Morning cough vector

The 15+ Most Common Causes of a Morning Cough (2024)

by | Updated: Feb 14, 2024

Morning cough, a prevalent symptom experienced by many, often leads to discomfort and concern. It can stem from various causes, ranging from transient conditions to chronic diseases.

Understanding these causes is crucial for effective diagnosis and management.

This article breaks down the most common factors contributing to morning cough, providing insights into the underlying health issues that might be at play.

Watch this video or keep reading to learn the most common causes of a morning cough.

What is a Morning Cough?

A morning cough is a common symptom where one experiences coughing predominantly upon waking. Often linked to conditions like postnasal drip, asthma, acid reflux, or smoking, it can indicate underlying health issues. Morning cough can vary in severity and duration, reflecting different health concerns.

Person with a morning cough vector

Common Causes of a Cough in the Morning

  1. Postnasal Drip
  2. Asthma
  3. Cold or Flu
  4. Dry Mouth
  5. Gastroesophageal Reflux Disease (GERD)
  6. Smoking
  7. Allergies
  8. Chronic Obstructive Pulmonary Disease (COPD)
  9. Bronchitis
  10. Environmental Irritants
  11. Infections
  12. Medication Side Effects
  13. Dehydration
  14. Thyroid Disease
  15. Cancer

1. Postnasal Drip

Postnasal drip occurs when excess mucus from the nasal passages drips down the back of the throat, often leading to a morning cough.

This condition can be caused by allergies, sinus infections, or changes in weather. Sufferers typically experience a sore throat, stuffiness, and a constant urge to clear the throat.

Treatment options include nasal sprays, antihistamines, decongestants, and managing underlying allergies or sinus issues. Additionally, using a humidifier at night and staying hydrated can help alleviate symptoms.

In persistent cases, consulting a healthcare provider for targeted treatments like nasal irrigation or allergy testing and treatment may be recommended.

2. Asthma

Asthma, a chronic respiratory condition, can cause a morning cough due to airway inflammation and constriction. This cough is often accompanied by wheezing, shortness of breath, and chest tightness.

Asthma-related coughs are typically more prevalent in the early morning and at night.

Managing asthma involves avoiding triggers like allergens, cold air, or irritants, and using prescribed medications such as inhalers containing bronchodilators and steroids.

Regular monitoring and adjustments in treatment plans are crucial, as asthma symptoms can vary over time. In some cases, long-term control medications or allergy treatments may also be necessary to effectively manage asthma and reduce morning cough.

3. Cold or Flu

A morning cough during a cold or flu is typically due to congestion and postnasal drip as the body fights off the viral infection. Symptoms include a sore throat, runny or stuffy nose, body aches, and fatigue.

Treatment focuses on relieving symptoms and includes over-the-counter cough medicines, decongestants, and pain relievers. Adequate rest, hydration, and a healthy diet are essential for recovery. Steam inhalation or using a humidifier can also ease congestion and cough.

Since colds and flu are viral, antibiotics are ineffective; however, antiviral medications may be prescribed in some flu cases. Preventative measures like annual flu vaccinations and good hygiene practices are recommended to reduce the risk of infection.

4. Dry Mouth

Dry mouth, or xerostomia, can lead to a morning cough due to a decrease in saliva production during sleep, leaving the throat dry and irritated.

Common causes include dehydration, certain medications, mouth breathing during sleep, or underlying health conditions.

Symptoms often include a sticky, dry feeling in the mouth, bad breath, and frequent thirst. To alleviate dry mouth, it’s essential to increase hydration, use saliva substitutes or mouthwashes designed for dry mouth, and maintain good oral hygiene.

Using a humidifier at night can also help. If medications are the cause, consulting with a healthcare provider for alternative treatments may be beneficial.

Addressing underlying conditions like diabetes or Sjogren’s syndrome is also important for long-term relief.

5. Gastroesophageal Reflux Disease (GERD)

GERD is a digestive disorder where stomach acid frequently flows back into the esophagus, often causing a morning cough. This acid reflux can irritate the throat and airways, leading to coughing, heartburn, chest pain, and difficulty swallowing.

Lifestyle changes are a primary treatment approach, including eating smaller meals, avoiding acidic or spicy foods, and not eating close to bedtime.

Over-the-counter antacids, H2 blockers, or proton pump inhibitors can help reduce stomach acid and alleviate symptoms.

In severe cases, prescription medications or surgery may be necessary. Elevating the head during sleep and maintaining a healthy weight can also significantly reduce GERD symptoms.

