What causes that terrible nighttime cough?

Woman lying in bed coughing at night

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

What causes nighttime coughing?

While many issues trigger coughing, there are two common causes I see among many of my patients: acid reflux and post-nasal drip.

When you lie down at night, you lose the gravitational advantage that you have while standing during the day. If you have acid reflux, the acid comes back up your esophagus, essentially burning and irritating your throat and causing you to cough. If you’re a victim of post-nasal drip, the mucus drains into your upper airway and activates the coughing reflex.

Are your lifestyle choices worsening the problem?

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

For example, patients with acid reflux often report that they had 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 ensues.

In addition, post-nasal drip is often caused by allergies. Many patients have allergies to pets, pollen, ragweed and dust, and daily behaviors can irritate these allergies, causing post-nasal drip and coughing at night.

What are these behaviors and how can you change them?

If you have acid reflux, you might be guilty of grabbing late-night drinks with friends and hitting the hay as soon as you get home, which triggers coughing fits. Instead of immediately going to bed, give your stomach some time to digest. It’s also important to keep in mind that alcohol, caffeine and fatty foods promote acid reflux at any time of day.

People with animal allergies are often guilty of sleeping in bed with their furry friend. While it may be difficult, you might benefit from purchasing a dog bed and making sure your pet sleeps separately. For patients with outdoor allergies such as pollen or ragweed, I recommend sleeping with the windows closed to prevent irritation and post-nasal drip.

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

A simple measure is to prop yourself up with a pillow before you go to sleep. By doing so, you’re able to combat the acid threatening to irritate your throat and minimize the mucus in your upper airway.

It’s also crucial to be compliant with your doctor’s recommendations. If you’re supposed to take allergy or acid reflux medicine, make it a priority to do so. Small changes can go a long way in dodging nighttime coughing.

Although coughing can be attributed to a dry atmosphere, I don’t recommend purchasing a humidifier. They can harbor mold and spray moldy water into the air. For people with mold allergies, this worsens the problem and is harmful to your health.

What about cough medicine?

The reality is that most over-the-counter and prescription medications numb the cough reflex rather than treat the true cause of the cough. While lung disease is treated by prescription medications, these cases are rare.

Remember that coughing is a protective reflex: your upper airway protects you from choking, and your lungs help you eject unwanted substances. Sometimes, although it’s quite aggravating, coughing is necessary.

When is it time to see a doctor?

If your cough is persistent for more than three weeks, or if it’s associated with other symptoms such as 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 issue.

Note: Parents — if your child has a persistent cough, be aware that it could be due to foreign body aspiration. Children are susceptible to swallowing small objects such as marbles or figurines. If you believe this could have happened, take your child to the doctor.


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