Having a cough is unpleasant enough during the day, but it can also disturb your sleep at night. If you already feel unwell due to an infection, allergy, or health condition, a lack of sleep might make you feel worse.
Your body relies on sleep to repair and restore itself. As a result, you have likely noticed that you feel better after a good night’s sleep. When sleep is disrupted, your immune system does not function properly, and you may feel fatigued during the day. Ongoing sleep deprivation can also increase inflammation, worsening illness symptoms.
While high-quality sleep can boost the immune system, trying to sleep with a cough is often easier said than done. Coughing can get worse at night for a number of reasons. However, there are steps you can take to make yourself feel more comfortable and fall asleep even with a cough.
What Causes Coughing?
Coughing is your body’s way of attempting to clear the airway of irritants, substances, or foreign matter that make breathing difficult.
Irritants in the throat and windpipe trigger sensory receptors. These receptors transmit signals to a part of the brain responsible for the muscles used in coughing. This process happens every time you cough. Coughing can be intentional or automatic.
A variety of infections, health conditions, and environmental factors can cause coughing.
- Upper respiratory infections: These infections include the common cold and acute bronchitis. Although coughs associated with the cold virus are usually mild, they may last for up to 10 days or longer. Individuals who get COVID-19 may also experience a long-lasting cough.
- Postnasal drip: When mucus from a runny or stuffy nose runs down the back of the throat, it may trigger a cough. This phenomenon is known as postnasal drip.
- Pneumonia: A cough is often present in pneumonia, which is inflammation of the lungs that is typically caused by a bacterial infection.
- Allergies: Allergens irritate the upper respiratory system, often causing post-nasal drip and a cough.
- Asthma: Asthma is a disease that causes a person’s lungs and airway to become inflamed and constricted when they are exposed to irritants.
- Other health conditions: Many medical conditions cause coughing, including chronic obstructive pulmonary disease (COPD), gastroesophageal reflux (GERD), chronic bronchitis, sleep apnea, heart conditions, and genetic conditions like cystic fibrosis.
- Smoking: People who smoke or who are exposed to secondhand smoke may cough frequently.
- Medications: Coughing can be a side effect of certain drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) and some medications used to regulate blood pressure.
Why Do I Cough More at Night?
A cough often becomes worse at night when you lie down to sleep, especially if you have an infection that causes postnasal drip. Lying flat on your back may cause mucus to shift to the throat.
GERD may also trigger coughing when lying down. This position allows stomach acid to flow back up the windpipe, causing heartburn.
Asthma symptoms can fluctuate over the course of a day. People with asthma may find that their coughing increases at night or in the early morning. Allergens in bedding can also make asthma worse.
Other environmental factors that can trigger nighttime coughing include cold temperatures and overly dry or humid air.
How Does a Cough Affect Your Sleep?
Coughing disrupts sleep and may cause you to wake frequently at night. Over time, interrupted sleep can impact mental health. People who are sleep-deprived sometimes experience symptoms associated with depression or anxiety, such as irritability, fatigue, and poor judgment.
Individuals with a chronic nighttime cough also report an overall lower quality of life than those who do not cough at night. Although this difference could exist for multiple reasons, coughing can interrupt sleep, and the body needs uninterrupted, high-quality sleep in order to stay healthy.
Sleep plays an important role in healing and preventing illness. People who do not get enough rest are less equipped to fight infections. They may be more susceptible to colds and the flu virus and may take longer to recover.
Tips to Improve Sleeping With a Cough
Having a cough might make falling asleep difficult or interrupt your sleep. However, some home treatments can make you more comfortable, and hopefully help you get some rest.
Take Cough Medicine
Coughing plays an important role in maintaining a clear airway and recovering from upper respiratory infections. If coughing prevents you from getting adequate sleep, however, medicine can numb the cough reflex long enough for you to rest and recharge.
Over-the-counter medications that contain dextromethorphan can be effective at temporarily preventing coughs. Check with your doctor first to see if this medication is right for you and your specific cough. Your doctor may also prescribe codeine-based cough syrups or benzonatate capsules.
Try a Nasal Decongestant
If congestion or postnasal drip gives you a cough, a decongestant might help you breathe more easily. Steroid nasal sprays are most effective at treating congestion caused by allergies and inflammation.
Depending on what is causing your cough, you may also benefit from using an antihistamine. Antihistamines come in nasal spray and pill forms and are typically used to treat respiratory symptoms due to allergies. In some cases, they may be combined with a decongestant. Talk with a health care provider before using any of these medications.
Drink Warm Liquids
Dry air can trigger coughing, especially in people with asthma, and leave the throat feeling irritated. Keep your throat moist, prevent inflammation, and stay hydrated by drinking warm liquids such as tea and broth.
Have Some Honey
Evidence suggests that the old advice to consume honey while sick may help prevent coughing, especially at night. One study found that honey is at least as effective as over-the-counter cough medicines. Never give honey to a child under 1 year of age as it can be toxic.
Honey may be eaten straight or diluted in a liquid, like tea, to reduce coughing. You can also use corn syrup if you don’t have honey available.
Use a Humidifier
Consider using a humidifier if dry air or nasal congestion trigger your cough. Although humidity can make asthma symptoms worse, moisture might loosen congestion due to an upper respiratory infection.
Be sure to clean your humidifier on a regular basis to prevent mold growth, which may worsen symptoms in the long run.
Wash Your Bedding
Blankets, sheets, pillowcases, and curtains tend to attract household allergens like dust mites and dander. In damp rooms with poor air flow, bedding and soft surfaces can also accumulate mold. Exposure to dust, dander, and mold may increase symptoms in people with asthma or sensitivities to certain allergens.
To reduce allergens that can cause coughs, wash your bedding in hot water on a regular basis. You may also want to try using special mattress covers and pillows made from synthetic materials. These items are designed to attract fewer allergens than those made with conventional fabrics.
If you believe that mold in your household is giving you a cough, consider running a dehumidifier to remove dampness from the air. Steam cleaning can also remove allergens from rugs and textiles.
Elevate Your Head
Since lying flat on your back can make congestion worse and cause post nasal drip, try maintaining an upright position when you go to bed. If you find it difficult to sleep sitting up, additional pillows may elevate your head enough to help you breathe better and keep you from coughing.
People with GERD may also want to sleep with their heads elevated to prevent coughing and reflux. Experts suggest that the best way to sleep with a cough due to GERD is by raising the head of the bed 3 or 4 inches.
Talk to Your Doctor if Symptoms Worsen
Coughs that occur due to the common cold often last for about 10 to 14 days. Contact your doctor if your cough lasts longer than 10 days, your other symptoms persist for more than three weeks, or your cough gets worse over time.
In certain situations, a cough might require professional medical attention. See a doctor if you:
- Cough up gray, yellow, or green mucus
- Struggle to catch your breath while coughing
- Cough up blood
- Lose a significant amount of weight without trying
- Have a fever that doesn’t go away
It is especially important to discuss your concerns with a doctor if you are at risk for HIV or tuberculosis infection or if you believe a medication may be causing your cough. Also, if you smoke, a health care professional can help you quit and order tests to rule out smoking-related medical conditions.
References
About The Author
Clinical Psychologist, Sleep Medicine Expert
Michael Breus, Ph.D is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. He holds a BA in Psychology from Skidmore College, and PhD in Clinical Psychology from The University of Georgia. Dr. Breus has been in private practice as a sleep doctor for nearly 25 years. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is also the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan, Good Night!, and Energize!
- POSITION: Combination Sleeper
- TEMPERATURE: Hot Sleeper
- CHRONOTYPE: Wolf
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