6. Smoking

Smoking is a leading cause of a chronic morning cough, often referred to as ‘smoker’s cough.’ This cough is due to irritation and damage caused by smoking to the airways and lungs. Smokers may experience a persistent, hacking cough that produces phlegm.

The most effective treatment is to quit smoking, which reduces respiratory symptoms and improves overall lung health. Nicotine replacement therapies, prescription medications, and support groups can aid in cessation.

In addition to quitting smoking, treatments may include expectorants to clear mucus, bronchodilators to open airways, and in some cases, pulmonary rehabilitation.

Regular health check-ups are important for smokers, as they are at increased risk for chronic obstructive pulmonary disease (COPD) and lung cancer.

7. Allergies

Allergies can cause a morning cough due to the body’s reaction to allergens like pollen, dust, or pet dander. This reaction triggers histamine release, leading to symptoms like sneezing, nasal congestion, and postnasal drip, which in turn cause coughing.

Treatment for allergy-induced cough includes antihistamines to reduce histamine effects, decongestants to relieve congestion, and nasal corticosteroids to decrease inflammation.

Avoiding known allergens and using air purifiers can also help. In severe cases, allergy shots (immunotherapy) may be recommended to gradually reduce sensitivity to allergens.

Keeping windows closed during high pollen seasons and regular cleaning to reduce indoor allergens are also effective preventive measures.

8. Chronic Obstructive Pulmonary Disease (COPD)

COPD, a group of lung diseases including emphysema and chronic bronchitis, often causes a chronic morning cough. This cough is typically productive, producing a large amount of mucus, and is accompanied by breathing difficulties.

Smoking is a primary cause of COPD. Treatment focuses on relieving symptoms and slowing disease progression and includes bronchodilators to open airways, steroids to reduce inflammation, and oxygen therapy in advanced cases.

Pulmonary rehabilitation programs can improve exercise tolerance and breathing techniques.

Quitting smoking is crucial in managing COPD. Vaccinations against flu and pneumonia are recommended, as respiratory infections can exacerbate COPD symptoms.

9. Bronchitis

Bronchitis, an inflammation of the bronchial tubes, often leads to a morning cough that produces mucus. It can be acute, typically following a cold or respiratory infection, or chronic, commonly seen in smokers.

Symptoms include a persistent cough, wheezing, and chest discomfort. Treatment for acute bronchitis is primarily supportive, including rest, increased fluid intake, and possibly cough suppressants or pain relievers.

For chronic bronchitis, bronchodilators and steroids may be prescribed to ease symptoms, along with pulmonary rehabilitation.

Smoking cessation is vital in chronic cases. In both acute and chronic bronchitis, it’s important to avoid lung irritants and ensure good hand hygiene to prevent infections.

10. Environmental Irritants

Environmental irritants such as pollution, dust, chemical fumes, and smoke can trigger a morning cough. These irritants cause irritation and inflammation in the airways, leading to coughing as the body attempts to clear them.

Symptoms can include a dry or productive cough, throat irritation, and sometimes shortness of breath. The best treatment is avoiding exposure to known irritants.

This may involve using air purifiers, wearing masks in polluted areas, and ensuring good ventilation in living spaces.

In cases where exposure is unavoidable, using saline nasal sprays or inhalers may provide relief. For those with sensitive airways, such as asthmatics, preventive inhalers or allergy medications might be necessary.

11. Infections

Respiratory infections like bronchitis, pneumonia, or whooping cough can cause a persistent morning cough. These infections lead to inflammation and mucus production in the respiratory tract.

Symptoms often include coughing, fever, fatigue, and sometimes difficulty breathing.

Treatment depends on the type of infection; bacterial infections may require antibiotics, while viral infections typically need supportive care like rest, hydration, and over-the-counter medications for symptom relief.

Vaccinations, like the flu shot and pneumococcal vaccine, can prevent certain infections. Good hygiene practices, such as frequent handwashing, can also reduce the risk of catching or spreading respiratory infections.

12. Medication Side Effects

Certain medications, particularly ACE inhibitors used to treat high blood pressure and heart conditions, can cause a dry, persistent cough as a side effect. This cough is due to the accumulation of bradykinin, a peptide, in the respiratory tract.

Treatment involves switching to an alternative medication, usually under a doctor’s guidance. It’s important not to stop or change medications without consulting a healthcare provider.

If a medication-induced cough is suspected, a review of all current medications with a doctor is necessary to identify the cause and find a suitable alternative.

Maintaining open communication with healthcare providers about any new or worsening symptoms is crucial for effective management.

13. Dehydration

Dehydration can lead to a morning cough by drying out the mucous membranes of the throat and respiratory tract, making them more susceptible to irritation. This dryness can cause a tickling sensation in the throat, leading to coughing.

