Cough is the body’s natural defense mechanism that helps expel mucus, microbes, or foreign particles from the respiratory system. Coughs are very common and are harmless, but the one that persists for several weeks or produces bloody or discoloured mucus may be a sign of an underlying condition. A cough can occur at any time of the day, but several conditions may cause morning cough.
Some mucus (phlegm) and fluids build-up in the lungs during the night while one is asleep. Upon waking up and being active, the accumulated phlegm begins to loosen, triggering a cough. Morning coughs can signify different conditions as well as the seriousness or intensity of the underlying disease.
Acute cough vs. chronic cough
Cough can be classified based on the duration and features like how it sounds and feels. It can occur in different forms such as dry cough and wet cough. Cough can be the only symptom of a disease, or it can occur with other symptoms associated with diseases of the lung, heart, and stomach.
Based on the duration of the cough, it can be acute or chronic. Acute cough refers to a cough that lasts less than a month. A common cold or flu can cause an acute cough. Chronic cough is one that lasts for over eight weeks in adults and four weeks in children. It usually indicates an underlying condition that may require medical attention. Though not a condition by itself, chronic cough can be a symptom that requires a diagnosis of the underlying disease and the right course of treatment.
Underlying conditions which can cause a morning cough
There are many reasons for a morning cough, and they need not necessarily be a cause for concern. However, if the morning cough persists for long, it can be because of an underlying disease, and one should seek medical attention.
- Chronic obstructive pulmonary disease (COPD) - This condition is characterized by a chronic lung inflammation that causes constriction of the airways, causing difficulty in breathing. The cough is usually worse in the early morning hours and is associated with the production of yellowish mucus.
- Bronchitis - This condition refers to inflammation of the bronchial tubes, the air passages which carry air to the lungs. Bronchitis causes cough along with mucus production. The cough tends to worsen in the morning because the phlegm and fluids that settle in the lungs over the night get mobilized due to activity in the morning.
- Asthma - Asthma is a chronic lung condition that causes inflammation and narrowing of the airways. Coughing is one of the common symptoms in asthmatics that is often worse at night or early in the morning. The cough is usually accompanied by the production of mucus. However, in people with cough-variant asthma, dry cough occurs as a major symptom.
- Allergy - Cough related to dust mite allergies become worse at night and early morning, as dust mites are often concentrated in the bedding. People with pollen allergy also have cough in the morning, as pollen counts are high in the early hours of the day.
- Postnasal drip - The body produces excess mucus when sinus problems or allergies occur with upper respiratory tract infections. The excess mucus can drain down into the throat, especially when lying down. This is called postnasal drip and is one of the most common causes of morning cough.
- Gastroesophageal reflux disease (GERD) - GERD occurs when the stomach acids flow back into the oesophagus (food pipe) and irritate its lining. These acids can reach the throat and cause a dry cough when lying down and in the morning.
- Smoking - People who smoke commonly experience a morning cough. When a person stops smoking in night for a couple of hours, the cilia (tiny hairs in the lungs) work to remove the accumulated chemicals or toxins from the lungs. This causes severe cough in the early morning.
Coughs can be an important diagnostic tool for many health conditions. Learning and recognizing the cause of coughs, including morning cough, can help to identify the onset of a medical condition that needs intervention. As morning cough can be seen in several conditions, it is crucial to record the duration, type of cough, its features, and any other symptoms that occur along with it. This information will help the doctor provide the most appropriate treatment.
Consult a pulmonologist for any queries on respiratory health including the occurrence of cough.