Night-Time Cough in Kids
By Dr Joann

A child’s night-time cough—especially when it disrupts sleep—can be distressing for both the child and caregiver. As the sun sets and bedtime approaches, many parents notice an unsettling pattern: their child, who may have seemed fine during the day, suddenly starts coughing more persistently at night. This is one of the most common concerns parents bring up during consultations, and understandably so.

So why does this happen? Is it something to worry about? And what can you do about it?

Let’s break down the reasons behind night-time coughing in children, how to ease the symptoms at home, and when to seek medical attention.

Why Night-Time Cough Happens

Night-time cough isn’t always a sign of something serious, but understanding why it worsens during sleep can help you better manage your child’s symptoms.

Postnasal Drip

This is one of the most common culprits. When your child has a cold, sinus infection, or allergies, mucus from the nose or sinuses can drip down the back of the throat, especially when lying flat. This triggers the cough reflex as the body tries to clear the airway.

Tip: If your child’s cough sounds wet or if they frequently clear their throat, postnasal drip could be the cause.

Dry Air

Air conditioning or a fan running throughout the night can dry out the airways. Dry air irritates the throat and nasal passages, triggering a cough. This is especially common during dry weather or when sleeping in air-conditioned rooms without proper humidity.

Lying Flat

Gravity plays a role here. When your child lies down, mucus isn’t able to drain as easily. It can accumulate in the throat or trigger coughing as the airway becomes more sensitive. This is also why reflux symptoms—like heartburn—can worsen at night.

Asthma or Reactive Airways

Children with asthma may cough more at night due to increased airway sensitivity, inflammation, or mucus buildup. Night-time coughing can sometimes be the only symptom of mild asthma. If your child has a recurrent dry cough at night, especially if they also have eczema, hay fever, or a family history of asthma, it’s worth discussing with your doctor.

Gastroesophageal Reflux (GERD)

Children with acid reflux might experience more coughing at night. Stomach acid can flow back into the esophagus while lying down, irritating the throat and triggering a cough.

What You Can Do at Home

Night-time coughing can be exhausting, but there are ways to manage it and keep your child comfortable.

Elevate the Head While Sleeping

Raising your child’s head slightly by placing a pillow under the mattress (for older children) or propping up the head of the bed can help mucus drain more easily and reduce reflux.

Note: For babies under 1 year old, do not place pillows or soft bedding in the crib due to the risk of suffocation.

Use a Humidifier

A cool-mist humidifier in your child’s room can help keep the air moist and soothe irritated airways. Just be sure to clean the humidifier regularly to prevent mold or bacterial growth.

Honey for Children Over 1 Year

A teaspoon of honey before bed can coat the throat and ease coughing. Studies have shown honey to be more effective than some over-the-counter cough medicines. But remember—never give honey to babies under 1 year old due to the risk of infant botulism.

Keep the Room Allergen-Free

If allergies are contributing to the night-time cough, make sure your child’s bedding is washed regularly in hot water. Consider using dust mite-proof covers on pillows and mattresses. Remove soft toys, carpets, or heavy curtains that may harbor allergens.

Saline Nasal Spray or Rinse

For older children, using a saline spray before bedtime can help clear nasal passages and reduce postnasal drip. A warm bath before bed may also help loosen mucus.

Encourage Fluids

Make sure your child stays hydrated during the day. Fluids help thin mucus and soothe irritated throats.

When It’s Time to See a Doctor

While many causes of night-time cough are not serious, there are times when medical attention is necessary.

See a doctor if:

• Your child has a persistent cough lasting more than 2 weeks

• The cough is accompanied by wheezing, shortness of breath, or difficulty breathing

• There is vomiting after coughing, or coughing fits (which could point to pertussis or whooping cough)

• Your child has a fever, chest pain, or seems unusually tired or unwell

• The cough sounds barky (as in croup) or whooping

• There’s a history of asthma, and the night-time cough is frequent or worsening

• Your child’s growth or appetite is affected

Your doctor may suggest investigations such as a chest X-ray, allergy testing, or lung function tests (for older children) if the cough is persistent or concerning.

Final Thoughts

Coughing is the body’s way of protecting the lungs and clearing the airways. While it can be frustrating when it interrupts your child’s sleep, it’s often manageable with simple home care and a little patience.

Still, trust your instincts. If your child seems uncomfortable, if the cough worsens, or if you’re simply unsure, don’t hesitate to reach out to your paediatrician. We’re here to help.

Remember: Not every cough needs medicine, but every child deserves restful sleep and a parent who feels supported.

Did You Know?

Night-time cough can sometimes be the first sign of an allergy or asthma in children. If your child often coughs after playing, laughing, or during the night, it might be worth exploring further.

---