Night Cough: Causes, Symptoms, Management, Treatment and Recommendations

Everyone gets that annoying feeling in their throat that starts as a tickle and then turns into a whooping cough.

Coughing is your body’s way of releasing irritants, mucus, germs, and pollutants from your lungs.

The cold season has hit and that means no one is safe from the dreaded sneezing, congestion, and fever – or worse, a stubborn cough that only seems to get worse when night falls.

No matter what you do in your attempts to alleviate it, that pesky trick seems like it just won’t go away and is costing you precious hours of plenty of rest.

And while you may find yourself in a desperate moment dealing with that cough, taking cough and cold medicine may not be the best option (or even work).


The coughing fit can happen just when you’re trying to fall asleep, or it wakes you up in the middle of the night.

What causes that terrible night cough?

When you lie down to get a good night’s rest, a persistent cough can be extremely frustrating. You don’t sleep, you keep your partner awake, and they stun you the next day. What triggers these annoying coughing spells and what can you do to avoid them?

While many problems trigger coughs, there are two common causes that I see among many of my patients: acid reflux and postnasal drip.

When you go to bed at night, you lose the gravitational advantage you have while on your feet during the day. If you have acid reflux, the acid goes back up your esophagus, essentially burning and irritating your throat and causing a cough.

If you are the victim of a post nasal drip, the mucus drains into the upper airway and activates the cough reflex.

Why is the cough worse at night?

Symptoms generally tend to be worse at night, although no one is sure why. But in the case of a cough, there are a few possible explanations.

When you are asleep, you are not coughing and coughing is the way we get rid of the mucus that is in the airways.

So if you are asleep and you are not coughing up and clearing that mucus that is building up, you will wake up sometime at night or first thing in the morning and have a lot of mucus that you will have to get rid of.

In fact, being physically active and moving around actually helps loosen secretions in the airways. So when you’re moving less (i.e., asleep), that mucus buildup can’t break down.

And if you happen to have a respiratory tract infection (and not just a cold), there may be nasal and sinus symptoms causing congestion and postnasal drip, which can leak down your windpipe.

If this affects the upper airways or vocal cords, that can cause irritation of the area and induce coughing.

Wet and dry cough

The type of cough you have can help determine what type of illness you have. The wetter type cough tends to be attributed to bacterial infections of the respiratory tract due to the production of mucus in the respiratory tract.

However, drying coughs tend to be associated with viruses and often irritate the respiratory tract.

It is important to note that this is not always the case and that a doctor would be the best to determine the type of ailment you are suffering from.

Are your lifestyle choices making the problem worse?

Although there are some patients with more serious underlying conditions, there is a good chance that your nighttime cough can be stopped by changing your habits.

For example, acid reflux patients often report having a late-night snack before bed. When food has no chance to enter your stomach before your body shuts down for the night, reflux worsens and coughing occurs.

Also, postnasal drip is often caused by allergies. Many patients have allergies to pets, pollen, ragweed, and dust, and daily behaviors can irritate these allergies, causing postnasal drip and cough at night.

What are these behaviors and how can you change them?

If you have acid reflux, you could be guilty of drinking late night drinks with friends and hitting the hay as soon as you get home, triggering coughing fits. Instead of immediately going to bed, give your stomach time to digest it.

It’s also important to note that alcohol, caffeine, and fatty foods promote acid reflux at any time of the day.

People with animal allergies are often guilty of sleeping in bed with their furry friend. While it can be difficult, you can benefit from purchasing a dog bed and making sure your pet sleeps separately.

For patients with outdoor allergies like pollen or ragweed, I recommend sleeping with the windows closed to avoid irritation and postnasal drip.

The science behind a cough that is worse at night

There are a number of reasons why cough symptoms get worse, or seem to get worse.


The biggest reason we cough more at night is simple: gravity. When we go to bed, mucus begins to accumulate automatically. The position in which you sleep can help with a nighttime cough.

Certain positions may make things worse and certain positions make things better. Some people may find it easier to sleep with the head of the bed elevated slightly because that could help reduce post nasal drip.

The best way to counteract this gravitational pull is elevation.

A dry, indoor environment

Dry, warm air can irritate and aggravate an already irritated nose, throat, and airways, making your nighttime cough worse.

Some people also cough when they turn on the heater in the winter. This is due to the release of pollutants that have accumulated in the heating ducts.

