3 Reasons Your Cough Symptoms Get Worse at Night

A persistent cough tends to get worse at night — just when you need it to abate so that you can get the quality sleep that’ll help you feel better. Here’s why it happens and what you can do to ease your cough symptoms.

When it comes to getting over a persistent cough and other cold and flu symptoms, there are a few relatively simple steps you can take: Health experts suggest a regimen of drinking fluids, taking over-the-counter pain relievers and a decongestant if needed, and getting lots of rest. In fact, rest is one of the most important ways for your body to fight off infection of any kind.

But ironically, getting enough rest can also be the hardest thing on your list to accomplish. You know the scenario: You lie down 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 up all night.

The Science Behind Nighttime Coughing

There are a number of reasons why cough symptoms get worse — or seem to — at night:

Gravity. The biggest reason we cough more at night is simple: gravity, says Mitchell Blass, MD, an infectious disease specialist with Georgia Infectious Diseases, PC, and staff physician at Saint Joseph’s Hospital in Atlanta. “When we lie down, the gastroesophageal reflex kicks in because mucus automatically begins to pool.” The best way to counteract this gravitational pull is elevation. “Sleep with a pillow propping you up a little,” Dr. Blass suggests. “It will help keep the mucus from collecting in the back of the throat.”

Cough Symptoms

A dry, indoor environment. Dry air can aggravate an already irritated nose and throat, making your nighttime cough worse. You can try a humidifier to put moisture back into the air and make it easier to breathe, but be sure to take proper care of the unit. “Humidifiers are not always safe,” warns Blass. “If the water you put in it isn’t sterile, you run the risk of cycling the germs back into the air or breeding other diseases.” The last thing people with a cold or flu want is to experience complications, says Blass. “Bacterial infections can set in. Many flu-related deaths are caused by pneumonia that hits after people think they’re over the flu.” To ensure you use a humidifier safely, be sure to follow all the directions that it comes with carefully.

Clearing congestion. Before you curse the cough, remember this: Coughs are actually important in helping you get well. The coughing reflex helps keep your throat and airways clear. As annoying as it may be, that persistent cough is breaking up mucus and helping your body get well.

Managing a Dry Nighttime Cough

Though most coughs associated with colds and flu are beneficial for clearing congestion from your lungs and airways, sometimes you can get a dry, hacking cough that lingers. Dry coughs can make your airways, throat, and chest sore and keep you from getting much-needed rest.

When it seems like you just can’t stop coughing, try these tips:

  • Be sure to drink plenty of fluids throughout the evening before bed — liquids help thin the mucus in your throat and make it easier to cough up.
  • Before you go 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 for more than 7 to 10 days. If your cough persists with nasal symptoms that improve but then get worse, you should be checked for sinusitis, says John A. Zora, MD, of the Atlanta Allergy & Asthma Clinic. In that case, an antibiotic may be prescribed. A cough lasting longer than a week or two could be the result of another health condition, such as bronchitis, chronic sinusitis, reflux, asthma, or pneumonia, so getting a doctor’s input is crucial.

Follow these tips to help get some quality rest. And remember, while coughs can play a positive role in helping you recover, it’s 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.


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