Common symptoms include dry mouth, increased thirst, and reduced urine output.

The primary treatment for dehydration-related cough is to increase fluid intake, especially water. It’s important to drink consistently throughout the day, even before feeling thirsty.

In more severe cases of dehydration, oral rehydration solutions or intravenous fluids may be necessary. Preventing dehydration by consuming adequate fluids, especially in hot weather or during exercise, is key to avoiding this type of cough.

14. Thyroid Disease

Thyroid diseases, particularly an enlarged thyroid gland (goiter) or thyroid nodules, can sometimes lead to a morning cough.

These conditions may exert pressure on the windpipe (trachea), causing irritation or a sensation of tightness in the throat, which can trigger coughing.

Other symptoms can include changes in voice, difficulty swallowing, and neck swelling.

Treatment for a thyroid-related cough involves addressing the underlying thyroid condition. This may include thyroid hormone replacement therapy for hypothyroidism, medications or radioactive iodine for hyperthyroidism, or surgery in cases of large goiters or nodules.

Regular monitoring and treatment adjustments are crucial in managing thyroid conditions effectively.

15. Cancer

In rare cases, a persistent morning cough can be a symptom of lung cancer or cancer that has metastasized to the lungs.

This cough may be dry or produce blood-tinged sputum. Other symptoms can include chest pain, shortness of breath, unexplained weight loss, and fatigue.

Treatment varies based on the type and stage of cancer and may include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these.

Early detection and treatment are crucial for better outcomes. It’s important for individuals with a persistent cough that doesn’t improve or is accompanied by other concerning symptoms to seek medical evaluation.

Quitting smoking and reducing exposure to environmental carcinogens are important preventive measures.

How to Treat a Morning Cough

Treating a morning cough effectively involves identifying and addressing its underlying cause. Here’s a general approach:

  • Hydration and Humidification: Drink plenty of fluids and use a humidifier at night to soothe dry or irritated airways.
  • Medications: Depending on the cause, use antihistamines and nasal corticosteroids for allergies and postnasal drip, antacids or proton pump inhibitors for GERD, prescribed inhalers for asthma, or bronchodilators and steroids for COPD.
  • Lifestyle Changes: Quit smoking, make dietary adjustments to alleviate GERD, and elevate your head during sleep to reduce coughing.
  • Home Remedies: Use honey as a natural cough suppressant and consider steam inhalation to loosen mucus and moisten the throat.
  • Avoid Irritants: Stay away from environmental triggers like dust, pollen, and chemical fumes.
  • Seek Medical Attention: If the cough persists, worsens, or is accompanied by other symptoms such as fever, shortness of breath, or blood in the sputum, consult a healthcare professional for a proper diagnosis and targeted treatment.

Remember: Treating a morning cough effectively often requires a combination of these methods, tailored to the specific cause of the cough.

FAQs About a Morning Cough

Is it Normal to Cough Every Morning?

Coughing every morning is not necessarily normal and can be a sign of an underlying condition. Occasional morning coughing might be benign, especially if it’s brief and infrequent.

However, persistent morning coughing should be evaluated, as it can indicate allergies, asthma, GERD, or respiratory infections.

Why Do I Have a Persistent Cough?

A persistent cough can be caused by various factors, including smoking, asthma, chronic bronchitis, GERD, and postnasal drip.

Environmental irritants, certain medications, and chronic infections are also common causes. Persistent coughs should be evaluated by a healthcare professional to determine the underlying cause and appropriate treatment.

What Causes a Dry Cough?

A dry cough is often caused by irritation of the airways due to factors like viral infections, allergies, asthma, exposure to pollutants or irritants, and GERD.

It can also be a side effect of certain medications, such as ACE inhibitors. Unlike a productive cough, a dry cough does not produce mucus.

Why are Coughs Worse in the Morning?

Coughs can be worse in the morning due to the accumulation of mucus overnight, especially in conditions like chronic bronchitis or sinusitis.

Lying down can also cause reflux and postnasal drip to worsen, leading to increased coughing in the morning. Asthma symptoms are often more pronounced in the early hours as well.

What Causes a Buildup of Mucus in the Lungs?

A buildup of mucus in the lungs can be caused by various conditions, including chronic bronchitis, pneumonia, cystic fibrosis, and COPD.

Respiratory infections, allergies, and asthma can also increase mucus production. This excess mucus can lead to coughing as the body attempts to clear it from the lungs.

Is Having a Morning Cough a Symptom of COPD?

