• Asthma – this is a chronic disease of the bronchioles and more commonly encountered in young people. These small tubes transport air into the depths of the lungs and can become inflamed and narrowed as a result of a variety of factors, including an allergic tendency. Some of the early signs of asthma include coughing at night, coughing whilst exercising and a mild wheeze
• Heart failure – this is a weakening of the heart’s ability to pump blood. As the heart struggles to move blood round the body, fluid builds up in tissues. In the lungs, the cough reflex is triggered in an attempt to rid the body of unwanted fluid. The situation is made worse when lying down as this posture allows fluid to accumulate more easily in the lungs. Heart failure and heart disease are the main causes of persistent coughing at night in those over 65 years of age
• Gastro-oesophageal reflux disease (GORD) – this is also referred to simply as ‘acid reflux’. It is associated with indigestion and reflux occurs when acid in the stomach escapes up into the oesophagus. If severe, this irritates the pharynx (back of the throat) and the upper parts of the respiratory system, triggering the cough reflex . Lying down encourages reflux as the stomach and mouth are at approximately the same level which is why people with acid reflux may cough more at night
• Sinusitis – the sinuses are small cavities lying within the cheekbone and forehead. Sinusitis is the condition which comes about when the lining of these cavities become infected and inflamed, giving rise to the main symptom of the feeling of a blocked nose. Mucus in the sinuses drains into the back of the nose and pharynx. When you lie down, excess mucus drips down into the back of your throat, irritates the tissues, triggering the cough reflex

The Science Behind Nighttime Coughing

There are a number of reasons why cough symptoms get worse — or seem to — at night:

Gravity. The biggest reason we cough more at night is simple: gravity, says Mitchell Blass, MD, an infectious disease specialist with Georgia Infectious Diseases, PC, and staff physician at Saint Joseph’s Hospital in Atlanta. “When we lie down, the gastroesophageal reflex kicks in because mucus automatically begins to pool.” The best way to counteract this gravitational pull is elevation. “Sleep with a pillow propping you up a little,” Dr. Blass suggests. “It will help keep the mucus from collecting in the back of the throat.”

A dry, indoor environment. Dry air can aggravate an already irritated nose and throat, making your nighttime cough worse. You can try a humidifier to put moisture back into the air and make it easier to breathe, but be sure to take proper care of the unit. “Humidifiers are not always safe,” warns Blass. “If the water you put in it isn’t sterile, you run the risk of cycling the germs back into the air or breeding other diseases.” The last thing people with a cold or flu want is to experience complications, says Blass. “Bacterial infections can set in. Many flu-related deaths are caused by pneumonia that hits after people think they’re over the flu.” To ensure you use a humidifier safely, be sure to follow all the directions that it comes with carefully.

Tips for Nighttime Cough Relief

Nighttime coughs can be sleep-wreckers. The key is to soothe your ticklish throat and over-sensitive airways before you go to bed.

Drink herbal tea with honey. Get into the habit of having a mug of non-caffeinated tea before bed. “Any warm liquid can help break up mucus in your airways,” says Norman H. Edelman, MD, chief medical officer of the American Lung Association. Add a little honey.

Sleep on an incline. When it comes to nighttime cough, gravity is your enemy. All the postnasal drainage and mucus you swallow during the day backs up and irritates your throat when you lay down at night. Try to defy gravity by propping yourself up on some pillows while you sleep.

Another trick for people with acid reflux is to stick wooden blocks under the head of the bed to raise it 4 inches. With that angle, you might keep acids down in your stomach where they won’t irritate your throat. Of course, you’ll have to get your partner’s OK first.

Use steam cautiously. Dry airways can make your cough worse. You may find relief from taking a shower or bath before bed — or just sitting in a steamy bathroom. Edelman has one caution: “If you have asthma, steam can actually make a cough worse.”
Watch the humidity. Humidifiers can help coughs if the air is dry. But too much moisture in your bedroom can keep you coughing, too. Dust mites and mold — both common allergens — thrive in damp air. Edelman suggests that you keep humidity levels at 40% to 50%. To measure humidity, pick up an inexpensive device — a hygrometer — at your hardware store.

Prepare your bedside. In case you start coughing in the night, have everything you need by your bed — a glass of water, cough medicine or drops, and anything else that seems to help. The sooner you can stop a coughing fit, the better. Continually coughing irritates your airways, which can make your nighttime problem last longer.

Keep bedding clean. If you have a cough and are prone to allergies, focus on your bed. Dust mites — tiny creatures that eat dead flakes of skin and lurk in bedding — are a common allergy trigger. To get rid of them, each week wash all your bedding in hot water, Edelman says.

Consider medicine. Over-the-counter cough medicines can help in two ways. An expectorant can help loosen mucus. A cough suppressantblocks the cough reflex and reduces the urge to cough. Look carefully at the label to make sure you get the medicine that’s right for your cough. Ask your pharmacist or doctor if you’re not sure.

See your doctor. If you’ve had a nighttime cough for longer than 7 days, it’s time to check in with your doctor. It may take some time, but together, you and your doctor can figure out the cause — and ma