"Ahem, ahem, ahem, cough......" cough is really a "grinding little goblin", some people cough in the morning, some people cough in the afternoon, and recently many friends said in the "Look at Breathing" patient exchange group that they always cough at night, so that they can't sleep peacefully.
There is only one truth, but there are many reasons why coughs get worse at night...... Is it bacteria and viruses that are "making trouble"? How much of a cough do I need to go to the hospital immediately at night? Professor Xie Jiaxing from the First Affiliated Hospital of Guangzhou Medical University and the National Center for Respiratory Medicine gave detailed answers to these questions.
"Under the influence of an air-conditioned environment, even healthy people may occasionally cough at night. It is important to note that the term 'night' here refers to the period between one or two in the morning and five or six in the morning after falling asleep, not ten or eleven o'clock before going to bed. Professor Xie said.
"If the cough is very mild, such as once in two weeks, you don't have to worry too much about it. However, if the frequency is relatively high, such as nocturnal cough for two or three days in a week, then it is necessary to combine the following factors for a comprehensive analysis. ”
1. What is the appropriate temperature of the air conditioner?
"A few days ago, a rhinitis patient came to the doctor because he always coughed in the middle of the night, and after some conversation, he found that his cough was inseparable from the air conditioner. Recently, the night has been hot and there are many mosquitoes, so this patient often turns on the air conditioner to 24 degrees, and the quilt is very thin, so he catches a cold. ”
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The cold air released by the air conditioner stimulates the peripheral nerves in his nasal mucosa, and the nasal mucosa contracts and relaxes rapidly, causing the glands in the mucosa to produce more secretions, and these secretions flow backwards from the nasal cavity when he sleeps at night. If you can't cough up secretions that flow to your throat in time when you're asleep, they're likely to leak into your airways and cause an irritating cough. In addition, nasal congestion causes dry and cold air to be inhaled directly into the lungs through the mouth without nasal filtration, heating and humidification, and direct irritation of the mucous membrane of the bronchial tubes is also the cause of cough. ”
"Even healthy people can't withstand the constant irritation of cold air, let alone rhinitis patients with sensitive respiratory tracts. When you use the air conditioner, it is best not to turn it too low, control the indoor temperature at about 25-27 degrees Celsius, and use a humidifier to keep the indoor humidity between 40% and 60%; In addition, you can add a wind shield in front of the air conditioner outlet or adjust the direction of the air conditioner outlet to evenly disperse the cold air and avoid blowing directly on the body. ”
2. A worsening cough at night may be asthma
"Speaking of nocturnal cough, we have to mention asthma, which can be said to be a major feature of asthma when the cough at night is worse than during the day, and we can also push it back and see this symptom as a 'signal' of asthma. However, some patients are easy to ignore this 'signal', their main symptoms in the early stage are cough and sputum production, which has not yet progressed to the level of wheezing attacks, so even if they have frequent night coughs, they do not pay attention to it, and always think that there is no 'wheezing' is not asthma, and they think that it is just a cold. ”
Professor Xie also specifically mentioned a special type of asthma - cough variant asthma, which we have previously said has a very obvious feature of coughing caused by this kind of asthma is "three bursts of cough", that is, a cough before going to bed, a cough when you wake up in the middle of the night, and a cough when you wake up in the morning. (Click on the blue font to learn about cough variant asthma)
"If you cough once you exercise vigorously or encounter stimuli such as pollen and cold air, and the attacks are recurrent, more severe at night than during the day, and the symptoms are not relieved by taking conventional antibiotics and cough suppressants, and you gradually have obvious wheezing as the course of the disease becomes longer, then you should be careful. Pulmonary function tests, bronchial provocation tests, bronchodilator tests and other tests can be used to see if you have asthma. ”
3. If you eat too much at night, you will "make trouble"
"Recently, many people stay up late to watch the 'European Cup' (football match), and feel that it is enjoyable to have some cold beer and barbecue, and in the process of eating and watching, they unconsciously eat too much, and the digestive system begins to 'make trouble' at night, I want to sleep well, but gastroesophageal reflux brings you a 'sour experience'."
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"When it comes to gastroesophageal reflux, everyone should be familiar with it, in fact, the 'valve' between the esophagus and the stomach is loosened, and the stomach contents reflux into the esophagus, throat, mouth or respiratory tract. Normally, everyone has some degree of esophageal reflux in the supine position, but when they are overfeaten, the stomach volume is large, the burden is heavy, and the emptying is slow, and reflux is more likely to occur. Professor Xie said.
"Reflux can cause damage to the airways or irritate nerve pathways, which can cause coughing, sputum production and even difficulty breathing, and gastroesophageal reflux can make symptoms worse if you have a respiratory condition, such as sleep apnea (snoring). It is recommended that everyone do not eat too much food before going to bed, especially sour, spicy, sweet, and indigestible foods. If you occasionally eat too much at once, you can appropriately raise the head of the bed by 15-20 cm when you go to bed at night. ”
Fourth, cardiovascular disease is "at work"
"Middle-aged and elderly people, especially patients with more serious hypertension, coronary heart disease, chronic obstructive pulmonary disease and other cardiopulmonary diseases, are prone to chronic heart failure, their own heart working capacity is lower than normal people, the blood flow to the heart increases when lying down and sleeping at night, the load of the heart increases, the ability to pump blood is further reduced, the blood content of the lungs increases, and it is easy to have paroxysmal dyspnea and cough and other symptoms in the middle of the night, and even have to sit up and take a few breaths to relieve it."
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Professor Xie reminded everyone, "Patients with chronic heart failure should actively carry out anti-heart failure treatment under the guidance of doctors, and if they continue to have worsening cough at night, or even have symptoms of coughing up pink frothy sputum, breathlessness, and cyanosis, they must seek medical attention in time." ”
5. Stay in the same room with allergens
"For people with allergies, there are all kinds of allergens hidden in the bedroom, such as animal dander, dust mites, mold, electric mosquito coils, mosquito repellents, and so on. Most people sleep in the bedroom for at least six or seven hours at night, and when the bedroom doors and windows are closed, the air circulation is not smooth, and the allergens take the opportunity to 'make trouble', inducing allergic reactions such as shortness of breath, coughing, phlegm, chest tightness, wheezing, etc. ”
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"You can pay attention to the characteristics of your cough, if it is an irritating dry cough, and cough as soon as you enter the bedroom or go to bed, and recurrent attacks at night, then you need to consider the factor of allergens."
Professor Xie recommends that everyone keep the bedroom clean and hygienic, such as changing bed sheets, quilt covers, pillows and other bedroom items every 2 to 4 weeks. Do not use feathers, fluff, cotton, etc. as pillow cores, and it is best to use synthetic materials; Do not place soft stuffed animals on the bed or next to the pillow; Open windows frequently for ventilation and use a vacuum cleaner to remove dust 2 to 3 times a week; Do not keep pets indoors, etc.