Health Info > Coughs Published on : May 9, 2025

Why does a dry cough get worse at night?

Written by the editorial staff writer at Hola. Medically Reviewed by Dr Nelson Lau, MBBS FRACGP, GP & Digital Health Specialist.

Why does a dry cough get worse at night?

Summary: A dry cough often worsens at night due to changes in position, dry air, compromised immune system, and increased sensitivity to irritants. Conditions like acid reflux, asthma, and allergies may also contribute. Proper hydration, using a humidifier, and adjusting your sleeping position can help ease nighttime coughing.

A dry cough can be a real night owl, worsening when you settle in for the night. While you might expect relief as you rest, it often picks up once you’re in bed. What’s behind this nighttime irritation? Let’s explore the causes and how to manage them.

Why do coughs get worse at night?

Coughs tend to get worse at night due to many reasons, including:

Lying down:

When upright or seated throughout the day, mucus can flow more easily from your nasal passages. But when you lie down at night, the congestion runs down your throat, which may trigger your coughing reflex more often.

Lung passages tighten during the night:

Circadian rhythms impact the lungs, causing the airways to become narrower at night. This can lead to worsening symptoms like coughing and shortness of breath. This nighttime effect is stronger in people with asthma, though even individuals without asthma may experience some decline in lung function at night.

Indoor allergens in the bedroom:

For individuals with indoor allergies, coughing can be triggered by mould, dust mites, or cockroaches. These irritants may more often accumulate in the bedroom. If you notice that your cough mostly occurs at night at home but disappears when you are on vacation, indoor allergens may be the cause. There are ways to minimise these indoor allergens.

Dry air:

Many individuals sleep in heated or air-conditioned rooms, where the air becomes dry, irritating the respiratory system. Dry air may cause the throat lining to become dry and tender, leading to coughing. Coughs often become more severe at night due to several reasons. When you lie down, mucus and irritants in your airways can build up, prompting cough. The body’s immune response also slows at night, making it more difficult to control inflammation. Furthermore, dry air and allergens in your room can aggravate your throat, intensifying the cough. Conditions like acid reflux and asthma tend to flare up at night, resulting in increased coughing.

What brings on a dry cough at night?

There are several causes of dry cough at night, including:

Asthma
Viral bronchitis
Gastroesophageal reflux disease (GORD)
Postnasal drip

Other causes include side effects from certain medications like ACE inhibitors and, less commonly, heart failure, which can cause fluid buildup and coughing that worsens when lying down.

Signs of a dry cough getting worse

A worsening dry cough could indicate an underlying issue or a condition's progression. Here are some signs that suggest a dry cough may be getting worse.

Worsening throat irritation
Chest pain
Difficulty breathing
Racing heartbeat
Swelling in legs or ankles (if related to underlying cardiac issue such as heart failure)
Difficulty sleeping
Coughing up blood or pink-tinged mucus
Sore or tender ribs
Fever
Unintended weight loss

Also read: Types of dry cough and their potential causes

What type of cough gets worse at night?

A dry cough or cough caused by postnasal drip becomes more severe at night. When lying down, mucous can accumulate in the throat, leading to irritation and coughing. Coughs related to asthma and those caused by acid reflux (GORD) also worsen at night because of airway constriction and irritation from stomach acids. Using humidifiers, raising the head while sleeping, and maintaining hydration can provide relief.

What position should I sleep in to stop coughing?

Sleeping in a raised position can help minimise coughing at night. Consider these sleeping arrangements:

Propped-up position: Employ additional pillows or a wedge pillow to keep the head and chest elevated, which helps prevent the accumulation of mucus and acid reflux.
Side sleeping: Resting on your side can assist in clearing postnasal drip and lessening airway irritation.
Left-side sleeping (for acid reflux): This position helps keep stomach acid from flowing back into the oesophagus, reducing coughing triggers. Maintaining an elevated position and sleeping on your side can help alleviate coughing by stopping mucus buildup and acid reflux. Upholding good sleep posture, employing a humidifier, and remaining hydrated can also improve nighttime cough symptoms for a more restful night.

Also read: How to get rid of dry cough after respiratory infection?

Does pneumonia make you cough more at night?

Yes, pneumonia can exacerbate coughing during the night. Horizontal lying can result in mucous piling up in the lungs, which leads to ongoing coughing. The cough is generally productive and wet, bringing up phlegm. Fever, chest discomfort, and breathing difficulty may also escalate overnight. Sleeping with your head elevated and drinking plenty of fluids can help relieve symptoms. If your cough becomes wet or is accompanied by fever and breathlessness, seek medical advice.

Home remedies to sleep better at night with a cold and cough

Dealing with a cough and cold while trying to sleep can be frustrating. Easy home remedies can alleviate congestion, soothe the throat, and help improve sleep quality.

Raise your head: Use extra pillows or a wedge pillow to minimise mucus buildup and facilitate breathing.
Employ a humidifier: Adding moisture to the air helps prevent throat dryness and eases irritation.
Consume warm liquids: Herbal teas, warm water with honey, or broths assist in loosening mucus and keeping the throat moist.
Consider steam inhalation: Inhaling steam before bedtime can clear nasal passages and alleviate congestion.
Mix honey and turmeric: A teaspoon of honey or a warm glass of milk mixed with turmeric can help relieve a persistent cough. If you’re on medication, check with your doctor before using turmeric regularly as it may cause interactions.
Gargle with salt water: Saltwater gargle may ease throat irritation and lessen postnasal drip.

Maintaining hydration, utilising steam, and elevating your head can relieve cough symptoms for improved sleep quality.

When to consult a doctor

Consult a doctor if a cough lasts longer than three weeks, worsens at night, or is accompanied by fever, chest pain, difficulty breathing, or coughing up blood. Seek immediate care if you experience shortness of breath, bluish skin around the lips, or confusion, since these symptoms may indicate pneumonia or a serious respiratory issue. If a cough is linked to asthma, acid reflux, or allergies and does not get better with home remedies, it's important to seek medical advice. A persistent, worsening, or painful cough should not be overlooked, particularly in young children, elderly individuals, or those with compromised immune systems. Timely diagnosis and treatment can avert complications and promote faster recovery.

A telehealth appointment with a doctor online can be helpful for people who are looking to discuss their condition and request Dr certificate, scripts online or referral from home.

Nighttime coughing doesn’t have to keep you up all night! Staying hydrated, using a humidifier, and adjusting your sleep habits, can help soothe that annoying cough. If it persists, it’s a good idea to consult a doctor for extra support.

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