Bronchitis is a respiratory condition that causes inflammation and irritation of the bronchial tubes. The bronchial tubes are the airways that carry air into and out of the lungs. There are two main types of bronchitis:
Acute Bronchitis
Acute bronchitis is a short-term infection usually caused by viruses. The most common viruses that cause acute bronchitis are the same ones that cause colds and flu, including influenza A and B, parainfluenza, respiratory syncytial virus (RSV), rhinovirus, and adenovirus. Acute viral bronchitis typically clears up within a few weeks without any lasting problems.
Chronic Bronchitis
Chronic bronchitis is defined as a productive cough (a cough that expels mucus) that persists for three months or longer within a year. It is most commonly caused by irritation from cigarette smoke or air pollution. Other causes include allergens, bacterial or viral infections, and underlying health conditions like asthma. Chronic bronchitis is one type of chronic obstructive pulmonary disease (COPD).
Does Bronchitis Get Worse at Night?
Many people report that bronchitis symptoms do seem to worsen at night. There are a few reasons why this may occur:
More coughing at night
Coughing often worsens at night when lying down. This may be due to increased mucus production and postnasal drip while lying down. Irritants remain in contact with the bronchial tubes longer when a person is immobile during sleep. The cough reflex also seems to be heightened at night.
Difficulty breathing when lying down
Congestion and inflammation from bronchitis can make it more difficult to breathe when lying flat at night. Gravity pulls mucus back toward the throat area, which can obstruct breathing. Trying to sleep propped up on pillows can help.
Disruption of sleep cycles
The coughing, wheezing, and difficulty breathing caused by bronchitis make it hard to get a good night’s sleep. This sleep disruption can then make symptoms feel more pronounced. Fatigue the next day may also intensify the feeling of symptoms being worse at night.
Circadian rhythm changes
Some research indicates the body’s circadian rhythms affect respiratory function. Lung function may naturally decrease somewhat at night. Inflamed bronchial tubes may struggle more with these minor nightly changes.
Tips for Managing Worsening Bronchitis at Night
If your bronchitis symptoms do worsen at night, try these self-care remedies to reduce discomfort:
- Use a humidifier to add moisture to the air, which can loosen mucus.
- Sleep propped up with extra pillows to make breathing easier.
- Take expectorant cough medicine like guaifenesin before bed to loosen mucus.
- Try over-the-counter nighttime cold and flu medicine containing decongestants and/or cough suppressants.
- Avoid heavy meals and caffeine before bedtime.
- Perform airway clearance techniques like huff coughing before going to sleep.
It’s also important to see your doctor if symptoms persist more than a few weeks or seem to be worsening. You may need an antibiotic for bacterial bronchitis or other treatments for severe cases.
When to See a Doctor
Consult your doctor if:
- Your cough lasts more than 3 weeks.
- You experience worsening wheezing or shortness of breath.
- You cough up blood.
- You have recurring fevers, chills, and body aches.
- You have discomfort or tightness in your chest.
These may be signs of pneumonia or another complication that requires medical treatment. People at high risk for complications like the elderly, very young children, smokers, and those with chronic illnesses should see a doctor sooner if bronchitis symptoms don’t improve.
Diagnosis
To diagnose bronchitis, your doctor will:
- Ask about your symptoms and medical history.
- Listen to your breathing with a stethoscope.
- Tap on your chest to check for fluid in the lungs.
- Order an x-ray or other imaging tests if pneumonia is suspected.
- Take a sputum (mucus) sample for analysis.
- Do blood tests to assess for infection.
Treatment
Treatment for bronchitis usually focuses on managing symptoms and may include:
- Cough medicine – Expectorants, cough suppressants, and anti-inflammatory drugs can help control cough and ease irritation.
- Inhalers – Bronchodilator inhalers like albuterol open airways and make breathing easier.
- Antibiotics – These treat bacterial bronchitis but are not effective for viral infections.
- Steroids – Oral or inhaled corticosteroids reduce airway inflammation.
- Oxygen therapy – Severe cases may require oxygen administration.
Most cases of acute bronchitis resolve on their own within a few weeks. Quitting smoking, avoiding pollutants, drinking fluids, and getting rest will help speed recovery. Chronic bronchitis usually requires regular medical treatment to control inflammation and prevent complications.
Complications
Potential complications of untreated or severe bronchitis include:
- Pneumonia
- Worsening of asthma or COPD
- Lung abscess
- Respiratory failure
Prompt medical care can prevent lasting lung damage or other problems. Let your doctor know right away if your symptoms are not improving.
Conclusion
It is common for bronchitis symptoms like coughing and difficulty breathing to worsen at night when lying down. The cough reflex is heightened and mucus accumulates more easily in the airways while sleeping. Managing nighttime symptoms with medication, air humidification, and sleep positioning adjustments can provide some relief. Seek medical attention promptly if bronchitis is not improving or new concerning symptoms develop, as complications like pneumonia can arise. With proper care, acute viral bronchitis usually resolves within a few weeks without complications. Chronic bronchitis may require regular treatment but can often be well-controlled with a combination of lifestyle changes and medication.
