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Coughing When Lying Down

Coughing when lying down can be a source of distress and make it impossible for one to enjoy a peaceful night rest after a hectic day job. According to the University of Maryland Medical Center, coughing is one of the top reasons for visiting a doctor. The need to see a doctor is even heightened when the cough is made worse by lying down.

Orthopnea as the case is referred to, is a medical condition whereby an individual experiences coughing as he/she lies down. This problem can happen to you for different reasons. We shall talk about the causes of the problem in the course of this write-up.
This post shall attempt to answer a few questions regarding the cause of coughing when lying down, the treatment, when you should be concerned, and the relief. If you have the condition or you know of someone who has, we would advise you to pay adequate attention to every part of this article and make sure you understand and follow the tips highlighted in the post.

What Causes Coughing when lying down?

Orthopnea is caused by different factors. The commonest causes of coughing when lying down include but are not limited to the following:


One of the infectious disease specialists with Georgia Infectious Diseases, PC, and who is also a staff physician at Saint Joseph’s Hospital in Atlanta, Dr. Mitchell Blass, MD, makes it clear that the main reason for coughing when lying down is as a result of gravity. Lying down leads to pooling of mucus, and eventually brings about gastroesophageal reflux. This makes mucus to collect in the throat and trigger off coughing.

Congestive Heart Failure

The inability of the heart to pump and distribute blood effectively leads to a backflow of blood to the superior vena cava and the pulmonary veins. This manifests with swelling of the lower legs/ankles, weight gain, sense of fullness in the abdomen, coughing when lying down, shortness of breath when you lie or on exertion, etc. These symptoms usually come from the congestion of blood vessels and poor venous return, which are the major challenges in congestive heart failure.

Dry Air

When the surrounding air is dry, it can irritate the nose and the throat thereby leading to cough especially when you lie down.


Infection of the sinus, or other chronic diseases or allergies that lead to long-term stuffiness of the nose can as well cause coughing when lying down. With clogged sinuses, the only escape route for mucus is to trickle along the back part of your throat. This can trigger cough and make you uncomfortable at night.


A lot of people with asthma suffer from dry cough. The dry cough coupled with wheezing, can make it really difficult to observe adequate sleep at night.


This is the inflammation of the lungs. Apart from the inflammation, the infecting organisms can as well irritate the walls of the lungs, leading to cough. The cough is made worse when lying down. The extent of the cough can also be determined by the severity of the condition.

Acid Reflux (GERD)

For people who are prone to GERD, eating late at night can cause a reflux of the stomach acid which may seep into the throat and lungs, leading to heartburn and cough when lying down. Acid reflux into the lungs can even cause choking in some cases.


The inflammation of the bronchi of the lungs brings about irritation of the lungs with subsequent production of cough, which can sometimes be made worse with other respiratory infections. Symptoms of bronchitis include cough, shortness of breath, chest discomfort, mucus production (with white, green or yellowish-gray phlegm), fatigue, and chills and slight fever.


This is a viral infection that is responsible for inflammation of the larynx (voice box) as well as the trachea (windpipe). The disease is commoner among toddlers and is characterized by coughs that are milder during the day but return at night. Croup can be accompanied by Stridor (high pitched sound) when the sufferer inhales, and can sometimes come when there is cold in some children.


Dry cough is common in any stage of pregnancy. But when there is cold in a pregnant woman, the virus can make the symptoms worse especially when lying down at night.

Certain Medications

Some medications that are taken for the management of high blood pressure can give rise to a dry cough which eventually makes sleeping a big challenge. Some of those drugs are the ACE inhibitors.


One of the side effects of smoking is that it irritates the lungs and leads to production of mucus. In an attempt to get the mucus out of the lungs, the individual may cough unintentionally. This can also be problematic as the cough becomes a nuisance at night.

