A frequent cough that gets much worse at night is usually a sign of something specific irritating your airways when you lie down or when your body’s night‑time rhythms kick in, and it’s worth taking seriously if it’s persistent or severe.

Key reasons you cough more at night

  • Postnasal drip (mucus from nose/sinuses)
    When you lie down, mucus from allergies, a cold, or sinus infection can drip down the back of your throat and tickle your airway, triggering a cough and “throat clearing” feeling.
  • Allergies and bedroom irritants
    Dust mites in bedding, pet dander on pillows, mold, or strong scents (candles, diffusers) can all inflame your airways more in the closed bedroom environment at night.
  • Asthma or “cough‑variant” asthma
    Asthma often worsens at night because of changes in lung function and airway inflammation; for some people, a nagging night cough is the main symptom, even without obvious wheezing.
  • Acid reflux / GERD
    Lying flat makes it easier for stomach acid to creep up into your esophagus and even the back of your throat, which can trigger a dry, irritating cough and hoarseness, especially if you also get heartburn or sour taste.
  • Respiratory infections (cold, flu, bronchitis, COVID, pertussis)
    Infections increase mucus; when you lie down, your body uses the cough reflex to move that mucus, so the cough can feel much worse at night even if the infection is mild.
  • Dry air and temperature changes
    Heated or air‑conditioned bedrooms often have very dry air, and cooler night air can irritate sensitive airways, provoking a scratchy, unproductive cough.
  • Medications (like ACE‑inhibitors for blood pressure)
    Some blood pressure medicines can cause a dry, persistent cough that people often notice most at night once everything is quiet.
  • Less common but important causes
    Chronic lung disease, heart problems, or other serious conditions can also show up as a worsening night cough, especially if there’s shortness of breath, chest pain, or leg swelling.

A simple way to think of it: lying down changes where mucus and acid go, night‑time changes how sensitive your airways are, and your bedroom environment adds extra triggers.

What you can try at home (not a substitute for medical care)

You should still talk to a medical professional, but many people get some relief by experimenting with a few safe changes:

  1. Change your sleeping position
    • Sleep with your head and upper chest elevated on extra pillows or a wedge.
    • If reflux is likely, avoid lying completely flat and do not eat 2–3 hours before bed.
  1. Tame postnasal drip and allergies
    • Use saline nasal spray or a gentle saline rinse in the evening to clear mucus.
    • Wash bedding weekly in hot water, keep pets off the bed, and consider a dust‑mite cover for pillows and mattress.
 * Avoid bedroom perfumes, sprays, or smoke.
  1. Soothe the airways
    • Run a cool‑mist humidifier (cleaned regularly) if your room is very dry.
    • Sip warm fluids (herbal tea, warm water with honey) in the evening to calm the throat.
 * Avoid cigarette or vape smoke completely.
  1. Think about reflux
    • Notice whether cough is worse after late meals, spicy/acidic foods, coffee, or alcohol.
    • Raising the head of the bed a few inches and changing those triggers can help a lot.
  1. Review your medicines
    • If you’re on blood pressure medicine ending in “‑pril” (like lisinopril), ask your doctor if your cough could be a side effect.

When to see a doctor urgently

Get urgent medical help (ER/urgent care or emergency services) if:

  • You are short of breath, wheezing, or struggling to breathe.
  • You have chest pain, feel faint, or notice fast heart rate.
  • You cough up blood.
  • Your lips or face look bluish.

Make a prompt appointment with a doctor or clinic (within a few days) if:

  • Your night‑time cough lasts more than 2–3 weeks.
  • It’s waking you up most nights.
  • You have fever, weight loss, night sweats, or a change from your usual cough.
  • You have known asthma or reflux that seems suddenly worse despite your usual treatment.

A clinician can listen to your lungs, check your nose and throat, review your medications, and decide if you need tests (like a chest X‑ray, lung function tests, or reflux treatment), which is the only way to get a confident diagnosis.

Mini example story

Imagine someone who feels fine in the day but every night, as soon as they lie down, they start a dry tickly cough and need water. They sleep with their dog, have stuffy sinuses, and like a late spicy dinner. In that single scenario, postnasal drip from mild allergies plus reflux and bedroom irritants all stack together to drive a “why am I coughing so much at night” experience, and simple changes plus medical advice can make a big difference.

Bottom line: night‑time cough is common, often treatable, but can occasionally signal something serious. If it’s frequent or worrying you, you should be checked by a healthcare professional rather than trying to self‑diagnose.