Nighttime coughing? Here’s what you should and shouldn’t do

The position in which you sleep may help lessen nighttime coughing, experts say. Getty Images

Cold season has hit and that means no one is safe from those dreaded sniffles, heavy congestion and fever – or worse yet, a stubborn cough that only seems to be getting worse when nighttime comes around.

No matter what you do in your attempts to relieve it, that annoying hack seems like it just won’t go away and it’s costing you precious hours of much-needed rest.

READ MORE: Here’s why Canada may be in for a miserable 2017-18 flu season

And while you may be at a point of desperation in treating that cough, reaching for cough and cold medicines and remedies may not be the best option (or even work at all).

So what can you do to relieve that cough? Or should you even relieve it at all? Here’s what Dr. Nick Vozoris, respirologist and sleep physician at St. Michael’s Hospital, has to say.

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Why are coughs worse at night?

Symptoms, in general, tend to become exacerbated at night, Vozoris says, although no one is sure why that is. But in the case of coughs, there are some possible explanations.

“When you’re asleep, you’re not coughing and cough is the way we get rid of mucus that’s in the airways,” Vozoris says. “So if you’re asleep and you’re not coughing and clearing that mucus that’s building up, you’ll wake up at some point in the night or first thing in the morning and have a lot of mucus you’ll need to get rid of.”

So in fact, being physically active and moving around, Vozoris says, actually helps loosens secretions in the airways. So when you’re moving less (i.e. asleep), that buildup of mucus is not able to break down.

And if it turns out that you have a respiratory tract infection (and not just a cold), there may be nasal and sinus symptoms causing congestion and post-nasal drip, which may drip down the windpipe. If this hits the upper airway or vocal chords, that can cause irritation of the area and induce coughing, Vozoris explains.

Wet versus dry coughs

The type of cough you have may help determine what kind of illness you have, Vozoris says. Wetter-type coughs tend to be attributed to bacterial respiratory tract infections due to the production of mucus in the airways.

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Dryer coughs, however, tend to be associated with viruses and will often irritate the airways.

It’s important to note that this may not always be the case and a physician would be best at determining the kind of ailment you’re suffering from.

Sleep positions

The position in which you sleep may help with nighttime coughing, Vozoris says.

“It’s possible that certain positions might make things worse and certain positions might make things better,” he says. “Some people might find it easier to sleep with the head of the bed elevated a bit because that might help reduce post-nasal drip.”

It may also help reduce heartburn or reflux if those symptoms are also present, which may aggravate a cough, Vozoris adds.

Nasal salt water rinse

If nasal symptoms are present during a respiratory tract infection – in particular, if there is post-nasal drip – you could try a nasal salt water rinse, Vozoris says.

“You can use this to clean out your nose and sinuses and mucus in the evening before getting into bed,” he says. “This will help minimize nasal congestion and post-nasal drip that may be worse at night.”

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The rinse can be purchased over-the-counter at your local drug store.

Cold versus warm

When it comes to being exposed to warm or cold drinks or air, Vozoris says it comes down to what makes the person more comfortable.

However, he explains that there are receptors in the upper airway which respond or get activated when they’re exposed to cold temperatures.

“If one breathes in cold air or has a very cold beverage, those receptors in the upper airway get stimulated and induce cough,” Vozoris says. “So in some people, drinking cold beverages when they’re sick might aggravate cough because they’re stimulating and activating those cold receptors.”

Should you use over-the-counter medications?

In desperation, it’s tempting to want to reach for an over-the-counter cough-cold medicine that promises to suppress your cough. However, Vozoris advises against using these products regularly.

“You don’t actually want to suppress or eliminate cough entirely because the cough – while it is annoying and bothersome – it’s your body’s way of clearing out mucus that’s in your airways and lungs,” he explains. “You want to get rid of that puss that contains bacteria and inflammatory cells that are plugging up lower airways.”

READ MORE: Cold or flu? Here’s how to tell the difference

While it’s OK to want to use these medications to lessen some symptoms at times, you don’t even want to eliminate a cough entirely.

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In fact, if you suppress a cough, it could make the cough linger longer, Vozoris says.

“If you suppress the cough, the mucus will continue to build up,” he says. “You may go from an upper respiratory tract infection to actually having pneumonia or a lower respiratory tract infection, and that may be more of an issue in people who have chronic lung diseases like COPD or asthma who already have inflammation.”

When to see a doctor

“As the infection goes away, the cough should go away but it can take a bit of time – even up to eight weeks [to go away],” Vozoris says. “If the infection is thought to be bacterial in origin, getting an antibiotic would help reduce all the symptoms, including nighttime coughing.”

However, if a respiratory tract infection is viral in origin, antibiotics won’t help, he adds.

“The common cold is a virus,” Vozoris points out. “So it’s important that when people start to get the sniffles or a cough that they’re not started on an antibiotic because it may be a viral infection that will last for 48 hours, so antibiotics wouldn’t do anything.”

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But if a cough persists and symptoms aren’t getting better, it may be time to visit your physician, Vozoris says.

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