How to sleep well with a cough

A cough is a reflex action triggered by irritation in the airways. It is your body’s way of clearing the throat and air passages. While it helps remove irritants and mucus, a persistent cough may significantly disrupt your sleep cycle. 

The repeated spasms and sharp exhalations associated with a persistent cough may lead to multiple awakenings at night, leaving you feeling fatigued and irritated the following day. It is possible to stop coughing at night and get your rest at bedtime.

Bedtime prep for sleeping well with a cough

By adding some bedtime preparations into your routine, you can significantly reduce the chances of coughing when sleeping as well as coughing in the morning, allowing you to rest more comfortably. You might try:

• Hydration times: Staying hydrated throughout the day is key, but consider reducing your fluid intake closer to bedtime. This may help relieve throat irritation and persistent cough during the night.
• Throat-soothing activities: Soothing activities before bed, such as gargling with warm salt water or sipping on a cup of noncaffeinated tea, may help ease throat irritation and reduce the frequency of coughing episodes while you sleep.
• Humidifying: A humidifier in your bedroom helps you maintain optimal moisture levels. Proper humidity can prevent your throat and air passages from drying, reducing the need to cough frequently.
• Avoiding trigger foods: Spicy or acidic foods before bedtime may trigger or worsen your cough. Avoiding these irritants can help prevent acid reflux, which is a common cause of cough at night. It can also help minimize coughing fits during the night.

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Tips for sleeping better with a cough

As you settle into bed, consider these tips to create a relaxing environment, even when experiencing a persistent cough when sleeping:

• Optimal sleep position: Lie on your side instead of your back. This position may help reduce mucus buildup in your throat, which can trigger coughing. Use pillows to support your head and maintain a comfortable angle that minimizes postnasal drip and acid reflux.
• Temperature control: Keep your bedroom at a comfortable temperature. A slightly cooler room, usually around 60-67°F, can promote better sleep. This environment helps prevent too much dryness that might worsen your cough.
• Bedding and pillows: Opt for hypoallergenic bedding materials and regularly wash your bedding to minimize allergens that could trigger coughing. Choose pillows that support your head and neck to help you maintain a comfortable and cough-reducing sleep posture.
• Stay calm: If a coughing episode occurs, try to remain relaxed. Rapid, shallow breathing can worsen coughing, so focus on slow, deep breaths to help manage and minimize the episode’s duration.

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What not to do

To avoid sleep disruptions due to a persistent cough, consider avoiding these:

• Late-night caffeine: Caffeinated beverages or foods close to bedtime may dry your throat and worsen coughing.
• Heavy meals before bed: Large portions or spicy meals before sleep may trigger acid reflux and worsen coughing symptoms.
• Smoking: Tobacco use may damage the cilia in your airways, worsening your cough. The cilia are hair-like structures that help move mucus and trapped particles out of the respiratory system.
• Stress and anxiety: Try your best to manage stress and anxiety, as heightened emotions can trigger or worsen coughing episodes. 

Cough medications for a restful sleep

Over-the-counter (OTC) cough expectorants like guaifenesin (Robitussin, Mucinex) may help loosen mucus in your airways and suppress your cough. Additionally, menthol or honey lozenges can temporarily relieve throat irritation.

Keep in mind that cough suppression is not recommended in all cases. And if your cough has persisted for over 2 weeks, you may want to consult a healthcare professional before taking OTC cough syrups.

While medications may provide temporary relief, they do not treat the underlying cause of your cough. If your cough persists or worsens, seeking the advice of a healthcare professional is highly advised. 

Depending on the cause of your cough, your healthcare team may prescribe codeine-based cough suppressants like promethazine (Phenergan). Other options include antihistamines, antibiotics, or inhaled corticosteroids if your cough is severe or persistent.

It is essential to adhere strictly to a doctor’s recommendations on codeine-based cough suppressants, as they have the potential to cause dependence. Dependence is when your body needs to continue using a drug to function as it usually does.

If acid reflux triggers your cough at night, your medical professional may recommend:

• antacids, like calcium carbonate (Tums)
• proton pump inhibitors (PPIs), like omeprazole (Prilosec) and lansoprazole (Prevacid)

Consider consulting with a doctor before using any OTC and prescription cough medications if any of these applies:

• You have pre-existing medical conditions, such as heart conditions and sleep apnea, that the ingredients in cough medications could worsen.
• You’ve experienced allergic reactions to cough medications in the past.
• You’re currently taking other drugs that may interact with cough medications, leading to unwanted side effects or reduced effectiveness.
• You’re experiencing unexplained symptoms alongside your cough, such as persistent fever or blood in your coughed-up mucus.

When to see a doctor

Consider talking with a doctor if you experience the following symptoms alongside your persistent cough:

• high fever
• difficulty breathing
• coughing up blood
• persistent chest pain 
• unexplained weight loss 

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Summary

Sleeping with a cough can be disruptive and frustrating. Making adjustments such as staying hydrated, elevating your head, and sleeping under controlled temperature and humidity may enhance your quality of sleep while you’re experiencing a cough.

Use of OTC and prescription cough medications may be needed in some cases, but medical guidance is highly encouraged, particularly if your cough lasts for more than 2 weeks and you live with chronic conditions.