02 June 2019

What is that morning cough all about?

Not a smoker, but waking up with an annoying cough? This is what might be causing it…

A cough, no matter what time of day it occurs, is vital for clearing the airways of irritants.

However, if you're not a regular smoker and keep on waking up with a cough, you might start wondering why. There are several conditions that can cause an early morning cough:

1. Postnasal drip

Postnasal drip is one of the most common causes of a persistent cough. Your nose serves as a gateway to your respiratory tract – and to protect it from irritants, the nose produces mucus that serves as a filter. But sometimes the body produces too much, which has to go somewhere – usually all the way down the respiratory tract, which will cause irritation and a cough. As mucus pools at the back of the throat while you are lying down, a cough associated with nasal drip can be especially bad at night and first thing in the morning.

What to do: Postnasal drip has various causes: it could be an allergy, sinusitis, a cold or flu. If the postnasal drip is persistent and causing a cough, especially first thing in the morning, you might want to address the underlying cause of the nasal drip by means of a decongestant or antihistamines.

2. Hay fever

There are various things inside the home that may cause an allergic reaction that triggers hay fever symptoms. It could be dust, pollen or pet dander. These allergens are present in many homes and can irritate your airways.

What to do: Make sure your house, especially your bedroom, is always free of dust. If pet dander is the issue, try to make your bedroom a pet-free zone. Make sure your bedroom is well-ventilated.

3. Bronchitis

If you cough up phlegm, especially in the morning, it might be a sign of bronchitis. Acute bronchitis is the most common form and occurs when the bronchi (the airways of the lungs) become inflamed. The cough tends to be worse in the morning as phlegm and fluids settle in the lungs during the night while you are sleeping.

What to do: Acute bronchitis is a common condition and is often mild enough not to require medical intervention. If, however, you experience a high fever, green or yellow sputum and are struggling to breathe, you should see your doctor as soon as possible. The cough will most likely last for up to three weeks and will resolve itself. Repeat courses of antibiotics might not have any effect and be pointless.

In conclusion, most coughs which are more persistent at night and first thing when you wake up tend to be caused by phlegm or mucus pooling in the throat or respiratory system. If you are treating the underlying condition, but your cough persists, you can take the following steps.

  • Keep the air in your bedroom moist by investing in a humidifier. Dry air can irritate the nasal passages, causing your body to produce even more mucus.
  • Drink plenty of fluids to keep the mucus thin.
  • Sleep with your head slightly elevated to keep mucus from pooling inside the throat.
  • Take half a teaspoon of honey before you go to bed – this can provide soothing relief from coughs.
  • Suck on a lozenge or take small sips of water to suppress your cough.
  • Take a mucolytic as this may help reduce your cough.

Image credit: iStock


Ask the Expert

Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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