Nighttime coughing is a common symptom with several possible causes, and it often happens because the body’s normal rhythms and the way the airways behave change when you lie down. Key reasons include:

• Postnasal drip
  • When you’re upright mucus drains from the nasal passages more easily. Lying down can cause mucus to pool in the throat, triggering a cough.
• Gastroesophageal reflux (GERD)
  • Acid from the stomach can reflux into the esophagus during the night, especially after meals or while lying flat, irritating the throat and provoking coughing.
• Dry air and irritated airways
  • Heating or air-conditioning can dry the air, drying out the throat and nasal passages and making coughing more likely.
• Asthma or airway hyperreactivity
  • Some people experience worse symptoms at night due to circadian changes in airways reactivity.
• Allergens in the bedroom
  • Dust mites, pet dander, mold, or other indoor allergens can irritate airways and cause coughing during sleep.
• Infections or lingering congestion
  • Cold or flu symptoms can persist and be more noticeable at night when you’re still.

What you can try

• Sleep position and environment
  • Elevate your head with an extra pillow to reduce postnasal drip and reflux involvement.
  • Use a humidifier to add moisture if dry air is a trigger.
  • Keep the bedroom free of common allergens: wash bedding weekly, vacuum, and consider air purifiers.
• Hydration and humidification
  • Stay well-hydrated during the day; sip water before bed and consider warm drinks to soothe the throat.
• Address reflux
  • Avoid large or spicy meals close to bedtime; limit caffeine and alcohol in the evening; consider waiting 2–3 hours after eating before lying down.
• Over-the-counter options (discuss with a clinician if you have other conditions or take medications)
  • Saline nasal sprays, decongestants (short-term use), or antihistamines can help some people, but they aren’t suitable for everyone.
• When to seek care
  • Cough lasting more than 3-4 weeks, coughing up blood, night-time coughing that severe or wakes you from sleep, shortness of breath, wheezing, fever, or unintentional weight loss warrant evaluation by a healthcare professional.

Important note

• Nighttime coughing can be a sign of several different conditions, some benign and others more serious. If symptoms are persistent, worsening, or accompanied by concerning signs (shortness of breath, chest pain, coughing up blood, or fever), a medical assessment is recommended to determine the exact cause and appropriate treatment.