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Why Do My Cold, Flu & Cough Symptoms Often Feel Worse At Night?

Man sneezing in bed

Most colds resolve within 7 to 14 days, but when you’re dealing with symptoms like cough, stuffy nose, and sneezing, that can feel like an eternity. What’s worse is that symptoms can often feel more intense at night, even if you’ve spent the day feeling on the up-and-up.

Why do colds get worse at night? The short answer is, they don’t. If your immune system is fighting an infection, it’s unlikely that the infection is going to suddenly become stronger after sundown. What’s true is that symptoms feel more intense at night. There are real reasons your nighttime cold and flu symptoms feel worse than in the daytime. Read ahead to learn why you tend to feel more sick at night.

Understanding Why are Symptoms Worsen at Night

Why do my cold symptoms feel worse at night, you ask? There are a few reasons why your nighttime cold and flu symptoms can feel more egregious.

Circadian Rhythm

If you’re wondering, why do I feel more sick at night, it might have to do with your body’s internal clock, better known as the circadian rhythm. The circadian rhythm will tell your body when to rise and shine, and when to prepare for sleep. When your body recognizes it’s almost bedtime, it causes immune cells to become more active. These cells identify germs, causing inflammation to fight off infection, which in turn makes your symptoms feel more severe.[1]

Hormones Like Cortisol

Levels of the hormone cortisol (which regulates the body’s stress response) are typically elevated in the morning. This helps to suppress inflammation and reduce cold symptoms throughout the day. At night, however, the body experiences lower levels of cortisol, enabling cold and flu symptoms, including fever, to flare.[1]

Lying Down

This may feel a little paradoxical, as one of the most assured ways to fight a cold or flu is to get plenty of rest. But lying down could be intensifying some of your symptoms, namely post-nasal drip. That’s because lying down may cause mucus to pool at the back of the throat.[1]

Treatments

While your body fights off infection, there are a multitude of ways to manage symptoms, including home remedies, over-the-counter treatments, and simple lifestyle changes. Please talk to your doctor if you have any specific questions or concerns.

Home Remedies

Here are some simple remedies you can try from home to manage symptoms[2,3]:

  • Hydrate throughout the day – consuming plenty of fluids throughout the day prevents dehydration, and can also help loosen the mucus that’s causing your congestion. Warm liquids like tea or broth are especially helpful for keeping mucus at bay.

  • Hot baths and saline sprays – all of these options can help thin mucus and prevent nighttime congestion.

  • Gargle with salt water – Salt water can help break up mucus and relieve a sore or dry throat.

  • Use a humidifier – keeping the air in your bedroom nice and moist can help ease stuffiness and prevent a dry throat.

  • A spoonful of honey – Whether you add it to hot tea or swallow it whole, honey can help soothe a sore throat and may alleviate cough.

Over the Counter Treatments

TYLENOL® offers a variety of nighttime cold and flu product options that relieve symptoms before bedtime. Consider these over-the-counter nighttime cold and flu options:

When to Seek Medical Attention

Both the common cold and the flu tend to resolve on their own, and do not typically require a trip to the doctor. However, you should stay vigilant and seek medical attention if any of the following occur:

  • Trouble breathing or shortness of breath

  • Chest pain or pressure

  • Ongoing dizziness

  • Hard to wake up or confusion

  • Dehydration

  • Seizures

  • Worsening of existing medical conditions

  • Severe weakness or muscle pain

In severe cases, your doctor may prescribe an antiviral medication that can shorten the length of illness and reduce your risk of severe complications.[5]

FAQs

Consider using an over-the-counter cold and flu medicine to address nighttime symptoms, or a single ingredient pain reliever/fever reducer if you’re running a temperature. Make sure you drink plenty of fluids, and refrain from drinking alcohol or smoking until your cold is fully resolved. Additionally, warm baths, hot tea, and air humidifiers are all good ways to mitigate congestion and prevent dry air that could intensify cough or dry throat.

Whether you sleep on your back or on your side, consider elevating your head with a few extra pillows, to help drain mucus while you sleep.[6]

References

  1. Why are cold symptoms worse at night? Harvard Health Publishing, Accessed April 21, 2025, https://www.health.harvard.edu/diseases-and-conditions/why-are-cold-symptoms-worse-at-night
  2. Cold remedies: What works, what doesn’t, what can’t hurt, Mayo clinic, Accessed April 21, 2025, https://www.mayoclinic.org/diseases-conditions/common-cold/in-depth/cold-remedies/art-20046403
  3. Chest Congestion, Cleveland Clinic, Accessed June 2, 2025, https://my.clevelandclinic.org/health/symptoms/chest-congestion
  4. Common cold, Mayo Clinic, Accessed April 21, 2025, https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605
  5. Influenza (Flu), Mayo Clinic, Accessed June 2, 2025, https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719
  6. How to Sleep When You Have a Cough, Columbia, Accessed June 2, 2025, https://www.columbiadoctors.org/news/how-sleep-when-you-have-cough

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