How to Stop a Dry Cough at Night
Medically reviewed by Sameena Zahoor, MD
A cough is a natural reflex that protects your body's airways and lungs from damaging irritants like mucus, germs, dust, and smoke.
A dry cough does not produce or bring up mucus and has many possible causes, including a chest cold, asthma, and acid reflux. At night, a dry cough may worsen for many reasons, including gravity, exposure to dry air, or increased airway sensitivity.
This article will review what might bring on a dry cough and why it may worsen at night. It will also explore how to manage a dry cough and when to see a healthcare professional.
Reasons a Dry Cough Is Worse at Night
There are a few possible reasons why your dry cough may worsen at night.
For many nighttime coughs, gravity is a pivotal contributor. When you lie flat to sleep at night, mucus and other fluids can pool together in the throat.
The mucus may be draining from the nose and sinuses (if you have allergies or a cold), or stomach acid may move up the esophagus (the hollow tube that carries food to your stomach) and collect in the throat if you have acid reflux. Ultimately, the pooling of mucus and other fluids creates a tickling throat sensation that can trigger the cough reflex.
Environmental factors can also contribute to a worsening cough at night. For example, breathing in dry air can worsen a cough by aggravating the nose, throat, and airways due to moisture loss.
Also, exposure to allergens, namely dust mites in your bedding or pet dander (if you sleep with your pets), can irritate your airways, triggering a dry cough.
Hormone and lung function changes and increased airway sensitivity may also be behind a worsening cough at night. These nighttime changes have been reported in individuals with asthma.
Related:When Asthma Symptoms Are Worse At Night
What Brings on a Dry Cough at Night?
There are many potential causes of dry cough at night. Four common ones include:
Viral bronchitis ("chest cold")
Gastroesophageal reflux disease (GERD)
Bronchitis develops when the bronchi (the tubes that transport air to the lungs) suddenly become irritated and inflamed, causing a persistent cough that may be dry or wet.
Most cases of bronchitis are acute—they come on suddenly and go away within one to three weeks—and are caused by the common cold or another viral upper respiratory infection (URI).
A COVID-19 infection can cause a dry cough, especially early on, as the virus inflames the vagus nerve, which regulates the cough reflex. An infection with COVID-19 can also progress into viral bronchitis, causing a dry or wet cough.
Asthma is a chronic lung condition associated with inflammation and narrowing of the airways. It's a prominent cause of chronic cough in adults and the most common cause in children.
Asthma symptoms include an intermittent cough, wheezing (a high-pitched whistling sound), trouble breathing, and chest tightness.
Some individuals with asthma only experience a cough, typically dry. This form of asthma is called cough-variant asthma.
Various factors trigger asthma symptoms, such as viral infections, cold or dry air, dust, mold, cigarette smoke, perfumes, and air pollution.
GERD occurs when stomach contents move back up the esophagus. The main symptom is heartburn, a burning sensation behind the breast bone. A dry cough may also occur if stomach acid is inhaled into the lungs.
Postnasal drip describes excess mucus from the nose and sinuses that drips down the back of the throat, causing an itchy sensation that can trigger a cough. Postnasal drip has many causes, including allergies and colds.
Allergies occur when your immune system mistakes a harmless substance for something foreign and harmful and reacts abnormally. Symptoms include runny nose, sneezing, and dry cough from airway inflammation.
While not an exhaustive list, other possible, albeit less common, causes of a nighttime dry cough include:
Pulmonary embolism (blood clot in a lung artery)
A side effect of certain medications, such as angiotensin-converting enzyme (ACE) inhibitors (a type of high blood pressure drug)
Related:Causes and Risk Factors of Cough
How to Ease Dry Coughing at Night
Easing a dry cough at night depends on the underlying cause, which includes:
Viral bronchitis: Viral bronchitis slowly resolves on its own. Home remedies like fluids, saline nasal spray or drops, taking a spoonful of honey (avoid in babies under 1 due to the risk of botulism), and running a cool-mist humidifier are often helpful.
Asthma: The primary treatment is the daily use of inhaled corticosteroids. They reduce the airways' swelling and decrease symptoms over time.
GERD: Lifestyle modifications, such as elevating the head of your bed, weight loss (if overweight or having obesity), and quitting smoking, are recommended. Drugs like Pepcid (famotidine) or Prilosec (omeprazole) may also be used.
Postnasal drip: Elevating your head at night can reduce mucus drainage. Additional therapies depend on the specific cause. For example, a steroid nasal spray and allergen avoidance (e.g., allergen-proof bedding if allergic to dust mites) are advised if allergies are responsible.
Under the guidance of a healthcare provider, you might consider trying an over-the-counter (OTC) cough medicine for viral bronchitis, such as the cough suppressant Robitussin or the expectorant Mucinex, both containing dextromethorphan and guaifenesin and either a pain or nasal decongestant. OTC cough medicines should not be given to children under age 6, as they can cause harmful side effects.
Related:15 Home Remedies for a Dry Cough
Signs of a Dry Cough Getting Worse
Most dry coughs from viral bronchitis clear up on their own and, therefore, can be managed at home.
Sometimes though, a case of viral bronchitis can turn into pneumonia (a lung infection) or resemble a more serious condition, like bacterial bronchitis, a pulmonary embolism, lung cancer, or heart failure.
With that, be sure to see a healthcare provider if your cough is not improving or is associated with concerning features, such as:
Difficulty breathing or chest pain
A high or prolonged fever or fever that starts after days of coughing
Blood or mucus that was clear and turned into a yellowish-green or rust color.
Rapid heartbeat (tachycardia)
Unintended weight loss
Weight gain and/or swelling in ankles and legs (edema)
Learn More:When to See a Healthcare Provider for Your Cough
Dry Cough at Night for Weeks: What to Do
A dry cough at night for weeks could indicate chronic health problems like asthma, GERD, or allergies. These chronic health conditions cannot be treated at home.
They require guidance from a healthcare provider and a well-devised treatment plan that often includes a combination of lifestyle modifications and medication.
See a healthcare provider if your nighttime dry cough is lingering for more than three weeks or if you are experiencing recurrent episodes of dry cough.
It's also essential to see a healthcare provider in the following scenarios:
An infant or young child is coughing, or an older adult.
You have a chronic medical condition, like diabetes, heart disease, or chronic obstructive pulmonary disease (COPD).
You have not received the flu vaccine, the pertussis (whooping cough) vaccine, or the pneumococcal vaccine for pneumonia, if applicable.
Learn More:Why Can’t I Stop Coughing, and How Do I Stop?
Dry cough is a common symptom and may worsen at night for many reasons, including the pooling of mucus or fluids in the throat and exposure to dry air or nighttime allergens. Stopping a dry cough at night involves addressing the root cause, whether that cause is a chest cold, asthma, acid reflux, or postnasal drip, among other conditions.
While many cases of dry cough can be treated at home, don't delay seeing a healthcare provider if your cough is worsening, persisting for more than three weeks, or is associated with worrisome features like high fever or trouble breathing.