Why Coughing at Night Happens
It’s time for bed, and you’re settling in for the night, feeling drowsy enough to fall asleep, only to develop a nagging cough that keeps you awake. Now what? Why are you coughing when you weren’t before you laid down?
Coughing at night can happen for a variety of reasons, including the following:
- Postnasal drip or after a viral respiratory infection
- Asthma
- ACE inhibitor drugs being taken for high blood pressure
- Chronic bronchitis or emphysema
- Gastroesophageal reflux disease (GERD) or acid reflux
- Heart failure
Most cough-related conditions are not severe, but many can interfere with sleep enough to harm your overall health over time.
How Coughing Affects Sleep Quality
Nighttime cough can interfere with getting to sleep or staying asleep. It can also cause frequent awakenings or interfere with getting enough deep or restorative sleep. Research on asthmatics shows that sleep quality declines when the cough is more prominent.
When to Seek Medical Attention
If you know why you have a cough, and it is self-limited (like nasal allergies or a cold), you can probably treat it and expect it to pass. On the other hand, if you don’t know why you are coughing or if your cough interferes with more than two to three nights of sleep in a row, you may want to see your doctor to find out the cause of the problem.
If you feel short of breath at any time, even if you think you know why you are coughing, you should seek urgent medical attention. Fevers, chills, and coughing up blood or yellow sputum might also be a reason to see a doctor right away.
Best Sleep Positions for Coughing Relief
There are a couple of reasons why you tend to cough more at night:
- Lying down can automatically worsen your GERD, post-nasal drip, or other conditions.
- Your body’s natural cortisol levels are lower at night, which may mean that disorders like allergies and asthma have breakthrough symptoms.
- Lying down means fluid redistributing from other parts of your body into the lungs. You could have worsened coughing episodes during the night if you have mild heart failure or fluid overload.
Most of the time, the best sleeping position for a nocturnal cough is one that keeps the head of the bed elevated, regardless of the cause of the cough. Elevating your head will reduce acid reflux, lessen postnasal drip, and reduce the amount of fluid in the lungs.
When you sleep with your head elevated and still cough, the cough will be more effective, and you will be more likely to clear out your lungs with each cough. You will breathe easier if your cough clears your respiratory tract’s congestion.
How to Adjust Pillows and Bedding for Optimal Comfort
Optimal sleep with a cough can be achieved by keeping your head elevated using pillows or other devices. In the case of GERD or acid reflux, experts recommend placing two small blocks (around five inches in height) under the head of the bed, so your whole body is somewhat elevated.
Alternatively, you can use a bed wedge (wedge pillow) that only elevates your head and trunk. These can be purchased online or from a medical supply company. Pillows that mimic a bed wedge can also keep your head elevated at night. A combination of a wedge, blocks, and pillows is also possible.
How to Maintain Sleep Positions Throughout the Night
If sleeping with your head elevated is challenging to maintain, consider using blocks or a wedge instead of pillows. Pillows can be discarded at night when you are trying to switch to side-lying or are just uncomfortable, but a wedge pillow and blocks allow you to sleep in any position while maintaining an elevated head.
Natural Remedies for Coughing at Night
Natural remedies for nocturnal cough are widely available and easy to take before bedtime to reduce nighttime cough. Some are available over the counter, while others can be easily made at home.
Over-the-Counter Cough Suppressants
Over-the-counter cough suppressants include those that suppress cough, loosen secretions, or decrease the cough reflex:
- Dextromethorphan – This is a cough suppressant medication.
- Camphor, eucalyptus oil, or menthol – These can all suppress cough when used in cough syrup.
- Guaifenesin – This is an expectorant that thins mucus.
- Antihistamines – These are found in cough syrup but don’t directly suppress a cough. They may make you more tired, so you sleep more easily or control allergies.
- Decongestants – These do not suppress your cough but will sometimes dry up post-nasal drip.
- Honey – This is antibacterial and is known to improve cough by itself in children.
Be sure to pick something for cough with the least effective dose and one that does not contain ingredients you don’t need. In other words, if dextromethorphan alone is enough to suppress the cough, you can skip the decongestants or antihistamines you may not need.
Home Remedies for Coughing Relief
Home remedies for cough include honey taken by a spoonful before bedtime. Other choices for home remedies for cough relief that have some scientific basis include the following:
- Warm fluids like tea (reduce the cough reflex)
- Ginger (particularly for asthmatic cough)
- Steam (increasing the humidity will lower cough)
- Gargling with salt water (for sore throats)
- Marshmallow root (it coats the throat to soothe it)
- Thyme (researched in cases of bronchitis)
- Bromelain (acts as a mucolytic to break up thick mucus)
Home remedies are generally safe and do not involve medications or significant side effects.
Importance of Choosing the Right Mattress and Pillow for Coughing Relief
You may decide that your cough is not going away anytime soon by itself and that you want to invest in a bed, pillow, or something else to continue sleeping comfortably with a reduced cough. In this case, you need to know what to invest in for the long term that will be relatively inexpensive.
Types of Mattresses and Pillows That Promote Better Sleep
You can get adjustable mattresses that will elevate your head at the waist, helping you tailor the height of your head according to your needs. While these beds are more costly than regular beds, they are worth the investment if you need to sleep with your head elevated regularly.
Try out each bed or get one you can test at home before purchasing. Try out different heights of head elevation to see how you feel. If you aren’t sure you want to make such a significant investment, try buying four to five-inch blocks to raise the head of the bed instead.
The correct pillows can also improve your sleep and reduce coughing. You may do best with a wedge and regular pillow to keep your head elevated all night. The disadvantage is that they are not adjustable unless you have several pillows to stack.
Tips for Selecting the Right Mattress and Pillow
Pillows are often not expensive, so you can buy one that feels right and give it a try. Beds are a significant investment, especially if you buy an adjustable bed. Work with a company that will allow you to try the bed for up to a month before making your purchase.
FAQs
How long should I stay in one sleep position?
You do not need to change positions if you have a cough as long as your cough is relieved. If you have issues with bedsores or are at risk for bedsores because of immobility, you may need to change positions every two to three hours to avoid having too much pressure placed on major joints (hips, coccyx, knees, and ankles).
Can coughing at night be a sign of a more serious condition?
Coughing at night is generally not severe. It is more likely to be a sign of a serious condition if you have some other symptoms:
- Shortness of breath when lying down
- Fever, chills, and thick, yellow sputum
- Coughing of blood
- Sudden, severe cough of new origin without any prior cough
In such cases, you should seek medical attention to determine the cause of your cough.
Should I avoid eating or drinking before bed to reduce coughing?
If your cough is known to be due to acid reflux (GERD), eating a large meal before bedtime will worsen your symptoms by pushing stomach contents up into the esophagus. Fatty meals should also be avoided in the evening because fats slow stomach emptying.
Drinking water before bedtime is fine in almost all cases. Alcohol might help you feel sleepy before bedtime but will impair your ability to clear your cough secretions, so this should be avoided.
