Why Do I Have a Dry Cough at Night, and How Do I Stop It?

Why do coughs get worse at night? Certain illnesses might cause a dry cough at night. Acid reflux, for example, is more likely to move stomach acid back up into your esophagus when lying down, resulting in a cough. Postnasal drip from a cold, allergies, or sinus infection may cause a tickle in your throat and trigger coughing.

How can I stop a dry cough at night? Drinking plenty of fluids and elevating your head at night can help stop a coughing attack. Medications like antihistamines and guaifenesin may also help if you have a cold, allergies, or the flu. Here's what causes a dry cough at night and what to do about it.

Dry Cough at Night Causes

A dry cough does not bring up mucus. Common causes of a dry cough include allergies, some infections, and health conditions like asthma and chronic obstructive pulmonary disease (COPD).

Acid Reflux

Gastroesophageal reflux disease (GERD), or acid reflux, occurs when acid from your stomach backs up into your esophagus. Acid reflux might be to blame for your cough if it only occurs at night. Your stomach acid is more likely to flow backward when you lie down to sleep.

Other GERD symptoms may include:

• Chest pain and heartburn
• Difficulty swallowing
• Feeling like food is stuck behind your breastbone
• Hoarse voice
• Nausea
• Regurgitation, or food that comes back up after eating
• Sore throat

A healthcare provider can usually diagnose GERD by taking note of your symptoms. They might perform an endoscopy, which involves inserting a thin, flexible tube down your throat to examine it.

Lifestyle changes, medications, and surgery can reduce acid reflux. Try eating your last meal at least three hours before bedtime to avoid coughing.

Angiotensin-Converting Enzyme (ACE) Inhibitors

A study published in 2014 found that angiotensin-converting enzyme (ACE) inhibitors caused a cough in about 20% of participants. A dry cough during the day or night is a common side effect of these medications that treat high blood pressure. A cough may begin within a few weeks of starting ACE inhibitors, so you may not realize it's causing your cough.

Talk to a healthcare provider about changing to another type of blood pressure medicine, such as an angiotensin II receptor blocker (ARB), if your cough is severe.

Asthma

People with asthma have inflamed airways, which can cause coughing, difficulty breathing, and wheezing. Research has found that an asthma-induced cough might worsen at night. A study published in 2021 found that circadian rhythm, or the sleep-wake cycle, might affect the severity of asthma symptoms.

A healthcare provider can order spirometry, or a lung function test, to check for asthma. They might recommend an allergy skin or blood test to detect possible triggers, such as tobacco smoke.

Chronic Obstructive Pulmonary Disorder (COPD)

COPD includes chronic bronchitis and emphysema, both of which are lung diseases that make breathing difficult. You might have a hacking cough that produces a lot of mucus, particularly in the morning.

Other COPD symptoms include:

• Chest tightness
• Shortness of breath, especially with physical activity
• Wheezing
• A whistling sound when breathing

A healthcare provider can use chest X-rays and lung function tests to diagnose COPD. They might also administer blood tests and CT scans.

Pertussis (Whooping Cough)

Pertussis, commonly known as "whooping cough," is a bacterial respiratory infection. Coughing is one of the main symptoms of pertussis and can become violent, especially at night.

Pertussis symptoms initially resemble a cold: a runny or stuffy nose, fever, and watery eyes. The classic coughing signs typically emerge after one to two weeks. You might develop intense hacking that causes you to throw up.

Symptoms are usually the telltale sign with diagnosing pertussis, though a healthcare provider can also use a blood test and mucus sample. Pertussis is very contagious, but there's a vaccine to prevent the spread.

Pneumonia

Pneumonia is an infection that occurs in the lungs. Symptoms include:

• A cough that produces phlegm
• Fever and chills
• Trouble breathing
• Chest pain when breathing deeply and coughing

A healthcare provider can usually tell if you have pneumonia by listening to your chest with a stethoscope. They may order blood tests and chest X-rays to determine if the cause is a bacteria or virus.

Postnasal Drip

Postnasal drip, or upper airway cough syndrome, is one of the most common causes of chronic coughing. Illnesses like allergies and colds cause mucus to drip down your throat, which tickles nerve endings and triggers coughing. Congestion, itchy eyes, and sneezing might also occur with postnasal drip.

Dry Cough Home Remedies

You can usually treat a cough at home using some of the following methods. Make sure you also follow a healthcare provider's recommended treatment if you have a health condition like asthma or COPD.

Breathe in Hot Steam

Take a hot shower or use a vaporizer to breathe in hot steam, which helps moisten a dry throat and reduce coughing. Make sure you regularly clean a vaporizer to prevent mold growth.

Do Not Smoke

Not smoking and staying away from secondhand smoke can help manage a cough, especially if you have COPD. It can be difficult to quit smoking, but a healthcare provider can advise you on how to do it.

