What causes sudden severe sore throat and blood in phlegm overnight, and what should I do?

Generally, sudden and severe sore throat accompanied by blood in sputum overnight may be caused by dry air, excessive voice use, acute pharyngitis, acute tonsillitis, or postnasal drip syndrome. Appropriate measures such as general care or medication can be chosen based on the specific situation. Detailed analysis is as follows:

1. Dry Air

Remaining in a dry environment for prolonged periods during nighttime sleep can lead to significant moisture loss from the respiratory mucosa. The resulting dryness makes the mucosal lining fragile and prone to rupture and bleeding, causing sore throat and blood-tinged sputum. Using a humidifier in the bedroom before sleep to maintain indoor humidity between 40%–60%, along with drinking plenty of lukewarm water, helps moisturize the mucous membranes.

2. Excessive Voice Use

Shouting or speaking for extended periods the previous day can cause strong vibrations and friction to the vocal cords and pharyngeal mucosa, leading to congestion, swelling, or even tissue damage, resulting in pain and blood in sputum. Immediately stop loud talking to allow the throat adequate rest, and maintain a light diet avoiding spicy or irritating foods.

3. Acute Pharyngitis

Viral or bacterial infections can trigger acute inflammation of the pharynx, causing mucosal congestion and swelling. Inflammatory irritation may damage the mucosa and result in bleeding. Under medical guidance, medications such as Lanqin Oral Liquid, Cefuroxime Axetil Tablets, or Ribavirin Granules may be used. Eating fresh fruits and vegetables rich in vitamin C is also recommended.

4. Acute Tonsillitis

Invasion of pathogens causes acute suppurative inflammation of the tonsils, leading to swollen, congested tonsils. When the surface mucosa breaks down, bleeding occurs, often accompanied by severe sore throat. Follow medical advice to take Amoxicillin Clavulanate Potassium Tablets, Pudilan Anti-inflammatory Oral Liquid, and Paracetamol Tablets. Gargling with warm saline after meals is also beneficial.

5. Postnasal Drip Syndrome

Increased nasal secretions due to rhinitis or sinusitis may flow backward into the throat when lying down at night, irritating the pharynx and causing inflammation and mucosal injury. Treatment under medical supervision may include Mometasone Furoate Nasal Spray, Loratadine Tablets, and Eucalyptus Citrus Pine Enteric-coated Soft Capsules. Keeping the nasal passages clean and unobstructed is essential.

In daily life, it's important to maintain appropriate indoor humidity and avoid overusing the voice. Diet should focus on mild, moistening foods while avoiding tobacco, alcohol, and spicy items. Proper nasal care helps prevent postnasal drip. If symptoms persist beyond three days or worsen, prompt medical evaluation is necessary for accurate diagnosis and treatment.