Why does coughing get worse at night?

Dec 12, 2025 Source: Cainiu Health

Dr. Ren Yi

Introduction

In general, severe coughing at night may be caused by dry air, improper sleeping posture, allergic cough, bronchitis, gastroesophageal reflux disease, or other reasons. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, maintain good indoor ventilation and regularly clean and dust the environment; adjust clothing according to temperature changes to prevent respiratory infections.

Generally, severe nighttime coughing may be caused by dry air, improper sleeping posture, allergic cough, bronchitis, gastroesophageal reflux disease (GERD), and other reasons. If discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. Specific analysis is as follows:

1. Dry Air: Low indoor humidity at night can cause dry air to irritate the throat mucosa, leading to mucosal dryness and sensitivity, which worsens coughing. Using a humidifier before bedtime to maintain indoor humidity between 40%–60%, and drinking plenty of warm water can help soothe the throat.

2. Improper Sleeping Posture: When lying flat, the head is positioned lower, allowing respiratory secretions to more easily flow back and irritate the throat, or compress the lungs and impair ventilation, triggering coughing. Adjusting to a semi-reclining position by elevating the head and shoulders with pillows can reduce irritation from secretions.

3. Allergic Cough: Exposure to allergens such as dust mites or bedding fibers at night can trigger airway hyperresponsiveness, resulting in paroxysmal dry cough. Medications such as cetirizine hydrochloride tablets, loratadine capsules, or montelukast sodium chewable tablets may be used under medical guidance. Regularly washing bedding and sun-drying it to eliminate mites is also recommended.

4. Bronchitis: Inflammation of the bronchi caused by bacterial or viral infection can worsen at night due to increased vagal nerve activity, leading to bronchoconstriction and intensified coughing, often accompanied by sputum production. Under a doctor's supervision, medications such as amoxicillin capsules, ambroxol hydrochloride oral solution, or dextromethorphan hydrobromide tablets may be prescribed. Avoid exposure to smoke and cold air.

5. Gastroesophageal Reflux Disease (GERD): When lying down at night, stomach acid is more likely to reflux into the esophagus and irritate the throat, causing reflux-related cough, often accompanied by heartburn. Medications such as omeprazole enteric-coated capsules, hydrotalcite chewable tablets, or domperidone tablets may be taken as directed by a physician. Avoid eating within two hours of bedtime, and consume light, easily digestible meals for dinner.

In daily life, maintain good indoor ventilation and perform regular cleaning to reduce dust; dress appropriately according to weather changes to prevent respiratory infections; control portion sizes at dinner and avoid spicy or greasy foods; seek medical attention promptly if cough persists, to determine the underlying cause.

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