What Can Cause Coughing at Night to Occur During Sleep?

Asthma, Reflux, and Sleep Apnea May Provoke Coughing at Night

Coughing at night can disturb sleep
Coughing at night can disturb sleep. Getty Images

If you suffer from a persistent hacking cough at night, you may wonder about the potential causes. What leads to coughing at night? Is it possible to cough during sleep? Learn about the potential causes of nighttime coughs - from asthma to allergies to reflux to sleep apnea - and the best ways to resolve persistent coughing.

Causes of Nighttime Coughing

There are a number of potential causes of nighttime coughs.

They may occur in the setting of a cold. Coughing may be exacerbated by a post-nasal drip of mucus from untreated allergies. Early morning coughing, occurring in the last third of the night, may be associated with wheezing and asthma. A productive cough may occur with heart failure, resulting in fluid accumulation at the base of the lungs. Bronchitis may also incite a persistent cough. Other lung infections (including tuberculosis and pertussis or whooping cough) and diseases such as cystic fibrosis, COPD, or emphysema may contribute.

In addition, some causes of coughing at night may be unexpected. Children and adults may cough due to silent reflux from gastroesophageal reflux disease (GERD). This may be associated with heartburn complaints. A high-pitched sound called stridor may occur in rare conditions such as laryngospasm in multiple system atrophy. This often persists into wakefulness.

Coughing may actually represent choking or gasping out of sleep. This may be due to untreated obstructive sleep apnea. This condition is commonly associated with snoring, excessive daytime sleepiness, waking to urinate, and teeth grinding.

Can Coughing Occur During Sleep?

In general, sleep suppresses the body’s natural ability to generate a cough.

As a result, coughing truly only occurs during awakenings from sleep (called arousals) or with wakefulness. With a bad cold, you lie awake coughing, rather than waking with a cough.

This seems to be true no matter what the cause of the cough might be. There does not seem to be differences noted with pulmonary disease. The response to irritating stimuli within the lungs is suppressed during sleep. Much like other bodily functions, including sneezing and farting, coughing does not happen when we are asleep.

Treatments for Coughing During the Night

Ultimately, the optimal treatment for coughing at night depends on the underlying cause. It may be necessary to treat a cold, allergies, asthma, or heartburn with medications. Cough suppressants such as Robitussin or Codeine may be temporarily helpful. Decongestants or allergy medications may reduce sinus congestion and post-nasal discharge. Heartburn can be treated with proton pump inhibitor such as Prilosec. Sleep apnea is usually treated with continuous positive airway pressure (CPAP) therapy.

Mild or moderate sleep apnea also can be treated with the use of an oral appliance. 

If you have a persistent cough that disturbs your sleep at night, speak with your doctor about some of the treatments available to you. It may be necessary to do a chest x-ray or pulmonary function testing. In rare cases a computerized tomography (CT) scan may be recommended. If the underlying cause is sleep apnea, a sleep study may be arranged. By coordinating with your physician, you should be able to determine the underlying cause and select an option that helps you to both breathe and sleep better.


Kryger, M.H. et al. "Principles and Practice of Sleep Medicine." ExpertConsult, 5th edition, 2011.

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