What’s going on when you’re coughing all throughout the night while asleep or being awakened by it, but then your throat’s as clear as a bell while awake?

Do you wake yourself overnight from coughing?

Or, has someone told you that you cough in your sleep but you never have any recollection of it?

Yet during the day when you’re awake, you hardly cough at all.

My mother has always had this issue — being heard coughing during sleep, having no memory of it.

And then the coughing stops once she’s up and about for the day.

Her doctor said it was acid reflux.

Acid Reflux Overnight

“When lying down, there is no help from gravity to keep the stomach acid down, thus making it easier for reflux to occur,” says Sashini Seeni, MD, a family medicine practitioner with DoctorOnCall, an online doctor and pharmacy.

“The backflow of acid from the stomach into the esophagus can reach to the throat and larynx, causing coughing. This can lead to waking up from sleep.”

But it’s also possible for one to sleep through the coughing, as one does not need to be awake or conscious for the coughing reflex to occur.

When we lie down, the acid has an easier time making its way up the esophagus and to the throat, since while we’re awake and thus upright, gravity can more easily keep the acid contained in the stomach.


A weak esophageal sphincter can prevent the acid from remaining in the stomach when one is in bed.

Plus, during sleep, says Dr. Seeni, we swallow less. This reduces the body’s ability to keep acid contained in the stomach.

“Saliva can help neutralize stomach acid, but the production of saliva is reduced during deeper stages of sleep.”

Of course, eating close to bedtime can also cause overnight acid reflux.

The acid making contact with the larynx can cause enough irritation to generate the coughing.

How to Stop Coughing During Sleep

Dr. Seeni says to finish meals at least three to four hours before lying down and to avoid bedtime snacks.

My mother’s doctor told her to take an over-the-counter antacid before bedtime.

Finally, try sleeping on a wedge pillow. This elevates the torso, allowing some gravity to work against the acid.

DoctorOnCall is the largest digital healthcare platform for citizens of Malaysia, allowing patients to consult doctors for advice, book appointments and place orders with local pharmacies.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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