Cold versus warm

When it comes to exposing yourself to hot or cold drinks or air, it comes down to what makes you the most comfortable.

However, he explains that there are receptors in the upper airway that respond or become activated when exposed to cold temperatures.

If you breathe in cold air or have a very cold drink, these receptors in the upper respiratory tract are stimulated and induce coughing. So in some people, drinking cold beverages when they are sick can aggravate coughs because they stimulate and activate those cold receptors.

Clearing the congestion

Before you curse the cough, remember this: the cough is really important to help you get better. The cough reflex helps keep the throat and airways clear.

As annoying as it may be, that nagging cough is breaking up the mucus and helping your body get better.

How to manage a dry cough at night

Although most coughs associated with colds and flu are beneficial in clearing congestion from your lungs and airways, you can sometimes have a persistent, dry cough.

Depending on what causes it, there are different remedies and lifestyle changes that you can try to alleviate or prevent nighttime cough in both adults and children.

A dry cough can make your airways, throat, and chest ache and prevent you from getting much-needed rest. When you can’t seem to stop coughing, try these tips:

Make sure you drink plenty of fluids throughout the night before going to bed; Liquids can help thin the mucus in your throat and make coughing easier.

Before going to sleep, suck on a cough drop or hard candy to soothe your throat and decrease the urge to cough. Ask your pharmacist for the best cough medicine formulated specifically for a dry cough.

Call your doctor if the cough lasts longer than 7 to 10 days. If your cough persists with nasal symptoms that improve but then worsen again, your sinusitis should be checked. In that case, an antibiotic may be prescribed.

If you are waking up a cough or the cough lasts longer than a week or two, it could be the result of another health condition, such as bronchitis, chronic sinusitis, gastroesophageal reflux disease, asthma or pneumonia, so a doctor’s opinion it’s crucial.

Tilt the head of your bed

The cough is often worse at night because a person lies in bed. Mucus can collect in the back of the throat and cause a cough.

It’s easier for irritants to get into your throat to cause a cough when you’re lying down. Try some pillows to lift your head. It will help prevent mucus from building up in the back of your throat.

Sleeping with your head elevated can decrease postnasal drip and symptoms of gastroesophageal reflux disease, both of which cause coughing at night. A change in sleeping position can allow mucus to flow without causing a cough.

Use a humidifier

Dry air can make a cough worse. Air conditioning and refrigeration fans in summer and heating systems in winter can dry out the environment.

A person can try using a humidifier at night to add moisture to the air where they sleep.

A humidifier that produces a cool mist can help keep the air in your room moist. This can keep your throat feeling better.

You can try a humidifier to put moisture back into the air and make breathing easier, but be sure to take proper care of the unit.

Humidifiers are not always safe. If the water you put into it is not sterile, you run the risk of recycling germs in the air or developing other diseases.

The last thing people with a cold or flu want is to experience complications. Bacterial infections can appear.

Many flu-related deaths are caused by pneumonia that strikes after people believe they no longer have the flu.

To ensure you use a humidifier safely, be sure to carefully follow all of the accompanying instructions.

However, too much moisture can contribute to mold growth. Mold can be an allergen and cause even more coughing.

A device called a hygrometer can be used to check the humidity level in a room. A hygrometer can usually be purchased at a hardware store.

A humidity level of around 50 percent in a bedroom is a good target to aim for. There is a selection of humidifiers available to purchase online.

Taste the honey

Honey and a hot drink can help loosen mucus in the throat, calm the throat, reduce irritation, and loosen mucus.

Mix two teaspoons of honey into a caffeine-free tea, such as herbal tea, to drink before bed. However, you should never give honey to children under 1 year old, due to the potential risk of a form of food poisoning called botulism.

There is a selection of honey available to buy online.

Addressing your gastroesophageal reflux disease

Lying down makes it easier for stomach acid to back up into the esophagus. This condition is known as acid reflux.

Gastroesophageal reflux disease is a digestive disorder that causes some stomach contents to return to the esophagus, it is a chronic form of acid reflux and a common cause of night cough, it can cause throat irritation, especially at night.

But there are some lifestyle changes that you can try to reduce the cough caused by GERD. For instance:

Avoid foods that trigger your gastroesophageal reflux disease. Keep a food diary to help you figure out what these foods are if you are unsure.

Do not lie down for at least 2.5 hours after eating or avoid foods that can trigger heartburn and not eating for about 4 hours before bedtime can help lessen symptoms.

