Night Cough: Why It Worsens and What It May Indicate

During the day you almost forget about it, but by evening it returns — dry, persistent, as if someone is tickling your throat from the inside. Below is a look at what causes are linked to cough and what to pay attention to.

Why cough worsens at night

Cough is an innate protective reflex: a forced exhalation through the mouth that clears the airways of foreign substances and mucus. The receptors that trigger it are located along the entire respiratory tract — in the nose, pharynx, larynx, trachea, and bronchi. Postnasal drip of mucus down the back of the throat from the nose is named as one of the causes of cough. Night cough is identified as a separate variant by time of onset. The cough center is controlled by the cerebral cortex, so cough can be partially suppressed.

Dry cough at night: possible causes

A dry cough is a cough without sputum (nonproductive). Causes of cough include allergies, use of certain medications — in particular, ACE inhibitors and β-blockers — and inhalation of irritants. The list of causes of cough also mentions diseases of the upper respiratory tract: rhinitis, sinusitis, pharyngitis, laryngitis. If the cough occurs only at night and is dry, the doctor determines the cause of the cough: listens to the chest and, if necessary, orders tests.

Productive cough at night and coughing fits

A productive cough is accompanied by sputum — mucous, serous, purulent, viscous, or scanty. An evening cough occurs with pneumonia and bronchitis. A cause of cough may be aspiration in gastroesophageal reflux disease. Causes of chronic cough include chronic bronchitis, asthma, allergies, COPD, reflux, smoking, and certain medications. By duration, cough is divided into:

• acute — less than two weeks
• prolonged — 2–4 weeks
• subacute — 4–8 weeks
• chronic — more than 2 months

Night cough in a child: what distinguishes it from an adult's

Croup in young children is classified among the causes of chronic cough. Cough can be barking, resonant and chesty, hoarse, or muffled. Cough can be dry or productive, and by duration — acute, prolonged, subacute, or chronic; if it recurs at night, the doctor determines the cause.

How the cause of night cough is determined

During an appointment, the doctor listens to the chest with a stethoscope, may take a sputum sample, order an X-ray, an allergy workup, or a test showing how the lungs function. Less often, the patient is referred to a specialist in a hospital. Antibiotics for cough are usually not prescribed — only for a bacterial infection or risk of complications.

When night cough requires seeing a doctor

You should see a doctor if the cough lasts longer than 3 weeks, if a person loses weight without cause, or has a weakened immune system. Cough by itself is rarely a sign of something serious, but recurring nighttime episodes are a reason to find out the cause.

Night cough by itself is not a reason to call an ambulance; 103 or 112 — if the cough is very severe or rapidly worsening, you feel very unwell, there is chest pain, difficulty breathing, blood in the sputum, or swelling and tenderness on the side of the neck.

This material is for reference: it helps to understand what night cough may indicate, but does not replace a doctor's consultation, which will assess your situation as a whole.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer