Do you have increased coughing at night?

Every drug or substance we put in our bodies can have side effects. Even water or salt. But, there is always a "cost/benefit" analysis to be done when a drug is recommended.
Sometimes the answer it is obvious - insulin for a diabetic, antibiotics for a serious infection.
Other times, more thought is needed. That's when many of us tend to go down the "black hole" of Google and the internet.
Yes, Singulair lists potential side effects. The key is to figure out which are common, which are rare, and reported side effects for which no firm correlation could be proven.
Here is what Mayo Clinic, using FDA guidelines, has to say:
https://www.mayoclinic.org/drugs-supplements/montelukast-oral-route/side-effects/drg-20064902?p=1

Depression and discouragement, sleep disturbances and insomnia are common with MAC. I have taken Singulair for MANY years, and only began to experience the sleep & depression symptoms around 6 years ago when I became really ill with MAC.
Sue

I also have Mac and bronchiectasis and the dr put on Singular to help with breathing. I also had crazy dreams and more anxiety to the point where the dr. Told me to get off the Singular. Those side effects are listed in the medical info. I am back to normal, but if coy am still short of breath. Good Luck to you. 🙏

I take Tussin cough syrup at night when I start coughing. It only has guafinisen , and also puts me to sleep. I usually do not cough at night if I nebulize twice a day. Don’t nebulizer after 7pm. That may cause more coughing. Best of luck!

@caontm Hello. I want to respond to your question. I do not cough much during the day but I have sometimes relentless coughing at night. It has been going on like this for about a year now. It has become much worse recently. I use a nettie pot that helps a lot before bedtime and also nebulizer 6% saline. There also seems to be an increase in phlegm in my throat. Anyway....I went back to my pulmo and he sent me for a catscan but then cancelled my apt last minute but I went to pick up a copy of report from the radiologist and it seems that there are no new concerns. My GP says my lungs sound good. This finally lead me to an Ear Nose and Throat Dr. He thinks it is acid reflux, a situation that I thought I had under control. He suggested it is silent reflux and that I start a 30 day trial of a Proton pump inhibitor. It is about day 5 and it actually seems to be improving. I went to Mayo when originally diagnosed with MAC and Bronchiectasis and the Dr there told me that I needed to get acid reflux under control. Said fluid could aspirate into the lung. Now I also understand that Reflux can cause a dry hacking cough. Do you think this might be the case with you? So far it is much better in just 5 days with the PPI. Just something you might want to consider. The ENT Doc stuck a tube down my nose and said that my sinuses were not impacted or overly filled with fluid. I am hoping it is just this simple.
Good luck in working though this. The coughing can be just exasperating.
Best,
Kate

Thank you Kate. Glad to hear you are improving with PPI. I also suspect I have the GERD reflux. I now use an adjustable bed and stay 30 degree up during night. It seems to have helped a bit. According to the Facebook MTM group “Lung Matters”, we are not supposed to use PPI. You can check that group out to learn more. Best wishes! -Cao

@alleycatkate I want to share with you a few things from my journey with laryngoesophageal reflux. I was prescribed high dose PPI's when I was first diagnosed with reflux and MAC because of a chronic dry, especially early morning, cough, with lots of post nasal drip and throat clearing. The PPI's eventually helped a little with the cough, but getting a mechanical bed to achieve a 30 degree angle and going to bed with an empty stomach made the most difference. Then, after months, it was very difficult to wean off the PPI's! It took months. There can be a rebound increase in acid production, and it’s the only time I my life I’ve ever had heartburn!
In addition, everyone should know that the PPI's and things like Pepcid don’t decrease the volume or frequency of the reflux. They just reduce the level of acidity. There are other chemicals in the reflux that still harm lung tissue when they cross over into the wrong space. In fact, lowering the acidity is thought by some to actually increase the reflux activity, because the acid is a signal to the valve to close.
I’m sure there is individual variation, but it’s not a simple situation.

My husband’s ENT also put him on Gerd regimen despite fact that reflux has never presented issues to our knowledge. He has been in this regimen for several months with no obvious benefits but ENT insists he continue. Nocturnal coughing spasms are not an issue but chronic daytime coughing is debilitating. I notice less frequency when oxygen in use.

@caontm Thank you, Cao. I use a high wedge at night to sleep and do not eat or drink for 3 hours before bedtime and watch my strict diet. I have done this for almost 4 years now and thought I had my reflux handled. But perhaps not. I am only willing to use PPI's as a 30 day test to see if this is silent reflux. I don't like what they do and I will check out the "Lung Matters" to see what they say. Thanks for recommending that. Kate

@marthamac Thank you for your information. I have shunned the PPIs in the past. I have been sleeping on a high wedge and not eating for 3 hrs before bed along with adhering to a strict diet. I thought I had this under control but maybe not. My ENT suggested 30 days on PPIs as a trial to see if it was the reflux. So, I agreed but am aware of how they work and do not want to be on this prescription for any length of time. That is interesting that the acid is a signal to close the valve. Do you think the mechanical bed is superior to the wedge in helping this issue? Maybe a greater time period after eating and before bed might be helpful. ?? Thanks for your input. Much appreciated! Kate

@alleycatkate I’d be surprised if waiting longer than 3 hours after eating would make much of a difference (unless it was a huge slice of cheesecake maybe!). Lower fat at that time of day will clear faster.
The magic for me seems to be actually achieving and sustaining a 30 degree angle between stomach/hips and head throughout the night. I couldn’t really get there with a wedge, but the mechanical bed and a zoned latex mattress did it. I have to manage not to slide down or off during the night, and keep my joints comfortable enough to actually sleep.
It’s a real juggling act! Good luck! Please let us know how it goes with the PPI's. I learn so much from everyone in this group!