Raise the head of your bed 6 to 8 inches. People who have gastroesophageal reflux disease should consult with their doctor about how to manage their condition.

Use air filters and allergy testing in your room

When your immune system overreacts to an allergen, allergy symptoms such as a cough can appear.

Dust allergy is a common cause of coughing, especially at night when you are exposed to dust mites or pet dander in your bedding. Here are some strategies to protect your bedroom from mites:

Use allergy-free covers for pillowcases, duvets, mattresses, and box springs to reduce and prevent dust mites. Wash bedding in hot water once a week.

Run an air filter in your room to remove common allergens. Don’t leave pets on your bed or in your room. If you have rugs, vacuum frequently with a vacuum cleaner.

Prevent cockroaches

Roach saliva, feces, and body parts can cause coughing and other allergy symptoms. According to the Asthma and Allergy Foundation of America, cockroaches are a common cause of allergies and asthma attacks .

You can help prevent or reduce cockroaches in your home with these strategies:

  • Keep food containers sealed so they are not attractive to roaches.
  • Eliminate piles of newspapers and magazines that attract dust and give roaches places to hide. Use an exterminator to eliminate a severe roach infestation.

Decrease allergens

Allergies occur when the immune system overreacts to a generally harmless substance. Symptoms, such as sneezing, congestion, and coughing are common.

Common allergy triggers include mold, pet dander, and dust. According to the National Sleep Basis, a person can decrease allergy-related coughs in the bedroom by:

  • Use a vacuum cleaner with a filter on the bedroom floor weekly to remove dust. Removing the bedroom of magnets to remove dust, such as magazines, books and trinkets.
  • Washing the bedding in hot water once a week. Shower before going to bed to remove outdoor allergens, such as pollen.

Seeking treatment for a sinus infection

Stuffed sinuses or a sinus infection can cause postnasal drip, especially when lying down. Postnasal drip tickles the back of your throat and causes you to cough.

If your nighttime cough is caused by a medical condition, such as a sinus infection, it is important to get treatment. You may need a prescription from your doctor for antibiotics.

Saltwater nasal rinse

If there are nasal symptoms during a respiratory tract infection, in particular if there is a post nasal drip, you can try a salt water nasal rinse.

Salt water can soothe a sore or sore throat. It can also help clear mucus from the back of your throat.

You can use it to clean your nose, sinuses, and mucus at night before going to bed. This will help minimize nasal congestion and postnasal drip that can be worse at night.

The rinse can be purchased without a prescription at your local pharmacy. To reduce a cough, a person can mix a teaspoon of salt in about 6 ounces of warm water and gargle several times before going to bed.

Salt water should be spit out after gargling and not swallowed.

Rest and take decongestants for a cold

Your cough can be caused by the common cold. Your cough may be worse at night or when you lie down. Rest, chicken soup, fluids, and time are generally all it takes to fight a cold.

However, severe coughs due to a cold can be treated with cough medicine in adults and children older than 6 years. Decongestant sprays that help reduce postnasal drip can also be used in adults and children over 6 years of age.

Manage asthma

Asthma is a long-term lung disorder that involves inflammation and narrowing of the airways.

Asthma causes the airways to narrow and swell. A common symptom of asthma is a dry cough. You may need a prescription inhaler to treat asthma and you may stop coughing at night due to asthma.

Some inhalers contain respiratory medications to open the airways, which can relieve coughing and make breathing easier.

Stop smoking

Cigarette smoking is a common long-term cause of coughing. A chronic cough is a common side effect of long-term smoking. Quitting smoking will help decrease your cough over time, although it will not stop the problem overnight.

It’s not a quick fix, but if you’re a smoker, talk to your doctor about programs that will help you quit. Talking to a doctor about smoking cessation medications, such as nicotine patches, gum, and medications, can also help.

The American Lung Association offers resources to help people who want to quit smoking. Not only will your cough improve, your overall health will, too.

Follow these tips to help you get a quality sleep. And remember, while coughing can play a positive role in helping you recover, it is important to pay attention to the course of your illness.

If you continue to feel worse and the cough persists for more than a week, call your doctor.

How to relieve your child’s nighttime cough

Steam from a vaporizer in your child’s room can help calm a cough. For barking coughs, take your child to a steamy bath for about 20 minutes to help them breathe easier.

