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How to Control Coughing at Night?

Cartoon young boy coughing

The cough reflex is the body’s way of getting rid of irritants and pathogens from the upper respiratory tract and lungs, such as dust, smoke, mucus, viruses, and bacteria. But you may have noticed that cough symptoms tend to get worse at night and prevent you from getting a good night’s sleep. Please continue reading to find out what causes nighttime coughs and how to get relief.

What causes a nighttime cough?

The same things that cause daytime coughing can cause a nighttime cough. A night cough can be a dry cough or wet cough and may be accompanied by other symptoms such as sore throat, stuffy nose, runny nose, and postnasal drip (tricking in the back of the throat). 

There can be many reasons for coughing at night, such as a bacterial or viral infection, the common cold, allergic rhinitis (seasonal allergies), allergic reactions, gastroesophageal reflux disease (GERD), asthma, lung disease, acute bronchitis, chronic bronchitis, sleep apnea, damage to the vocal cords, smoking, exposure to secondhand smoke, and lung cancer. The underlying cause of a nighttime cough can also be the side effects of medications. 

Why is my coughing always worse at night? 

A couple of different things can make your cough worse at night. One, when you are lying flat in bed, your body position allows the mucus to pool in your nasal passages and airways. Secondly, the stagnant and dry air in your bedroom can aggravate an already irritated throat. In addition, dust mites, mold, and lint in your bedding can make a nighttime cough worse. This can leave you with a severe cough at night, making it difficult to fall asleep. 

How to treat a persistent cough at night?

Over-the-counter antitussives (cough suppressants) like dextromethorphan and expectorants like guaifenesin can help to relieve coughing. These cough medicines can allow you to get some rest if lying down at night makes your symptoms worse. OTC cough medicines are available in the form of tablets, syrups, lozenges, and sprays.

Most coughs respond to these treatments and some simple home remedies (see below). However, if OTC cough suppressants and home remedies do not work, you should consult your healthcare provider. They may give you prescription drugs such as benzonatate, promethazine/codeine, or hydrocodone/homatropine. If the underlying cause of your cough is a bacterial infection, your doctor may prescribe an antibiotic, such as augmentin or amoxicillin.

How to treat nighttime cough and sore throat at home?

If your cough symptoms are worse at night, the following home remedies may help you stop coughing and get some sleep.

Changes in your environment

  • Keep your head elevated on a couple of pillows or raise the head of your bed. This can stop the mucus from pooling and relieve a nocturnal cough due to acid reflux.
  • Use a humidifier. Dry air can make coughing worse at night. However, keep in mind that too much moisture can irritate the airways and make asthma symptoms worse. Moist air or damp air can also increase the levels of common allergens in the air. Make sure you use the humidifier according to the manufacturer’s instructions. 
  • Consider investing in a HEPA air filter. If allergies are causing your nighttime cough, this may help relieve symptoms.
  • Wash your bedding regularly. Keep carpets, rugs, curtains, and stuffed toys clean.
  • Keep your windows closed to reduce exposure to air pollution, dust mites, pollen, etc.

Lifestyle changes to relieve a nighttime cough

  • Stay well hydrated. This helps thin mucus.
  • Use a saline nasal spray to relieve postnasal drip and thin mucus.
  • Gargle with warm salt water. Avoid using hot water as this can further irritate your throat.
  • Drink herbal tea or other warm liquids like chicken soup. They will keep you hydrated and loosen mucus.
  • Swallow a spoonful of honey, which is a natural cough suppressant (do not give honey to children younger than 2 years of age). Other herbal remedies for cough include ginger and peppermint.
  • Suck on a cough drop or lozenge before bedtime. This may help you stop coughing at night.
  • Use a neti pot if you have a sinus infection. These devices clear out mucus and reduce postnasal drip associated with sinus infections. 
  • Take a dose of cough medicine that also makes you sleepy, such as Benadryl. 

Seeking treatment

  • Work with your healthcare providers to manage asthma, GERD (excess stomach acid), and other health conditions that can make nighttime coughing worse.
  • Seek treatment for viral and bacterial infections in a timely manner. 
  • Get your flu shot every year. This reduces your risk of contracting a viral infection that can cause daytime and/or nighttime cough.
  • Stop smoking. Talk to your healthcare professional about medications and programs that can help you kick the habit.

Always seek treatment from a healthcare professional for a chronic cough that lasts longer than 3 weeks. Also, consult your doctor if you have symptoms such as fever over 100F, wheezing, shortness of breath, chest pain, or swelling in your ankles or feet.

References:

  1. https://www.mayoclinic.org/diseases-conditions/chronic-cough/symptoms-causes/syc-20351575
  2. https://www.mayoclinic.org/symptoms/cough/basics/causes/sym-20050846
  3. https://my.clevelandclinic.org/health/symptoms/17755-cough