Elevate Your Head at Night

Research has shown that elevating your head at night helps reduce GERD symptoms, such as a dry cough, which may worsen when you lie down. Try propping your head up on a wedge pillow to prevent acid from your stomach from coming back up into your esophagus.

Stay Hydrated

Make sure you drink plenty of fluids, including broth, fruit juice, sports drinks, and water. These fluids help thin out the mucus in your throat and help you cough it up.

Suck on Cough Drops

Cough drops and hard candies might suppress a cough. Look for varieties that contain eucalyptus, honey, or menthol, which might help soothe your throat.

Treat Seasonal Allergies

You can alleviate seasonal allergy symptoms, including a dry cough, at home by:

• Avoiding using a fan that circulates air from outside
• Closing your windows and using an air conditioner
• Covering your pillows and mattress with dust mite covers
• Keeping pets with fur in a separate room when sleeping
• Showering and changing your clothes after being outside
• Staying indoors if there's a lot of pollen circulating outside
• Using an air purifier

Dry Cough Treatments

A healthcare provider might recommend over-the-counter (OTC) treatments, depending on the cause of your cough. They might prescribe medications, such as antibiotics or bronchodilators, if you have an illness or infection.

Antibiotics

A healthcare provider might prescribe antibiotics to help treat bacterial infections, including pneumonia and pertussis. Viral infections, in contrast, do not respond to antibiotics, though they may respond to some antivirals (such as Tamiflu for the flu or Paxlovid for COVID.

It's essential you follow a healthcare provider's instructions for taking antibiotics. You must complete the entire course of medicine, even if you feel better before that. The bacteria might remain in your body and reinfect you if you do not complete it.

Antihistamines

Try an OTC antihistamine, available as capsules, liquids, nasal sprays, and more, if allergies are causing your cough. Antihistamines block histamine, a chemical that your body releases in response to an allergen. Take an antihistamine before bedtime to help alleviate a dry cough at night or in the early morning. Some antihistamines last 24 hours, so check the medication instructions to determine frequency.

Bronchodilators and Oral Steroids

These drugs help treat asthma and COPD symptoms. Bronchodilators offer quick relief, opening up and relaxing the bronchi, or passageways that direct air into your lungs. Oral steroids, available as capsules, liquids, and pills, treat symptoms that persist for one to two weeks.

Decongestants

Decongestants help treat nasal congestion from a cold, allergies, and the flu. These medications are available over the counter in liquids, nasal sprays, pills, and more. Make sure you do not use decongestants for more than three days to avoid becoming dependent on them.

Guaifenesin

Guaifenesin, which is available as capsules, liquids, and tablets, helps alleviate chest congestion from a cold, allergies, or the flu. You can take guaifenesin alone or with antihistamines, decongestants, and cough suppressants. Make sure you read the label carefully and only use as directed.

When To Contact a Healthcare Provider

A dry cough from illnesses like a cold, sinus infection, or the flu typically subsides with home remedies and treatments. Contact a healthcare provider if your cough lasts longer than 10–14 days or if you have:

• A cough that brings up blood or rapidly becomes violent
• Fever
• Recent exposure to tuberculosis
• Signs of heart failure (e.g., a cough that worsens when you lie down, heart disease, and leg swelling)
• Stridor, or a high-pitched sound when you breathe in
• Thick phlegm that's yellowish-green and smells foul
• Unintended weight loss and night sweats

Get immediate medical attention if you have trouble breathing or signs of an allergic reaction. These include hives, difficulty swallowing, and face and throat swelling.

Coughing at Night in Infants and Young Children

Sit with your child in a steamy bathroom for 20 minutes if they have a bark-like cough. Place a cool-mist humidifier in their bedroom or help them use a saline nasal spray to get rid of congestion.

Make sure your child drinks plenty of fluids, such as breast milk or formula for infants and water for young children. Never give cough drops, which can be a choking hazard to a child younger than 6.

See a healthcare provider if your child is younger than 3 months or has:

• Blue or pale face, lips, and tongue
• A cough that lasts longer than one week or worsens
• A fever that lasts longer than two days
• Severe coughing and wheezing
• Shortness of breath and trouble breathing
• Stridor

Let a healthcare provider know if your child develops a cough at the same time each year or in response to an allergen, such as dust, pets, or pollen. They can help diagnose allergies and advise treatments.

A Quick Review

A dry cough at night may disrupt your sleep. Acid reflux, inflamed airways, and postnasal drip might cause a coughing attack. A dry cough might also be a side effect of ACE inhibitors or a sign of COPD, pneumonia, or pertussis. It's important to consult a healthcare provider, regardless of the cause. They can recommend at-home remedies and treatments to help you sleep better.