How to Sleep When You Have a Cough

Sleep is such an important part of getting better from being sick. But there's one persistent symptom that can make it impossible to get the rest you need: coughing. 

“It’s hard to sleep when you have a cough because it can prevent you from falling asleep, or it can wake you up,” says Romina Wahab, MD, who specializes in critical care medicine and pulmonology at Columbia, treating people with lung conditions and sleep-related breathing problems.

From propping extra pillows to taking a spoonful of honey, there are plenty of common tricks for getting sleep when you have a cough. But they often don’t work.

“The best way to sleep when you have a chronic cough is to control the cause when you’re awake,” says sleep medicine specialist Sanja Jelic, MD, who treats people who have difficulties breathing while asleep. “In the case of a cold, which is the most common cause of acute cough, that may be difficult to achieve. However, such cough is transient, usually lasting a few days to three weeks.”

Drs. Wahab and Jelic explain what a cough is, and how to get the rest you need.

Why do people cough?

Coughing is a natural reflex in response to stimuli ranging from particle irritation to dry air.

A cough involves a quick, usually involuntary, inhalation followed by a forceful exhalation when the abdominal and rib muscles contract. The purpose of a cough is to clear any irritants from your airway. Coughs clear mucus and protect your respiratory tract from inhaling foreign bodies.

What makes us cough?

The most common causes of cough are upper and lower airway infections, post-infectious cough, asthma, chronic obstructive pulmonary disease (COPD), chronic rhinitis (or stuffy nose), and gastroesophageal reflux disorder (GERD).

Other causes could include certain medications, smoking, and heart disease.

Why is it hard to sleep when you have a cough?

Normally, your body is less sensitive to the cough reflex during sleep. However, if a person has a daytime cough, this natural decrease in cough sensitivity is gone. As a result, you’re more likely to experience coughing that makes it difficult to fall asleep or maintain uninterrupted sleep. 

What’s the best way to sleep when you have a cough?

If your cough is part of a seasonal respiratory virus, like the common cold, try elevating your head and chest with extra pillows or a wedge. You can also try lying on your side, not back. These tricks can work because you usually have nasal congestion when coughing. Mucus buildup can drip back into your throat (AKA post-nasal drip) and trigger the cough. Elevating your head or lying on your side may let the mucus drip out of your nose instead.

If you have post-nasal drip, using a nasal decongestant for a brief period may help. Do not make this a habit.

If you have acid reflux or GERD, treatment specific to these conditions may help. If you have a chronic lung condition, such as asthma or COPD, discuss possible treatments with your healthcare provider.

What treatments work best for coughing?

It depends on the cause of the cough.

The common cold often involves a productive cough—meaning you cough up phlegm—which clears the airways of mucus, removing irritants. Over-the-counter (OTC) cough medicines can help thin out phlegm and make coughing up the phlegm easier.

OTC cough suppressants can calm the cough reflex (warning: They tend to cause drowsiness, so use them when you do not need to be alert).

If you have nose congestion, you might benefit from an OTC nasal decongestant spray for a brief period.

You might find a throat lozenge or honey soothing if you have a sore or dry throat or cough. It can also calm the cough reflex.

Staying hydrated and keeping the air warm and humidified may also help reduce coughing. Cold and dry air can trigger a cough.

What should everyone know about coughs and sleeping?

Acute cough almost always goes away within a few weeks. If the cough has not improved after a few weeks, or if you have a condition causing chronic cough, talk about possible treatments with your health care provider.

Wheezing, shortness of breath, coughing up blood, high fevers, body aches, chills, or difficulty swallowing or keeping down liquids/food are concerning conditions. If you develop any of these, please seek medical attention sooner.