At night, your body naturally produces less cortisol, the stress hormone. Cortisol has anti-inflammatory properties during the day, which can help ease cold symptoms. However, with lower cortisol levels at night, you may end up feeling worse. This shift could be why you might feel relatively fine during the day but experience a resurgence of symptoms when you try to sleep.
Understanding why cold symptoms intensify at night can shed some light on why a simple throat tickle can escalate into a disruptive coughing fit when bedtime rolls around. This insight can also provide strategies for improving your rest while you’re under the weather.
Why cold symptoms feel worse at night
Contrary to what you may think, the exacerbation of symptoms like nasal congestion, coughing, and body aches as bedtime approaches is not imaginary. The nighttime exacerbation of cold symptoms is a real phenomenon that many people experience, making it crucial to address how to better manage these issues during bedtime hours.
1. Congestion
Maybe you were breathing just fine during the day, but now that you’re lying down, you can barely get air through one nostril. What gives? Well, as we learned, immune cells become more active at night thanks to our body’s circadian rhythm, which can increase inflammation. This inflammation is what makes respiratory symptoms—like congestion—worse.
We also know that your circadian rhythm affects the amount of cortisol in your body at night. Generally, low cortisol levels in your body can also decrease the anti-inflammatory benefits you’ll reap. This heightened immune response explains why you get more swelling and mucus in your airways at night, which can lead to that pesky stuffiness, per St. Clair Health.
2. Postnasal drip and cough
Ever feel like you constantly have to swallow down mucus when you’re sick? This is called a postnasal drip—or when excess mucus builds up and drips down the back of your throat. A postnasal drip can lead to an irritating cough, hoarseness, and an itchy throat. Gravity is largely to blame for the pesky postnasal drip at night.
During the day (when you’re upright), watery mucus will likely drip forward and out your nose. But “when we lie down, secretions from our sinuses drip down the back of our throat,” Wayne Altman, MD, FAAFP, professor and chair of family medicine at Tufts University School of Medicine tells Well+Good. That tickle in your throat makes you cough or clear your throat, which keeps you up and robs you of the sleep you need to recover from a cold virus, Dr. Altman says.
3. Headache
When you’re sick, you can often get through the day without a hint of a headache. (Well, you may wake up with a headache, but it subsides throughout the day.) But as soon as bedtime rolls around, your head starts pounding. Once again, blame it on inflammation. When your sinuses are inflamed and swollen, mucus cannot properly drain. This problem only gets worse as you lie flat on your back (beware, back sleepers) and mucus continues to build up. All of it is a recipe for head pressure—aka, a sinus headache.
The quiet of the night can also make us more aware of our headaches. During the day, we’re often focused on a million other things besides our cold. At night, though, “there are fewer stimuli to distract us from our symptoms,” says Dr. Altman. In other words, it’s harder to ignore the pounding in your head without all the day’s activities.
4. Fevers, chills, and body aches
As your immune cells do their job to fight off germs and infection, your body temperature may increase. In fact, a fever often means that your body is actively fighting off whatever illness you’ve caught, per the Mayo Clinic. The shivery chills and body aches you get with the fever are uncomfortable, but often serve as a clear sign your body is defending itself.
How to relieve cold symptoms at night
The best way to counteract a cold that gets worse at night? Get plenty of sleep from the start, says Dr. Altman. He has a method he calls the “three-night challenge.” Here’s how it works: Try to log nine to 10 hours of sleep each night for the first three nights of your cold, and take it easy during the day. According to Dr. Altman, most people feel way better by the end if they stick to it.
But what are you supposed to do if you need rest, but your crappy symptoms are making it hard to fall or stay asleep? Here are some tips on how to manage nighttime cold symptoms, so you can catch much-needed quality zzzs and finally kick that cold to the curb:
1. Prop yourself up
“One way to address the postnasal drip is to sleep with extra pillows, partially upright, which will prevent some of that dripping,” Dr. Altman says. This minor adjustment “usually helps us cough less and get back to sleep,” he says. (Here’s a list of some of our favorite wedge pillows, including this Bluestone Wedge Pillow from QVC for $32.40.)
2. Drink more water
“If we are not adequately hydrated, our secretions will be thicker and harder to clear,” Dr. Altman says. “Being dehydrated also makes us feel achier,” he adds. So keep a water bottle handy and start sipping to help thin your mucus and minimize body aches. We recommend the Stanley Quencher H2.O FlowState Tumbler ($45, Amazon) or the Owala Free Sip 24oz Stainless Steel Water Bottle ($54.99, Walmart).
3. Take an over-the-counter pain reliever
“One simple remedy for nighttime symptoms is [Advil] ibuprofen or [Tylenol] acetaminophen which will decrease fever and take away pain from muscle aches, headaches, or a sore throat,” Dr. Altman says. “Most importantly, that will allow us to sleep more restfully.”
4. Drizzle a little honey into your tea
“Some herbal tea and honey before bed can be a useful combination,” Dr. Altman says. “Believe it or not, honey is actually a mild cough suppressant, which also can help us sleep better.” Some of the best teas to drink when you’re sick include peppermint, lavender, or ginger. We recommend Traditional Medicinals Peppermint Tea ($23.84, Amazon) or Traditional Medicinals Lemon Ginger Tea ($29.54, Amazon).
5. Run a humidifier
Keeping a humidifier running in your bedroom can help moisten the air, thin your mucus, and soothe your irritated airway, per the Mayo Clinic. Just be sure that your humidifier is properly cleaned, otherwise, you could be unwillingly spreading things like mold and bacteria into the air, which may just worsen your breathing symptoms.
When to see a doctor about cold symptoms
Though colds are not fun, they usually go away pretty fast. “The average upper respiratory tract infection [which is typically caused by a virus] lasts about a week,” Dr. Altman says. In most cases, you can usually treat a respiratory infection (like the common cold) at home with sleep, fluids, and over-the-counter meds while your body fights off the bug.
That said, Dr. Altman says it’s still best to check in with your healthcare provider if you:
- Have a cold that lingers for more than two weeks
- Experience your cold getting better and then suddenly getting worse again (called a “roller coaster course”)
- Notice one side of your face is throbbing
- Start feeling shortness of breath
These may be signs that you’re dealing with a possible bacterial infection or another underlying condition that your doctor can help you treat and make you feel brand-new.
