Why Do Coughs Get Worse at Night?

In order to stop uncontrollable coughing at night, we asked doctors to explain why coughing gets worse in the evening (and spoiler alert: the cause may vary depending on your specific circumstances). Once you understand the likely cause for your cough, it may be easier to figure out a fix. For some, that may mean investing in cough suppressants and a new humidifier, but for more severe cases, it could be time for medical intervention.

To figure out where to start, our doctors shared their best recommendations for coughs that get worse at night. This includes tried-and-true advice to reduce symptoms leading up to bedtime and tips for creating a more restful sleeping space.

Why Do Coughs Get Worse at Night?

Your cough may be worsening at night for a number of reasons. Some have to do with your own body, while others involve the world around you.

Take a look at some of the most common culprits:

• Sleeping Position: One of the main reasons your cough may get worse at night has to do with how your body is positioned in bed, says Akua Ampadu, MD. While sinus drainage is not thought to be entirely dependent on your sleeping position, lying flat on your back does exacerbate things like postnasal drip, which tends to increase coughing. Dr. Ampadu adds that supine sleeping positions also allow stomach acid to enter the esophagus, which can result in acid reflux and worsen your cough.

• Postnasal Drip: Think of postnasal drip as the excess gunk that drains from your nose and down your throat. This drip can tickle the hairlike structures in your throat called "cilia" which keep mucus moving. "Mucus within the respiratory tract — from postnasal drip or the upper respiratory tract — can pool into the back of the throat, causing you to cough," Dr. Ampadu tells PS. Along with nighttime coughing, the excess mucus can also cause you to feel hoarse or leave you with a sore throat.

• Asthma: Asthma also tends to flare up at night, which can result in wheezing, coughing, and diculty breathing, says Payel Gupta, MD. This is because asthma can cause inflamed and narrowed airways, making it harder for air to flow out when you breathe, per the National Heart, Lung, and Blood Institute.

• Environment: Other factors for nighttime coughing are purely environmental, including dry air, allergens, and mold. Especially in the winter, cold weather can irritate the throat and dehydrate your nasal passages, while seasonal allergies and airborne irritants often lead to excess mucus and postnasal drip, according to research from Harvard Medical School. This includes mold allergies, which can lead to red eyes, chest tightness, and a persistent cough year-round, per the Cleveland Clinic. Smoke also makes coughing worse at night, so experts recommend keeping it out of the bedroom.

• Respiratory Conditions: Dr. Ampadu says underlying conditions like emphysema, bronchitis, or even heart failure could also explain why your cough gets worse at night. Without proper treatment, these coughs may sound slightly different. The Cleveland Clinic describes a bronchitis cough as a "whistling or rattling sound" versus the more hollow sound that's often heard through a stethoscope in people with emphysema. For the most personalized medical advice, consult with a professional healthcare provider.

• Medications: Certain medications may be the reason why your cough gets worse at night. The Cleveland Clinic reports that birth control and blood pressure drugs can increase postnasal drip, which can trigger nighttime coughing. The American Academy of Allergy, Asthma & Immunologyadds that angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and non-steroidal anti-inflammatory drugs (NSAIDs) can all cause asthma symptoms to flare up — nighttime coughs included.

How to Stop Coughing at Night

Rest assured, for all the potential reasons your cough may get worse at night, there are also treatments to help. The above are some expert-approved ways to address the root cause of nighttime coughing. As a note, always check with your doctor before starting any new medications, and schedule an appointment if your coughing persists, gets worse, or is accompanied by other concerning symptoms.

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