Did you know cough is a friend of ours? Our body tries to speak to us by giving us many signs and signals. One among those signs is a cough which can sometimes be a warning sign.

So why do we cough? The answer is simple, to throw any harmful particle from our throat and respiratory tract.

Cough is one of the most common symptoms of respiratory problems. But when this cough is associated with chest tightness, it can even indicate something major.

In this blog, we will see the different causes of cough and chest tightness, especially at night.

Nights are calming and peaceful. It's the time we all forget our stress and go for a goodnight's sleep. But sometimes, these peaceful nights can be hostile. One such reason for this could be cough and chest tightness.

So, you might wonder what causes cough at night.

When we sleep, our muscles relax (including the muscles lining the throat and airways). When these throat and airway muscles are relaxed, there is less space for the air to pass through them as our airways get narrowed. Generally, we cannot notice it, and most are not even affected by it, but sometimes this narrowing may start to trouble us and show some unusual symptoms like cough, wheezing, snoring or even shortness of breath (or difficulty breathing).

There are many health conditions, which can cause or increase the narrowing of our airways apart from environmental factors. 

Common health conditions that may cause cough and chest tightness at night

Asthma- Asthma is an inflammatory condition in which our airways get narrowed. This narrowing of airways can cause different symptoms like cough, wheezing, chest tightness, and difficulty in breathing. However, it is not necessary that everyone experiences the same symptoms, or a person will experience all the symptoms.

Sometimes people with asthma may show nighttime symptoms like cough, wheezing, chest tightness and breathing difficulty. This commonly happens when asthma is not well managed.

GERD (Gastroesophageal reflux disease) - It is a digestive condition in which the acidic stomach content flows back to the throat, causing cough and shortness of breath.

Coughing at night or after meals is usually due to GERD and is known as cough induced by GERD (or acid reflux).

Asthma and GERD are mostly seen together. GERD is one of the most common causes or triggering factors of asthma. At the same time, even asthma can worsen GERD. 

Apart from asthma, there are many other things that may worsen GERD including:

• Obesity
• Eating fatty food items
• Spicy foods, including chilli peppers
• Consuming foods like garlic, onions, peppermint, and spearmint.
• Including beverages like cola, coffee, and tea.
• Chocolates, orange and tomato juice and some medicines.
• Eating larger meals
• Eating late at night or eating just before sleeping
• Smoking

Respiratory infections- Many respiratory infections like strep throat, cold, flu, bronchitis, pneumonia, etc., can cause cough. Increased cough frequency can also lead to chest tightness. 

COPD- COPD is another lung condition in which the lower respiratory tract (including the bronchi, bronchioles and alveoli) gets inflamed and narrowed due to obstruction in the airflow. The most common cause of COPD is smoking.

In COPD, the muscles lining the airways and air sacs (alveoli) lose their ability to stretch and shrink. The airways get inflamed, become thick, and produce excess mucus, which ultimately compromises the lung capacity and function. 

The most common symptoms associated with COPD include breathing difficulty, cough with mucus, chest tightness, and wheezing.

Obstructive sleep apnea- While snoring is one of the most common symptoms of obstructive sleep apnea (OSA), chronic cough at night can also be the only indicator of OSA.

OSA can trigger or worsen the symptoms of GERD, which can ultimately lead to coughing and chest tightness. Apart from this, OSA is also linked with higher chances of catching upper respiratory tract infections which may initiate cough.  

Post-nasal drip- Sometimes we may feel that mucus is dripping or is accumulated in the back of our throat, this is nothing but post-nasal drip. This post-nasal drip increases when we are lying down and can be the reason for your cough.

Environmental factors

Exposure to irritants- Our nose is lined by a thin layer of mucus and tiny hair-like structures like cilia. The mucus and cilia help to trap the irritants like dust, dirt, microbes, allergens, pollen, and other foreign particles and prevent them from entering the respiratory tract.

But sometimes, when our nose is dry, these irritants can pass through the nose and reach our throat. This is when our other defence mechanism comes into action, which is cough. Our body now tries to get rid of the irritants by coughing.

Apart from this, irritants can also try to enter our body through our mouth. One of the best examples is smoking. Smoking or inhaling other chemicals and irritants can cause inflammation of the airways, which ultimately leads to coughing, chest tightness, wheezing and breathing difficulty. 

Cold and dry air at night can be another reason for a dry cough and chest tightness.

Allergies- Allergy is an unusual response of our body to certain things (commonly caused as allergens) which are not harmful. Most common allergies include dust allergies, food allergies (which are most common in children), dust mites allergies, and allergies to medicines (like antibiotics, aspirin, etc.).