Exposure to cold air can ease a cough, but be careful if your child has asthma, as it can make asthma coughing worse.

If your child is younger than 3 years old, do not give him cough drops. Cough drops are a choking hazard for young children.

You should get medical help immediately if your child’s cough is hoarse or croupy or is accompanied by:

  • Fever.
  • Vomiting
  • Fast breathing or shortness of breath
  • Wheezing

You should also call the doctor right away if your child’s cough ends with a “buzzing” sound or produces green, yellow, or bloody phlegm.

What to do when the cough is severe

Most coughs go away on their own, but a strong nighttime cough can be a sign of a serious illness. For example, heart failure can cause a chronic cough that is worse at night.

Respiratory diseases such as bronchitis, pneumonia, and chronic obstructive pulmonary disease also cause severe, chronic coughing. Lung cancer and blood clots in the lungs are less common causes of a severe cough.

Get medical help if you have a cough and:

  • Fever of 100˚F (38˚C) or higher.
  • Difficulty breathing.
  • Suffocation.
  • Swelling in your legs or abdomen.
  • Wheezing
  • Green, yellow, or bloody phlegm.
  • It lasts more than three weeks.

Are there other little steps you can take to avoid coughing?

A simple measure is to get up with a pillow before going to sleep. By doing so, you can combat the acid that threatens to irritate your throat and minimize mucus in the upper respiratory tract.

It is also crucial to adhere to your doctor’s recommendations. If you’re supposed to take allergy or acid reflux medication, make it a priority to do so. Small changes can go a long way in avoiding a nighttime cough.

Although the cough can be attributed to a dry atmosphere, I do not recommend buying a humidifier. They can harbor mold and spray moldy water into the air. For people with mold allergies, this makes the problem worse and is harmful to their health.

What about cough medicine?

When it comes to overcoming a persistent cough and other cold and flu symptoms, there are some relatively simple steps you can take.

Health experts suggest a liquid regimen, over-the-counter pain relievers and a decongestant if needed, and plenty of rest. In fact, rest is one of the most important ways your body fights infection.

Ironically, getting enough rest can also be the hardest thing to do.

You know the scenario: You go to bed after a long day of feeling lousy, only to find that you can’t stop coughing. Just when you need sleep the most, your cough symptoms get worse and keep you awake all night.

Remember that coughing is a protective reflex: your upper airway protects you from suffocation, and your lungs help you expel unwanted substances. Sometimes, although it is quite irritating, it is necessary to cough.

Should you use over-the-counter medications?

In desperation, it’s tempting to reach for an over-the-counter cough and cold medicine that promises to suppress your cough.

You really don’t want to suppress or eliminate your cough entirely because coughing, while annoying and annoying, is your body’s way of clearing mucus from your airways and lungs.

You want to get rid of that pus that contains bacteria and inflammatory cells that are clogging your lower airways.

Although it’s okay to want to use these medications to lessen some symptoms at times, you don’t even want to completely eliminate the cough.

Although lung disease is treated with prescription drugs, these cases are rare. In fact, suppressing the cough can make the cough last longer. If you suppress your cough, mucus will continue to build up.

It can go from an upper respiratory infection to pneumonia or a lower respiratory infection, and that can be more of a problem in people who have chronic lung diseases such as chronic obstructive pulmonary disease or asthma who already have inflammation.

When is it time to see a doctor?

As the infection clears, the cough will clear up, but it may take a little time, even up to eight weeks [to clear up].

If the infection is believed to be bacterial in origin, getting an antibiotic would help reduce all symptoms, including a nighttime cough.

If your cough is persistent for more than three weeks, or is associated with other symptoms like shortness of breath, fever, weight loss, or bloody phlegm, it’s time to make an appointment. These symptoms could be signs of a more serious problem.

However, if a respiratory tract infection is viral in origin, antibiotics will not help.

The common cold is a virus. Therefore, it is important that when people start to have colds or coughs they are not given an antibiotic because it can be a viral infection that will last 48 hours, so the antibiotics would not do anything.

But if the cough persists and the symptoms don’t improve, it may be time to visit your doctor. The severity of your nighttime cough will depend on the cause. For example, a nighttime cough due to a common cold will usually go away in a week or two.

If the cause is a chronic lung disease, the cough may be more difficult to reduce.

People who have allergies, asthma, or gastroesophageal reflux disease can improve their prognosis by managing their condition and working with their doctor to find treatment options that decrease symptoms.