Yes, a morning cough can be a symptom of COPD, especially if it’s chronic and produces a significant amount of mucus.

COPD, which includes emphysema and chronic bronchitis, causes inflammation and damage to the lungs, leading to increased mucus production and difficulty clearing it, often resulting in a persistent morning cough.

What Does it Mean to Have a Productive Morning Cough?

A productive morning cough, where you expel phlegm or mucus, often indicates that your body is attempting to clear the airways of irritants, excess mucus, or infection.

It’s commonly seen in conditions like bronchitis, pneumonia, COPD, and respiratory infections.

What Causes a Cough with Phlegm in the Morning?

A cough with phlegm in the morning is often caused by conditions that lead to increased mucus production in the respiratory tract, such as chronic bronchitis, pneumonia, COPD, and sinus infections.

It can also be due to postnasal drip from allergies or sinusitis, where mucus accumulates overnight and is coughed up in the morning.

Is it Normal for a Cough to Wake You Up?

It’s not uncommon for a cough to wake you up, especially if you have a respiratory condition like asthma, GERD, or postnasal drip.

However, if this occurs frequently, it’s important to seek medical advice, as it could indicate a serious underlying issue such as sleep apnea, chronic bronchitis, or even heart failure.

Does Vaping Cause a Morning Cough?

Vaping can cause a morning cough due to the irritation of the respiratory tract by the chemicals and particles inhaled during vaping.

The cough may also be a sign of developing lung issues related to vaping, such as bronchitis or lung inflammation. If you experience a persistent cough after starting vaping, it’s advisable to consult a healthcare provider.

Can Alcohol Cause a Morning Cough?

Yes, alcohol can contribute to a morning cough. It can cause dehydration, which dries out the throat and airways, leading to a cough. Additionally, alcohol can trigger acid reflux and asthma, both of which can result in coughing.

Heavy drinking can also weaken the immune system, making one more susceptible to respiratory infections.

Does COVID-19 Cause a Morning Cough?

A morning cough can be a symptom of COVID-19, especially if accompanied by other signs like fever, shortness of breath, and loss of taste or smell.

COVID-19 primarily affects the respiratory system and can lead to a dry or productive cough. If you suspect COVID-19, it’s important to get tested and follow local health guidelines.

How to Prevent a Morning Cough?

Preventing a morning cough involves addressing its potential causes:

  • Maintain good air quality in your sleeping environment by using air purifiers and avoiding allergens.
  • Stay hydrated to keep your throat moist.
  • Manage conditions like GERD, asthma, and allergies with appropriate treatments.
  • Elevate your head while sleeping to reduce postnasal drip and acid reflux.
  • Quit smoking and avoid exposure to environmental irritants.
  • Practice good hygiene to prevent respiratory infections.

How Do I Know if My Morning Cough Is Serious?

A morning cough may be serious if it:

  • Lasts for more than three weeks.
  • Is severe or gets progressively worse.
  • Is accompanied by symptoms like shortness of breath, chest pain, coughing up blood, unexplained weight loss, or fever.
  • Interferes with your sleep or daily activities.

Note: If you experience any of these signs, it’s important to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

When to See a Doctor for a Morning Cough

It’s important to see a doctor for a morning cough if it persists for more than three weeks, becomes progressively worse, or is accompanied by alarming symptoms.

These include coughing up blood, significant weight loss, difficulty breathing, persistent chest pain, and severe fatigue.

A cough that disrupts sleep or daily activities also warrants medical attention. For individuals with a history of smoking, chronic respiratory conditions, or a weakened immune system, it’s advisable to seek medical advice even sooner.

Early diagnosis and treatment can be crucial for conditions like asthma, chronic obstructive pulmonary disease (COPD), or even lung cancer. Remember, a persistent cough is not just an inconvenience; it can be a sign of a serious underlying health issue.

Final Thoughts

A morning cough, though frequently dismissed as trivial, can be an indicator of various health conditions ranging from allergies to more severe respiratory diseases.

The causes discussed highlight the importance of not overlooking this symptom.

Individuals experiencing persistent morning coughs should consider environmental factors, lifestyle habits, and the possibility of underlying health issues, and are advised to consult healthcare professionals for accurate diagnosis and tailored treatment plans.

Recognizing and addressing the root causes of morning coughs is key to improving overall health and well-being.

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Lai K, Tang J, Zhan W, Li H, Yi F, Long L, Zhou J, Chen X, Huang L, Sun Z, Jiang Z, Chen Y, Lu H, Luo W, Chen R, Zhong N. The spectrum, clinical features and diagnosis of chronic cough due to rare causes. J Thorac Dis. 2021.

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