A persistent cough that tends to occur primarily in the morning upon waking up may be due to allergies, respiratory infections, or postnasal drip. Identifying the underlying cause is the recommended first step to treating morning cough.
Coughs can be classified into different types based on their characteristics and underlying causes.
A wheezing cough that produces a high pitched whistling sound often indicates narrowed airways, which are common in respiratory conditions like asthma or bronchitis.
A dry cough is often nonproductive (no phlegm) and may result from irritants or allergens, viral infections, or some medications.
A productive cough involves releasing phlegm or mucus from the respiratory tract and is commonly associated with respiratory infections, such as the common cold or pneumonia.
Identifying the type of morning cough you experience may help you understand triggers and the next steps.
Why do you cough in the morning?
Lucas Ottone/Stocksy United
It is natural to experience an occasional cough. This may result from temporary irritations like dust or a cold, and it tends to resolve within a few weeks.
Persistent coughs that last longer than 3–4 weeks may indicate a health condition that requires medical intervention.
A morning cough may be triggered by various factors, including:
Postnasal drip
When mucus from your nose and sinuses builds up in your throat overnight, it may lead to coughing in the morning. This cough reflex upon waking up may manifest as a pronounced dry cough.
Other symptoms of postnatal drip-related cough may include:
needing to clear your throat
tickling sensation in the throat
occasional runny or stuffy nose
Environmental irritants
Environmental irritants, such as dust mites or pet dander in your sleeping area, may irritate your respiratory tract while you sleep, triggering a cough reflex upon waking up. The cough can be dry or productive.
Other symptoms may include:
sneezing
watery eyes
mild nasal congestion or runny nose
skin rashes
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Tobacco use may irritate the respiratory tract, leading to inflammation and excess mucus production.
As you sleep and your airways clear, built-up mucus may trigger coughing in the morning. The cough may often be persistent and productive.
Other symptoms may include:
shortness of breath
increased mucus production throughout the day
Asthma
Coughing that is worse in the morning and persists throughout the day may indicate underlying respiratory conditions like asthma, which can lead to airway inflammation and increased mucus production. This may lead to a cough that is more prominent upon lying down or exposure to triggers.
Additionally, the body’s natural circadian rhythms and triggers like allergens and cold air may worsen asthma-related coughing. This can be a dry cough or a slightly productive cough.
Other symptoms during the day and night may include:
shortness of breath
chest tightness
wheezing
Gastroesophageal reflux disease (GERD)
GERD can lead to persistent light coughing throughout the day. Coughing may worsen in the morning from stomach acid irritants that reflux into the throat while you’re lying down. The cough is often dry and persistent, especially when you’re lying down.
Other symptoms of GERD may include:
heartburn
sour taste in the mouth
regurgitation of stomach contents
Chronic obstructive pulmonary disease (COPD)
COPD is a serious respiratory condition that results in an all-day cough that may be worse in the morning. This may be due to increased mucus production and airway inflammation overnight. COPD-related cough can be productive and persistent.
Other symptoms may include:
shortness of breath
chest discomfort or pain
worsening symptoms with activity
Sinus infection (sinusitis)
Sinusitis may cause an all-day cough that is worse in the morning. This is due to the built-up mucus from a postnasal drip, which irritates the throat and triggers cough reflexes. The sinus cough is often productive.
Managing morning cough may involve natural remedies, over-the-counter (OTC) options, or prescription medications, depending on the cause.
These strategies may not work for all cases of morning cough. Consulting a healthcare professional is highly advised if you experience persistent cough for more than 2 weeks.
Natural remedies for cough in the morning may include:
Hydration and rest: Drinking fluids helps thin mucus and soothe the throat.
Humidifiers: A humidifier can moisten the air, reducing throat irritation and counteracting dust.
Head elevation: Sleeping with an elevated head position helps prevent postnasal drip.
Honey: Consuming before bedtime may ease cough symptoms.
OTC options for morning cough may include:
Expectorants like guaifenesin may help thin and clear mucus.
Antihistamines like loratadine (Claritin) can be useful if allergies contribute to the cough.
Prescription medications may include:
Inhaled corticosteroids, like fluticasone (Flovent), reduce airway inflammation for asthma-related coughs.
Proton pump inhibitors, like omeprazole (Prilosec) and esomeprazole (Nexium), manage GERD-associated cough by reducing stomach acid production.
Bronchodilators, like formoterol (Perforomist), for COPD open airways and relieve cough by relaxing the muscles around the air passages.
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Consider seeking immediate medical attention if you develop the following symptoms:
persistent cough lasting more than 2 weeks
fever
shortness of breath or wheezing
blood in your mucus as you cough
severe chest pain
difficulty breathing
Summary
Coughing in the morning may have different causes, including postnasal drip, respiratory infections, and environmental irritants. Identifying the primary cause can guide your treatment.
While natural approaches and OTC options may relieve some people, persistent or worsening symptoms may require immediate medical attention.
