How to Sleep With a Cold: Easing a Cough and Blocked Nose at Night

A cold is often at its most irritating just as you try to sleep. Lying flat lets mucus collect, the dry air of a heated bedroom tickles the throat and the quiet makes every cough louder. The good news is that a handful of simple steps, such as propping up your head, adding steam, sipping something warm and using remedies carefully, can make the night far more bearable while the cold runs its course.

This is general guidance for adults with an ordinary cold. Children, pregnant women and people with long-term conditions should check with a pharmacist or doctor before using any remedy.

Why symptoms feel worse at night

When you are upright, gravity helps mucus drain. Lie down and it can pool at the back of the throat, which triggers coughing and that familiar drip. The lining of the nose also tends to swell when you are horizontal, so one nostril blocks and then the other. Add a warm, dry room and fewer distractions, and the symptoms seem to grow after dark.

Before bed: a short routine

1. Take a warm shower or bath shortly before bed. The steam can loosen mucus for a while.
2. Rinse or spray with salt water. A saline nasal spray from a pharmacy is gentle and can be used alongside most other remedies.
3. Have a warm drink. Hot water with lemon and a spoonful of honey is a long-standing favourite for a sore throat. Never give honey to a baby under one year old.
4. Drink through the evening, but ease off in the last hour so a full bladder does not wake you as well.
5. Blow your nose gently, one side at a time, just before you lie down.

Setting up the bed and room

• Raise your head and shoulders. An extra pillow, or a wedge under the mattress, helps mucus drain. Make sure your neck is supported rather than bent sharply forward.
• Try lying on your side. Many people find a blocked nose and post-nasal drip easier on one side than on their back.
• Keep the room cool but not dry. A slightly cool bedroom is usually more comfortable; our guide to the best temperature for sleeping explains why. If the air feels very dry, a humidifier can help, as long as it is cleaned regularly. A bowl of water near a radiator is a low-tech alternative.
• Keep tissues, water and a bin within reach so you do not have to fully wake up to deal with a sneeze.
• Consider separate beds for a night or two. Coughing and sniffing can keep a partner awake, and both of you will sleep better.

Easing a night-time cough

A dry, tickly cough and a chesty cough with mucus both tend to flare when you lie down. Sitting up a little higher, sipping water when a tickle starts and sucking a lozenge before bed can calm it. Avoid lozenges when you are lying down, as they are a choking risk if you drift off.

Cough medicines are widely sold, but the evidence that they help much is limited, and many contain more than one active ingredient. A pharmacist can tell you whether a product suits you and whether it may cause drowsiness or keep you awake.

Using cold remedies safely

• Read every label. Many cold and flu products already contain a painkiller such as paracetamol. Taking one of these alongside separate painkiller tablets can mean taking too much without realising.
• Be careful with decongestants. Some are not suitable for people with high blood pressure, heart problems or certain other conditions, and some can make sleep harder. Ask a pharmacist before using one.
• Do not use decongestant nasal sprays for long. Using them for more than a few days can cause the blockage to come back worse.
• Use menthol rubs as directed and keep them away from young children unless the product says otherwise.
• Skip the nightcap. Alcohol can worsen congestion and make sleep more broken.

If you still cannot sleep

Some nights a cold will win. If you have been awake a long time, get up, sit somewhere dim and comfortable, have a warm drink and return to bed when you feel drowsy. A short rest the next day is fine, but keep it early so it does not push bedtime back. If an early wake-up is becoming a pattern even after the cold clears, our article on waking in the small hours may help.

Common questions

How should I sleep with a stuffy nose?

Propped up on your side, after a steamy shower and a saline rinse, in a room that is cool rather than hot. Nasal strips that open the nostrils slightly help some people.

Is it better to sleep sitting up with a cough?

Fully upright is rarely needed. Being raised at a gentle angle is usually enough to reduce coughing while still letting you rest.

When to get medical advice

Most colds settle within a week or two. Contact a doctor or urgent care service if you have difficulty breathing, chest pain, a high temperature that will not come down, confusion, or you cough up blood. A cough that lingers for several weeks, symptoms that get worse instead of better, or a cold in someone who is frail or has a long-term condition also deserve a professional opinion.