Treatment for Coughing when lying down

Different treatments are available for this condition. Some of the treatments include:

  • Cough medicines: Some of the medicines you can use for the treatment of cough are readily available over the counter. Their modes of action include acting as an expectorant for productive cough and suppressing dry cough. They are usually not suitable for children below six years. Consult your doctor before giving them to a toddler or any infant.
  • Bronchodilators: These groups of medication assist in keeping the airways open in order to improve airflow. When the airways are open, breathing becomes effortless. They are highly suitable for asthmatic patients and for people suffering from bronchitis.
  • Decongestants: They are quite helpful in maintaining patent nasal passages, thereby easing passage of air through the nose to the lungs.
  • Nasal Corticosteroids: They come in the form of sprays, which are highly useful in reducing nasal inflammation, and relieving itching, sneezing and runny noses.
  • Antihistamines: Mainly assist in drying up nasal secretions and also lessen the cough that is triggered by allergies.
  • Corticosteroids: While the nasal corticosteroids are employed in the management of nasal inflammation, corticosteroids are used for relieving inflammation associated with COPD or asthma.

When should you be concerned?

Coughing when lying down may not give you a cause for alarm. But there are conditions under which you should be concerned. These conditions include:

  • Sudden onset of violent cough
  • Unexplainable weight loss
  • When inhalation comes with Stridor (a high pitched sound)
  • Swelling in the abdomen
  • Fever
  • Cough in children that are below the age of three months
  • Shortness of breath or difficulty breathing
  • Sputum missed with blood or coughing up blood
  • Green phlegm with bad odor or extra thickness


Apart from using over-the-counter drugs or medications prescribed by the doctor, there are several things you can do at home to help provide relief for your cough. Some of the things to do include:

Sleep on an incline

Since coughing when lying down usually comes from the mucus and post nasal drainage that you swallow during the day, which is made worse by the pull of gravity, you should attempt to overcome gravity by not lying down. Instead, you should pop yourself on several pillows to counter the force of gravity.

Another way to get relief is to raise the head of your bed on wooden blocks to make it at least 4 inches high. This will make the pull of gravity much less and allow you to have some uninterrupted night sleep.

Control humidity

Since coughing when lying is known to be provoked by dry air, it would be wise to control the humidity in your room. Get an inexpensive hygrometer for measuring the humidity of your room and aim to maintain a humidity level of between 40% and 50%. Avoid excessive moisture as this can help mould and other allergens like dust mites to flourish and cause coughing too. For humidity control, make use of sterile water in order to prevent microorganisms from taking advantage.

Use steam with caution

As coughing is provoked by dry air, one primary thing one might like to do is to take a bath, shower, or sit in a steamy bathroom before going to bed as they help in relieving dry cough. However, you must avoid steamy bath if you are asthmatic as steam can aggravate the cough in asthma.

Take herbal tea with honey

Dr. Norman H. Edelman, MD, Chief Medical Officer of the American Lung Association advises sufferers to take warm liquids as they are quite helpful in breaking up phlegm in your airways. So, taking a cup of non-caffeinated tea with honey before bed can go a long way in relieving the symptoms.

Keep bedding clean and tidy

Dust mites easily hide in your bedding. Having them in your bedding can easily trigger cough if you are allergic to dust mites. To alleviate your night cough, wash your bedding regularly and iron them, making sure you don’t use chemicals that would further irritate the airways.

Prepare your bedside

It is advisable to get everything you might need at night by your bedside before going to sleep. They include cough medicine, cup of water, or whatever you know of that can help reduce the cough. The earlier you can lay hands on them during a coughing fit the better for you.

Take honey lozenges or menthol

They are good at soothing the throat and the airways. So, before going to bed, you can take any of them that is available.

Avoid late foods

Eating late into the night can be a major challenge for those with GERD. Therefore, to keep this problem under control you must learn to eat your dinner earlier.


Coughing when lying down is such a medical nuisance nobody prays to have. But no matter the situation, you can always find a way out of the distress. Following our tips here can really help you out. However, if after applying our suggestions there still seems to be no relief, you need to see your doctor for further management.

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