Causes of dry cough at night

Causes of Dry Cough at Night

A dry cough at night can disrupt sleep and leave you feeling tired the next day. Unlike a productive cough that brings up mucus, a dry cough is “non-productive,” meaning it doesn’t produce phlegm. Understanding common triggers and underlying conditions can help you find relief and know when to seek medical advice.

Common Causes

• Postnasal drip (Upper Airway Cough Syndrome)
– Mucus from your nose or sinuses drips down the back of your throat when you lie flat.
– Often feels like a tickle in your throat or frequent throat-clearing.
– Can be worse at night if allergy or sinus symptoms flare when you’re horizontal.

• Asthma
– Some people have “nocturnal asthma,” where airways tighten during sleep.
– Symptoms include wheezing, chest tightness and a dry, spasmodic cough.
– Triggers can include cold air, dust mites or pet dander in your bedroom.

• Gastroesophageal reflux disease (GERD)
– Stomach acid flows back up into the esophagus, especially when lying down.
– Acid irritating the throat can trigger a dry cough, often worse at night or early morning.
– You may also notice heartburn, sour taste, or hoarseness.

• Environmental irritants
– Dry air, especially in winter or from air conditioning, can dry out your throat.
– Tobacco smoke, strong perfumes or cleaning chemicals can provoke a cough reflex.
– Indoor allergens (dust mites, mold) may be more concentrated in your bedroom at night.

• Medications
– ACE inhibitors (used for high blood pressure) can cause a persistent dry cough in some people.
– If you start a new medication and develop a cough, talk to your doctor about alternatives.

• Heart failure
– Fluid can back up into your lungs when you lie down, causing coughing at night.
– Often accompanied by shortness of breath and swelling in the legs or ankles.
– This is less common but important to recognize as it may need immediate attention.

Less Common Causes

• Lung infections in early stages (viral bronchitis)
• Interstitial lung disease or pulmonary fibrosis
• Whooping cough (pertussis) in adults presenting as a long-lasting dry cough
• Exposure to occupational irritants (chemicals, dust)

When to Consider a Free, Online Symptom Check
If you’re unsure what’s causing your nighttime dry cough, consider doing a free, online symptom check for to help narrow down potential triggers and decide if you need to see a healthcare provider sooner.

Managing a Dry Cough at Night

Lifestyle and home remedies can often ease a mild dry cough:

• Elevate your upper body
– Use extra pillows or a wedge under your mattress to keep your head and chest higher.
– This can reduce postnasal drip and acid reflux.

• Improve air quality
– Run a cool-mist humidifier to add moisture to the air, especially in winter.
– Clean humidifiers regularly to prevent mold and bacteria growth.
– Keep your bedroom free of dust and pet dander; wash bedding weekly in hot water.

• Avoid irritants
– Don’t smoke and avoid secondhand smoke.
– Steer clear of strong perfumes and cleaning sprays before bedtime.

• Stay hydrated
– Drink plenty of water throughout the day to keep your throat moist.
– Warm teas (with honey, if tolerated) may soothe irritation.

• Review your medications
– Talk to your doctor if you suspect an ACE inhibitor or other drug is triggering your cough.

• Dietary changes for GERD
– Avoid eating within 2–3 hours of bedtime.
– Limit spicy foods, caffeine and alcohol, which can worsen reflux.

Medical Evaluation and Treatment

If home measures don’t improve your cough within two to three weeks, or if you experience any worrying symptoms, it’s time to see a doctor. According to the American College of Chest Physicians and other expert guidelines (Irwin RS et al., Chest 2006; Irwin RS & Madison JM, N Engl J Med 2000):

• Diagnostic steps may include:
– Detailed medical history and physical exam
– Chest X-ray or, if needed, CT scan
– Spirometry (lung function test) to check for asthma
– 24-hour esophageal pH monitoring if GERD is suspected (Harding SM et al., Am J Gastroenterol 1999)
– Sinus imaging or allergy testing for postnasal drip

• Treatment options:
– Postnasal drip: nasal corticosteroid sprays, antihistamines, saline rinses
– Asthma: inhaled bronchodilators and steroids, allergy control measures
– GERD: proton-pump inhibitors, H2 blockers, dietary adjustments
– Cough-suppressant medications (short-term use) under doctor guidance

When to Seek Immediate Help

A dry cough at night is rarely an emergency, but you should seek prompt medical attention if you experience:
• Difficulty breathing or shortness of breath at rest
• Chest pain, especially if it feels crushing or radiates to your arm or jaw
• Coughing up blood or a large amount of fluid
• High fever with chills and sweaty night sweats
• Sudden swelling of legs or rapid weight gain (possible heart failure)

Speak to a doctor about anything that could be life-threatening or serious. Early evaluation can rule out dangerous conditions and get you on the right treatment plan.

Key Takeaways

• A dry cough at night often stems from postnasal drip, asthma or GERD.
• Lifestyle changes—elevating your head, improving air quality, avoiding irritants—can help.
• If symptoms persist after a few weeks, get a medical evaluation including imaging or lung tests.
• Always seek immediate care for severe breathing issues, chest pain, coughing blood or high fevers.
• Consider a free, online symptom check for to guide your next steps, and speak to a doctor about any serious concerns.