Coughing throughout the night

Posted by Arlo @equanimous, Apr 9, 2023

I have had a chronic cough since early 2000s. At times so bad that I tore my intercostal muscles between my ribs. UCLA and Kaiser doctors could not figure out the cause. After about 20 years, my pulmonologist finally diagnosed me with bronchiectasis. The only treatment she prescribed was a Rx for Advair. I had regular follow ups with her but the cough continued. I just accepted what was and trusted she knew what she was doing. Last January I had an appt with my Primary Care dr who noticed I hadn't had an xray in a very long time. One was ordered and the results lead to further testing and a bronchoscopy. If it wasn't for my Primary Care dr, I would never would have found out I was positive for MAC! Needless to say, I switched to another pulmonologist who is much more proactive. I am giving mucus samples, getting periodic CT scans, now have a nebulizer, an acapella device and a compression vest that I do 2x per day to help with my mucus plugs.

I have a big problem with coughing at night. Last night I barely got any sleep. I sleep on my back, head on a flat pillow (if I use more than one pillow I get a terrible neck ache), and I use a pillow under my knees. I sleep only on my back. Sleeping on my side causing really bad coughing so I avoid that. I use the NeilMed Sinus Rinse every night, before bed to clear things.

Some nights I am ok. But others....I get a deep tickle in my chest and then the coughing begins. It will stop for a bit and then start up again & this goes on all thru the night. I feel terrible because this not only keeps me awake, it disturbs my poor husband who has been very understanding and supportive.

I have spoken to my dr who prescribed cough med with codeine which I use VERY sparingly. Aside from that, I use Melatonin and take an occasional small dose of Ativan.

I am reaching out to ask if anyone might have a suggestion or observation as to what I can do or stop doing that may help.
In my short time on this site, I've learned a great deal. Knowledge is power and we are a powerful group! Thank you for your support.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

It is definitely miserable to cough through the night. I would suggest trying to sleep on an incline rather than flat on your back. Sleeping flat can cause increased coughing for a few different reasons. One possibility is gastroesophageal reflux (GERD). Another possible cause is that mucus can pool in the back of your throat, which triggers the cough reflex.

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@salynn

It is definitely miserable to cough through the night. I would suggest trying to sleep on an incline rather than flat on your back. Sleeping flat can cause increased coughing for a few different reasons. One possibility is gastroesophageal reflux (GERD). Another possible cause is that mucus can pool in the back of your throat, which triggers the cough reflex.

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That is a good point. I will have to figure out how to get my bed on an incline. Hopefully my husband will have some ideas. It definitely makes sense and is worth a try. Thank you so very mucy, Salynn.

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To sleep elevated, best option is a split king adjustable bed. When traveling, I use a wedge pillow from Amazon, sometimes sending it directly to my destination if not convenient to bring as luggage

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@dulwich

To sleep elevated, best option is a split king adjustable bed. When traveling, I use a wedge pillow from Amazon, sometimes sending it directly to my destination if not convenient to bring as luggage

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Thanks, Dulwich. I looked up wedge pillow on Amazon. Sounds like it may be just the right thing to address my issue!

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Try a mattress elevator. I love mine.

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I agree with those who say not to lie flat on your back. Have you been checked for GERD?
And
I have a totally different suggestion - don't use your NeilMed at night. Here is my logic - when you rinse your sinuses, you activate mucus production. That slides down the back of your throat, causing a tickle, and setting up the cough reflex. And the entire cough cycle. When that happens to me, my only choice is to sip water, take deep breaths and sleep in my recliner - the same as my husband does when his GERD acts up.

What I do is, around 8pm (I go to bed at 11), I stand & bend forward from the waist then stand, reaching my arms up & breathing deeply -I do it several times, then do one or two Aerobika breaths (similar to Acapella) then huff cough - for me, this brings mucus & sputum from both lungs and sinuses. Usually once is enough, but sometimes I need to repeat. Oh, and I also avoid using any inhalers near bedtime - again the "tickle factor"

Sue

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I have periodic issues with the tickle/back of the throat sinus type mucus and night coughing and I wonder what sets it off. My theory is allergy but I don't know for sure and I don't have a theory on how long it lasts. My night time heart rate also rises during these periods. I am conflicted about antihistamine (azelastine) use and do try it periodically but not sure it helps. Also saline at 8 pm is that a good or a bad idea? I also use a fisherman's friend besides water to quiet it down and that seems to help. I elevate my bed (it's an adjustable). I would love to know what sets this off and how to avoid it in the future.

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@sueinmn

I agree with those who say not to lie flat on your back. Have you been checked for GERD?
And
I have a totally different suggestion - don't use your NeilMed at night. Here is my logic - when you rinse your sinuses, you activate mucus production. That slides down the back of your throat, causing a tickle, and setting up the cough reflex. And the entire cough cycle. When that happens to me, my only choice is to sip water, take deep breaths and sleep in my recliner - the same as my husband does when his GERD acts up.

What I do is, around 8pm (I go to bed at 11), I stand & bend forward from the waist then stand, reaching my arms up & breathing deeply -I do it several times, then do one or two Aerobika breaths (similar to Acapella) then huff cough - for me, this brings mucus & sputum from both lungs and sinuses. Usually once is enough, but sometimes I need to repeat. Oh, and I also avoid using any inhalers near bedtime - again the "tickle factor"

Sue

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This sounds like a helpful suggestion, Sue, but it raises a couple questions. Do you bend all the way over or just until your back is horizontal? What time do you have dinner? Right now I have only 3 hours between dinner and bedtime, so it seems I would likely have to eat earlier or go to bed later to fit this in, even if I timed it two hours after dinner and two before bed.
Anna

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@annagh

This sounds like a helpful suggestion, Sue, but it raises a couple questions. Do you bend all the way over or just until your back is horizontal? What time do you have dinner? Right now I have only 3 hours between dinner and bedtime, so it seems I would likely have to eat earlier or go to bed later to fit this in, even if I timed it two hours after dinner and two before bed.
Anna

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I bend until my back is slightly tilted downward - I actually had to excuse myself from a meeting this morning to go out & do this because I had a disruptive cough. Sorry, I don't pay any attention to mealtimes, other than not eating after 8 pm.
I have nebbed for ?many years - sometimes as often as 5 times a day - if I spaced out nebbing and eating, I would have starved to death. I just do it before breakfast, otherwise I wait a "while" after I eat to neb. I used to have to neb plus eat in a 30 minute lunch break.
Sue

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@sueinmn

I bend until my back is slightly tilted downward - I actually had to excuse myself from a meeting this morning to go out & do this because I had a disruptive cough. Sorry, I don't pay any attention to mealtimes, other than not eating after 8 pm.
I have nebbed for ?many years - sometimes as often as 5 times a day - if I spaced out nebbing and eating, I would have starved to death. I just do it before breakfast, otherwise I wait a "while" after I eat to neb. I used to have to neb plus eat in a 30 minute lunch break.
Sue

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Thanks, Sue. I was wondering more about recommendation in regards to reflux, ie; keeping lungs above the stomach for two hours after eating, not going to bed for three hours after a meal. Doing a short airway clearance a couple hours before bedtime, then allowing time to settle, seems like a very good idea.

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