How to Tell if Your Cough and Sleep Apnea are Linked

A persistent cough and sleep apnea can both stand in the way of restful sleep, but understanding if they are connected may help you manage both conditions effectively.

For people with sleep apnea, coughing at night may be more than a random occurrence. In some cases, a cough and sleep apnea may actually have a direct relationship, with coughing being a symptom of complications or underlying issues associated with obstructive sleep apnea (OSA).

Sleep apnea is a sleep disorder where breathing stops and starts intermittently during the night. The most common form, obstructive sleep apnea (OSA), occurs when the airway becomes partially or completely blocked, leading to reduced oxygen levels and disrupting the normal sleep cycle. Typical symptoms of sleep apnea include loud snoring, gasping or choking sounds during sleep, daytime fatigue, and morning headaches. However, less commonly recognized symptoms, like coughing, may also signal an underlying problem with sleep apnea.

While coughing isn’t always directly associated with sleep apnea, there are several ways in which the two may be linked:

Individuals with sleep apnea are more likely to experience gastroesophageal reflux disease (GERD), a condition where stomach acid flows back into the esophagus, causing irritation and potentially leading to coughing. GERD tends to worsen at night when lying down, and it’s known that sleep apnea can increase the risk of acid reflux due to changes in airway pressure and breathing patterns. Acid reflux-induced coughing is often persistent, particularly at night, and may become chronic if sleep apnea is untreated.

People with sleep apnea often breathe through their mouths due to blocked nasal airways, which can result in a dry mouth and throat. This dryness can irritate the throat lining and lead to coughing. In cases where patients use continuous positive airway pressure (CPAP) machines for sleep apnea treatment, the airflow may exacerbate dryness and contribute to irritation, causing you to cough.

Sleep apnea can lead to upper airway resistance syndrome, where the airways become more prone to obstruction. This may cause congestion and post-nasal drip, where mucus collects at the back of the throat. This can create a feeling of throat irritation and lead to a nighttime cough that further interrupts your sleep.

The interruptions in breathing caused by sleep apnea can lead to frequent awakenings throughout the night. Each time you wake up, your throat muscles may constrict, triggering a coughing sensation or clearing of the throat, particularly if the airway has been partially obstructed or irritated.

If you’re experiencing both a cough and sleep apnea symptoms, certain patterns could suggest they’re related. Here are some signs to look for:

A cough that occurs mostly or only at night might indicate a link to sleep apnea. The position while lying down may worsen symptoms of GERD, nasal congestion, and post-nasal drip, all of which can exacerbate coughing.

If you regularly wake up with a dry, irritated throat and cough, this could be related to the dryness caused by mouth breathing associated with sleep apnea.

If you experience symptoms like heartburn, a sour taste in your mouth, or regurgitation along with your cough, it may be a sign that acid reflux, potentially worsened by sleep apnea, is contributing to your cough.

If you’ve noticed that coughing became more prominent after starting CPAP therapy, it might be related to the dryness from airflow. Many people benefit from using a humidifier with their CPAP machine to reduce this issue.

If you suspect that your cough and sleep apnea are related, there are several steps you can take to address both issues:

If you’re dealing with both a cough and symptoms of sleep apnea, a sleep specialist can assess the relationship between the two and recommend appropriate treatment. A sleep study may also help you to confirm if you have sleep apnea and understand the severity of the condition.

Since acid reflux is a common contributor to coughing, it may be beneficial to manage GERD with lifestyle changes or medications. Elevating the head of your bed, avoiding eating close to bedtime, and limiting acidic foods may all help reduce reflux and related coughing.

If you use a CPAP machine and find that your cough worsens, try adding a humidifier attachment to your device. Humidification helps add moisture to the air you breathe in, which can reduce dryness in your throat and alleviate coughing.

Avoiding alcohol and sedatives, which relax the throat muscles and worsen sleep apnea, can reduce breathing interruptions. Staying hydrated and using saline sprays or rinses can help prevent nasal dryness and irritation that might contribute to coughing.

Post-nasal drip is often associated with allergies, so managing allergy symptoms can help reduce throat irritation and associated coughing. Nasal strips, saline rinses, and allergy medication may help.

Managing both a cough and sleep apnea can be challenging, but addressing the potential link between the two can improve both your quality of sleep and your health. A healthcare provider can help you explore treatments that target both sleep apnea and the causes of coughing, such as acid reflux or post-nasal drip. Taking steps to address these issues not only improves your sleep but your overall health too, helping you manage both your cough and sleep apnea symptoms more effectively.