Coughing is a natural reflex of our body to clear the air passages from irritants or foreign particles.

Although it is a normal and necessary function of the respiratory system, recurrent coughing episodes can be troublesome and can affect the quality of a person’s sleep, especially during nighttime.

The causes of nighttime cough can vary from simple allergens, infections, to more severe conditions such as asthma and chronic obstructive pulmonary diseases (COPD).

However, there’s one surprising factor that can also contribute to nighttime coughs, and that is gastroesophageal reflux disease (GERD).

What is GERD?

GERD is a digestive disorder that affects the lower esophageal sphincter (LES), a circular muscle that acts as a barrier between the esophagus and stomach.

Normally, the LES opens when food passes through and closes tightly to prevent stomach contents from flowing back into the esophagus. However, in GERD patients, the LES doesn’t close correctly, allowing the stomach acid and sometimes food to regurgitate into the esophagus, causing irritation and inflammation. This condition is commonly known as acid reflux.

How does GERD cause nighttime cough?

The acid reflux that occurs in GERD patients can reach up to the throat and irritate the upper respiratory tract, leading to inflammation and coughing.

In some cases, patients may not even experience heartburn or other typical symptoms of GERD, but just chronic coughing.

Nighttime is when GERD-related coughs tend to worsen. When lying down, the stomach acid can flow back into the esophagus more easily, causing more irritation to the respiratory system.

Moreover, the body’s natural defense mechanisms such as swallowing and coughing are less efficient during sleep, making it more difficult to clear the air passages from irritants.

How is nighttime cough due to GERD diagnosed?

Diagnosing nighttime cough due to GERD can be challenging because it can sometimes be asymptomatic.

Your doctor may ask you about your medical history and symptoms, perform a physical examination, and prescribe medication to see if it helps improve your cough.

Your doctor may also recommend monitoring your esophageal pH levels, which measure the acidity of your stomach contents.

This test involves inserting a thin tube with a sensor through your nose and into your esophagus to measure the pH levels for 24-48 hours. A high pH level may indicate reflux.

Treatment options for nighttime cough due to GERD

Treating GERD can help alleviate nighttime coughing and improve the quality of life. Your doctor may prescribe medication to reduce the acidity of your stomach contents, such as proton pump inhibitors (PPIs) and H2 blockers.

These medications work by decreasing the production of stomach acid.

Lifestyle modifications can also help reduce GERD symptoms. Some recommendations include:.

Eating smaller, frequent meals instead of large ones
Avoiding trigger foods such as spicy or fatty foods
Not lying down for at least two hours after eating
Sleeping with an elevated head and upper body
Avoiding tight clothing around the abdomen
Quitting smoking

If medication and lifestyle changes aren’t effective, your doctor may recommend surgery to strengthen the LES and prevent acid reflux.

When to seek medical attention

You should seek medical attention if your nighttime cough persists for more than two weeks, is accompanied by shortness of breath, wheezing, chest pain, fever, or other symptoms that interfere with your daily activities.

Your doctor may want to evaluate you for other possible causes of nighttime cough, such as asthma, allergies, or medication side effects.

Conclusion

Nighttime coughing is a common complaint that can be caused by different factors, including gastroesophageal reflux disease (GERD).

GERD-related coughs can be challenging to diagnose, but treatment options such as medication and lifestyle changes can help alleviate symptoms. If you’re experiencing chronic nighttime coughing, it’s important to seek medical attention to determine the underlying cause and appropriate treatment.