Morning Cough: Underlying Causes, Diagnosis, and Treatment - Healthline

Posted: 02 Dec 2020 12:00 AM PST

A morning cough is a relatively common health issue, and there are numerous potential causes. Coughing is your body's way of clearing irritants from your respiratory system.

While you sleep, phlegm and other irritants can pool in your lungs and throat overnight. When you become active in the morning, the phlegm starts to break up and may trigger a coughing fit.

Often, a morning cough isn't a sign of a serious medical condition. But if it doesn't go away after a few weeks or if it's making breathing difficult, it may be time to see a doctor.

Let's examine the potential causes of your morning coughing fits and look at how you can treat them.

A cough that produces phlegm is known as a wet cough or productive cough. If it doesn't produce phlegm, it's called a dry cough or unproductive cough. Knowing which type you have can help you narrow down the cause.

Common cold

The average American has two to three colds per year, and children usually have more. A persistent wet cough is one of the most common symptoms.

Many people find their cough is worse in the morning from phlegm that accumulates overnight.

Other symptoms of the common cold include:

Respiratory infections

Respiratory infections are a group of infections that target either your upper or lower respiratory tracts. The common cold and COVID-19 are two of many examples.

Like with colds, other respiratory infections also have the potential to increase phlegm buildup overnight that leads to coughing fits in the morning. Along with cold-like symptoms, you may also experience:

Allergy

Hay fever (allergic rhinitis) is an immune reaction to airborne allergens such as pollen, pet dander, or dust mites.

Symptoms can include:

Because dust mites tend to live in bedding, people with dust mite allergies usually experience worse symptoms at night and in the morning.

Pollen counts are generally highest in the morning and may worsen your cough in the morning if you have a pollen allergy.

Postnasal drip

Postnasal drip is when your body produces excessive mucus that builds up in the back of your nose and drips into your throat. It's often a symptom of colds, allergies, or eating spicy foods.

Symptoms include:

a constant feeling of needing to clear your throat
a wet cough that's worse at night or in the morning
nausea
sore or scratchy throat
bad breath

Bronchitis

Bronchitis is inflammation of the bronchial tubes in your lungs and can be either acute or chronic. Acute bronchitis is often caused by the common cold or respiratory infection. Chronic bronchitis is often caused by smoking.

Symptoms include:

wet cough
general cold symptoms
chest discomfort
slight fever or chills

People with bronchitis often find their cough is worse in the morning from phlegm that pools overnight.

Asthma

Asthma is a chronic condition that causes the airways to your lungs to swell. This swelling can make it difficult to breath. Asthma severity can range from barely noticeable to life threatening. The most common symptoms of asthma include:

dry or wet coughing
wheezing
trouble breathing
chest tightness
fatigue

Many people with asthma have a cough that's worse at night or in the early morning.

Chronic obstructive pulmonary disease (COPD)

COPD is a group of progressive pulmonary diseases including emphysema and chronic bronchitis. The most common cause of COPD is smoking tobacco.

The primary symptoms of COPD are a wet cough and trouble breathing.

Other symptoms include:

wheezing
chest tightness
frequent sickness
fatigue

Late-stage COPD may cause emergency symptoms, such as:

bluish lips or gray fingernails from low oxygen levels
confusion
inability to catch your breath or talk
rapid heart rate

Symptoms can appear at any time of a day, but in general, people with COPD experience the worst symptoms in the morning.

Gastroesophageal reflux disease (GERD)

It's thought that more than 25 percent of chronic coughs are caused by GERD. GERD occurs when your stomach acid frequently flows back into your esophagus from your stomach.

Symptoms include:

chronic cough
burning in your chest, often after eating
chest pain
swallowing difficulty
feeling of a lump in your throat

GERD commonly causes a cough after eating and when lying down. Some people with GERD may notice their cough is worse in the morning after spending the night lying in bed.

A morning cough is frequently paired with other symptoms.

Chronic coughing in the morning

A chronic cough that lingers may be caused by:

COPD
asthma
allergies to dust mites
chronic bronchitis

Coughing up blood in the morning

Medical emergency

Coughing up blood may be a sign of a serious medical issue. You should see a doctor if you see blood in your phlegm. Possible causes include:

Coughing at night and in the morning

If you're coughing in the morning and evening, it may be caused by:

postnasal drip
common cold
respiratory infection
asthma
GERD
COPD
lung cancer

Babies can experience morning coughs for many of the same reasons as adults and older children. Potential causes are:

If your morning cough doesn't go away after several weeks, you should visit a doctor for a proper diagnosis. You should also see a doctor if you experience:

Signs that you should seek emergency medical care include:

If you're dealing with a chronic cough, a doctor will likely ask you questions about your medical history. They'll also likely perform a physical exam and listen to your breathing with a stethoscope.

The doctor may also order a blood test or send a sample of your mucus to a lab to search for a viral infection.

If they expect you may have COPD or asthma, they may measure your lung function with a spirometry test.

If none of the previous tests identify the cause of your cough, a doctor might order imaging tests like an X-ray or a CT scan to check for lung cancer, pneumonia, and other lung diseases. They may also consider a scope test called a bronchoscopy to look inside your lungs with a small camera.

The best treatment option for your cough depends on the underlying cause.

Common cold, respiratory infections, postnasal drip, acute bronchitis

There isn't a cure for the common cold or for respiratory infections. Getting plenty of rest will help your body fight the infection faster.

Cough medicine can help suppress your urge to cough while decongestants can help manage postnasal drip.

Allergy

Potential treatments for a cough caused by allergies include:

COPD

COPD treatment options include:

GERD

Treatment options for GERD include:

There are many potential causes of a morning cough. Often, a morning cough isn't a need for concern. However, if it persists for more than 2 weeks or if you're having trouble breathing, it's a good idea to visit a doctor for a proper diagnosis.

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