Why Is My Child's Cough Worse at Night?
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A child's cough often sounds worse at night. Lying down can let mucus collect in the back of the throat. That can trigger more coughing.
A common cold is the usual cause. Asthma, allergies, croup and postnasal drip can also cause nighttime symptoms.
Most children improve with time and simple home care. Trouble breathing, wheezing, stridor or a cough that keeps getting worse needs medical attention.
- Lying down can make mucus drain toward the throat.
- Colds are the most common cause.
- A dry cough may feel worse in dry indoor air.
- Repeated nighttime symptoms can be a sign of asthma.
- A barky cough with stridor may be croup.
- Honey may help children age 1 year and older.
- Breathing trouble needs prompt attention.
Why Does Coughing Get Worse at Night?
Several things change after bedtime.
Mucus can drain into the throat
When your child lies down, mucus from the nose can collect in the upper airway and throat. This postnasal drip can trigger the cough reflex.
The airway may still be sensitive
After a viral cold, the airway can stay irritated for a while. Your child may feel better during the day but still cough after bedtime.
Dry air can irritate the throat
Heating or air conditioning can dry the air. This may make a dry cough more noticeable.
Asthma may cause nighttime symptoms
Asthma can cause coughing at night. Wheezing, exercise symptoms or repeated nighttime episodes make asthma more likely.
What Else Can Cause a Nighttime Cough?
Allergies may cause nasal congestion, sneezing and postnasal drip.
Croup causes a barky cough. Some children also make a harsh sound when breathing in. This is called stridor.
Whooping cough can cause strong coughing spells. Some children make a high-pitched “whoop” when breathing in after a spell.
Acid reflux can sometimes irritate the throat and trigger symptoms, especially in older children.
Listen to the breathing between coughs.
The sound of a cough can be dramatic. What matters more is whether your child is breathing comfortably, drinking and acting like themselves between spells.
- Offer plenty of fluids.
- Use saline drops or spray for a stuffy nose.
- Try a clean cool-mist humidifier if the air is dry.
- Keep your child away from smoke and vaping aerosols.
- Let your child rest and recover.
For children 1 year and older, a small amount of honey may help ease coughing before bed.
Never give honey to a baby younger than 12 months.
Should I Give Cough Medicine?
Do not assume an over-the-counter cough medicine is needed.
These medicines are not recommended for young children unless your child's doctor tells you to use one. Simple home care is often safer and more useful.
For age-specific options, see What Can I Give My Child for a Cough?
Call if your child:
- Has a cough that lasts more than about 4 weeks
- Is getting worse instead of better
- Has repeated nighttime coughing
- Has wheezing or shortness of breath
- Has severe coughing spells or vomiting with coughing
- Has a barky cough or possible croup
- Has a whooping sound after coughing
- Is drinking much less than usual
- Develops fever after starting to improve
Get prompt medical help if your child has:
- Serious trouble breathing
- Ribs pulling in with each breath
- Blue or gray lips or face
- A harsh breathing sound while resting
- Very fast breathing
- Difficulty speaking, crying or drinking because of breathing trouble
- Unusual sleepiness or difficulty waking
Call 911 if your child is struggling for each breath, becomes blue, loses consciousness or appears to have a life-threatening emergency.
Frequently Asked Questions
Why does my child cough only at night?
Lying down can increase postnasal drip. A recovering airway may also be more sensitive at night. Repeated episodes can sometimes point to asthma or allergies.
Can asthma cause coughing without wheezing?
Yes. Some children with asthma mainly have a cough, especially at night or with exercise. Repeated symptoms should be discussed with your pediatrician.
Does a barky cough mean croup?
Often, especially in younger children. A barky cough with stridor or trouble breathing needs prompt medical attention.
Can I give honey before bed?
Yes, if your child is at least 1 year old. Do not give honey to a baby under 12 months.
The Bottom Line
Most nighttime coughing is caused by a common cold, mucus drainage or a sensitive airway.
Watch your child's breathing and overall behavior. If your child is breathing comfortably and gradually improving, home care is often enough. If symptoms are persistent, severe or getting worse, call your pediatrician.
Related Parent Resources
References
- American Academy of Pediatrics, HealthyChildren.org. Coughs and Colds: Medicines or Home Remedies?
- American Academy of Pediatrics, HealthyChildren.org. Cough Symptom Checker
- American Academy of Pediatrics, HealthyChildren.org. Croup Symptom Guidance
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