several factors contribute to the worsening of coughs at night:

Sleeping Position: When you lie down, gravity causes mucus to pool in the back of your throat, triggering a cough reflex. Dr. Liana Casusi explains, "Coughing is the body’s way of ridding the lungs and airways of invaders like dust, smoke, pollution, or mucus".

Dry Air: The air in your bedroom may be dry, especially if you use air conditioning or heating systems. Dry air can irritate your throat and airways, leading to coughing.

Postnasal Drip: Mucus from your nasal passages can drip down your throat when you lie flat, causing irritation and coughing. This is often exacerbated by allergies or sinus infections.

Gastroesophageal Reflux Disease (GERD): Stomach acid can flow back into the esophagus when you lie down, irritating the lining and causing a cough. Dr. Vontrelle Roundtree notes, "When stomach acid flows back into the esophagus, it can irritate the lining and potentially reach the back of the throat, causing a cough".

Allergens: Dust mites, pet dander, and other allergens in your bedroom can trigger a cough, especially if you have allergies or asthma.

Common Causes of Nighttime Cough

Respiratory Infections: Viral or bacterial infections like colds, flu, and pneumonia can cause inflammation and mucus production, leading to coughing.

Asthma: Narrowed airways and excess mucus production can cause coughing, especially at night.

Allergies: Allergic reactions to dust, pollen, or pet dander can lead to postnasal drip and coughing.

Heart Failure: Fluid buildup in the lungs can cause coughing, particularly when lying down.

Medications: Certain medications, like ACE inhibitors used for high blood pressure, can cause a persistent cough.

Effective Remedies for Nighttime Cough

Here are some practical tips and remedies to help you manage a nighttime cough:

1. Adjust Your Sleeping Position

Elevate Your Head: Use extra pillows or a wedge pillow to keep your head elevated. This helps prevent mucus from pooling in your throat.

Incline Your Mattress: If possible, incline the head of your bed to create a more upright sleeping position.

2. Improve Air Quality

Use a Humidifier: Adding moisture to the air can soothe your throat and reduce coughing. Ensure you clean the humidifier regularly to prevent mold growth.

Keep Your Bedroom Clean: Regularly wash bedding, vacuum floors, and use allergen-proof covers on pillows and mattresses to reduce exposure to allergens.

3. Stay Hydrated

Drink Plenty of Fluids: Staying hydrated helps thin mucus, making it easier to expel. Warm liquids like herbal tea or broth can be particularly soothing.

Honey: A teaspoon of honey can coat your throat and reduce irritation. Dr. Mathis recommends, "A simple remedy that's very effective for coughing is a nighttime herbal tea with honey and lemon".

4. Use Over-the-Counter Remedies

Cough Suppressants: Medications like dextromethorphan can help reduce the urge to cough.

Expectorants: These medications thin mucus, making it easier to cough up.

Antihistamines: If allergies are causing your cough, antihistamines can help reduce symptoms.

5. Home Remedies

Gargle with Salt Water: Gargling with warm salt water can reduce throat inflammation and kill bacteria.

Steam Inhalation: Breathing in steam from a hot shower or a bowl of hot water can help loosen mucus and soothe your airways.

Avoid Irritants: Keep your bedroom free of smoke, strong odors, and other irritants that can trigger coughing.

6. Address Underlying Conditions

Treat GERD: If acid reflux is causing your cough, avoid eating large meals or spicy foods before bed. Elevate your head while sleeping and consider over-the-counter antacids.

Manage Allergies and Asthma: Follow your doctor's recommendations for managing these conditions, which may include medications and lifestyle changes.

When to See a Doctor

While many nighttime coughs can be managed with home remedies and over-the-counter treatments, it's important to seek medical advice if:

• Your cough persists for more than a few weeks.
• You experience shortness of breath, chest pain, or coughing up blood.
• You have a fever or unexplained weight loss.

Nighttime coughing can be a disruptive and frustrating experience, but understanding its causes and exploring effective remedies can help you find relief. By adjusting your sleeping position, improving air quality, staying hydrated, and using appropriate medications, you can reduce nighttime coughing and improve your sleep quality. If your cough persists or is accompanied by other concerning symptoms, be sure to consult a healthcare professional for proper diagnosis and treatment.