Night Cough

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What is night cough?

Night cough is a cough, or tussis, that occurs primarily at night, typically when you are lying down (postural cough). Physiologically, coughing is a rapid expulsion of air from the lungs that happens reflexively to keep the airways clear. Night cough may be a symptom of conditions specifically affecting the lungs and throat or a more generalized condition, such as a cold or the flu.

Inflammation of the lungs or throat, due to smoking, colds, or flu, is a common cause of night cough. Smokers produce excess mucus in their airways and the lung struggles constantly to clear these passages. Remarkably, this symptom is one of the first to improve, even completely disappear, with smoking cessation.

In rare cases, night cough can be a symptom of a serious infection of the lungs, bronchial tubes, or throat. Night cough can also be a symptom of congestive heart failure if it occurs together with pink frothy mucus in the mouth, severe shortness of breath, wheezing, and rapid heartbeat. Night cough can also be a sign of lung cancer, especially if it is accompanied by hemoptysis (coughing up blood).

Depending on the cause, night cough may occur only while you are lying down or also while you are sitting up, and it may be accompanied by sputum production, sneezing, shortness of breath, wheezing, or gastric contents moving upward into the mouth.

In some cases, night cough can be a sign of a life-threatening condition, such as congestive heart failure, pulmonary edema, or a severe respiratory infection. If you, or someone you are with, have night cough that is accompanied by serious symptoms, such as chest pain, a high fever (higher than 101 degrees Fahrenheit), or severe breathing problems, seek immediate medical care (call 911).

If your night cough is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with night cough?

Night cough may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the respiratory tract may also involve other body systems.

Respiratory symptoms that may occur along with night cough

Night cough may accompany other symptoms affecting the respiratory system including:

  • Coughing up blood (hemoptysis)

  • Coughing up clear, yellow, light brown, or green mucus

  • Difficulty breathing

  • Rapid breathing (tachypnea) or shortness of breath

  • Sore throat

  • Stuffy nose or nasal congestion

  • Wheezing (whistling sound made with breathing)

Other symptoms that may occur along with night cough

Night cough may accompany symptoms related to other body systems including:

Serious symptoms that might indicate a life-threatening condition

In some cases, night cough may be a symptom of a life-threatening condition which should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

What causes night cough?

Night cough is a forceful expulsion of air from the lungs that occurs primarily at night. Allergic reactions are a common cause of night cough. Such reactions may be caused by pollen, animal dander, foods, or medicines. Infections, such as the common cold, flu, and acute bronchitis, that cause inflammation of the lungs, throat and sinuses are also common causes of night cough.

A condition called croup is a contagious viral laryngitis (inflammation of the throat) that causes night cough in young children. Chronic bronchitis associated with smoking is a common cause of night cough in adults. In severe cases, night cough can result from heart conditions such as congestive heart failure or pulmonary edema.

Allergic causes of night cough

Night cough may have allergic causes including:

Inflammatory causes of night cough

Night cough can have inflammatory causes including:

Other causes of night cough

Night cough can also have other causes including:

Serious or life-threatening causes of night cough

In some cases, night cough may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Congestive heart failure (deterioration of the heart’s ability to pump blood)

  • Lung cancer

  • Pulmonary edema (fluid in the lungs)

Questions for diagnosing the cause of night cough

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your night cough including:

  • How long have you been coughing at night?

  • Do you have any other symptoms?

  • Do you smoke?

  • What do you do to relieve your night cough?

  • What medications are you taking?

What are the potential complications of night cough?

Because night cough can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Difficulty sleeping

  • Excessive daytime sleepiness

  • Heart failure

  • Hypoxia (low levels of oxygen in the blood)

  • Respiratory failure and respiratory arrest

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 2
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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