It’s frustrating enough to deal with a cough during the day, but when that cough intensifies as soon as your head hits the pillow, it can feel unbearable. Nighttime coughing disrupts your sleep, prevents relaxation, and hinders your body’s ability to recover and heal. A persistent cough that worsens at night can significantly impact your rest and overall well-being.
As Dr. Vontrelle Roundtree, Associate Chief Medical Officer at MDLIVE of Evernorth, explains, “Sleep is crucial for our immune system. During rest, our bodies regulate cytokine production, which are vital proteins that fight off infections. Nighttime coughing disrupts sleep quality, potentially affecting cytokine regulation and hindering the immune system’s ability to combat illness.” Beyond interrupting crucial restorative processes, coughing at night can lead to additional discomforts. Dr. Roundtree further notes that “Coughing can also cause a dry throat and mouth, contribute to postnasal drip, and create general physical discomfort, all conspiring against a peaceful night’s sleep.”
Why Does Coughing Intensify at Night?
There are several reasons why your cough might feel amplified or become more frequent as nighttime approaches. Many of these reasons are linked to how your body functions when you lie down, particularly concerning your airways and mucus production. Dr. Samuel Mathis, Assistant Professor in the Department of Family Medicine at the University of Texas Medical Branch, points out that conditions like “lung infections, postnasal drip, allergies, and asthma” are common culprits for coughs that worsen at night.
One key factor is mucus. During the day and while upright, gravity assists your body in naturally clearing mucus. However, as Dr. Mathis clarifies, “with lung infections, lying down actually helps the cilia – the tiny hair-like structures in our lungs – to more effectively move mucus upwards and out of the lungs. The cough reflex is then triggered as the body attempts to expel this excess mucus.”
Dr. Roundtree elaborates on this, stating, “Moving around during the day aids the body in loosening and draining trapped mucus. When we recline to sleep, this position can impede the natural clearance of mucus, leading to postnasal drip. This occurs when nasal secretions accumulate in the back of the throat, triggering those irritating nighttime coughs.” Essentially, gravity shifts the way mucus behaves in your respiratory system, often leading to increased coughing when you are lying down.
Other Contributing Factors to Night Coughs
Beyond mucus and body position, gastroesophageal reflux disease (GERD), commonly known as acid reflux, can also be a significant cause of nighttime coughing. According to Dr. Roundtree, “GERD occurs when stomach acid flows back up into the esophagus, irritating its lining and potentially reaching the throat.” This backflow of stomach acid can trigger the cough reflex.
Dr. Sarah McBane, Associate Dean of Pharmacy Education at the University of California, Irvine School of Pharmacy, adds that “The act of lying down can exacerbate acid reflux, making it more likely for stomach acid to travel upwards. Consequently, this increased reflux can lead to more coughing episodes during the night.”
Understanding why you cough more at night is the first step in finding relief. If nighttime coughing is a persistent problem, consulting with a healthcare professional can help identify the underlying cause and determine the most effective course of action to improve your sleep and overall health.
