Are your flu symptoms getting worse at night?

Dr. Jen Tan

08 August 2014

Why do flu symptoms get worse at night?

There are 3 main reasons why symptoms of colds or flu seem to be worse as we try to get our much-needed rest, and understanding what is happening to our bodies at night can sometimes help us to glean more restful sleep.

1. Role of gravity

During the day when you are standing or sitting upright, nasal mucus drains down your nose and throat. When you blow your nose or swallow, the mucus is cleared away from your airways, making it easier to breathe. However, as you lie down at night, the flow of mucus changes and it does not clear in the same way – instead collects at the back of your throat and lodges in your airways. The extra congestion can mean that you are forced to breathe through your mouth, making your mouth and throat dry and more prone to coughing. So, the combination of not being able to breathe properly, along with persistent coughing, can cause your suffering to worsen during the small hours of the night.

2. Daytime distraction and the dreaded darkness

During the day we usually have plenty to get on with and to think about. Running from one thing to the next can mean that we have little time to dwell upon our symptoms. However, at night when all we have to look at is the darkness, we have the time to notice how unwell we are. Additionally, we can begin to worry that we are spending our precious sleeping hours blowing our nose and clearing our throat instead of getting much needed rest. Fretting about being awake can prevent us from falling asleep, and so the vicious circle continues…

3. Immune system function

Although we have to respect our immune systems for doing their job, it can be a bit frustrating that they are so active in the middle of the night. The inflammatory response of the immune system is heightened at night and this worsens symptoms of congestion and headache. Additionally, it raises the temperature of your body in an attempt to kill the flu virus, worsening your fever and resulting in alternating chills and hot flushes. Exactly what you need at two in the morning!

Easing your symptoms at night

So, armed with this knowledge about what is making night-time so problematic, what can you do to ease your symptoms?

Go to bed hydrated – being dehydrated will make any symptom worse, as well as reducing your body’s ability to fight and flush out infection.

Clear your nasal passages before going to bed – this will prevent difficulty sleeping because of a blocked or runny nose. Try inhaling steam, or better still, add some essential oils such as Eucalyptus or peppermint to a bowl of hot water and gently breathe in the steam. Alternatively, try a nasal spray to help clear those airways.

Elevate your upper body – this will mean that gravity will continue with its daytime job of draining mucus from your airways rather than allowing it to accumulate. Arrange your pillows so that your shoulders neck and head are slightly raised. Just raising your head can restrict your breathing and may result in a stiff and sore neck the next day.

Adapt your environment – being unwell means that you can be pedantic about your sleeping environment by making sure your room is completely dark and at a comfortable temperature. Some people prefer complete silence, while others find that listening to some relaxing music helps to transport you to the land of nod.

Keep your mouth and throat moist – breathing through your mouth because of a blocked nose can cause your throat to dry out, which can then cause a sore throat or dry, tickly cough. Use our cough spray to remedy this, as it leaves a protective layer in the throat that soothes dryness and irritation.

Be prepared – if you are lucky you may sleep peacefully till your alarm clock rings the next morning, but the chances of this happening when you have the flu are significantly reduced. My top tip is to be prepared for any night-time awakenings by having some water by your bedside to moisten your mouth and throat which can become very dry, and a nice stack of tissues for any nose troubles. There is nothing worse than having to get out of bed and put the light on to find a tissue or remedy, so try to have everything you will need to hand so that you don’t wake yourself up too much. Try to go back to sleep as soon as possible.

Support your immune system – your immune system needs to work a bit harder in order to fight infection, so be helpful to it by taking some Echinacea, a herb with traditional use of supporting the immune function and fighting colds and flu. This herb can be found in licensed herbal remedy Echinaforce Echinacea drops or tablets.


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  • Digvijay Sharma's photo avatar
    Digvijay Sharma — 08.08.2018 14:20
    Jen I have a question that my widal report is negative but still doctor is saying that i am suffering from typhoid and my fever increases at night but there is improvement in temperature and he also said that he wouldvadmit me and I'm afraid tell me is it a viral or typhoid?


    • Jen Tan's photo avatar
      Jen Tan — 08.08.2018 13:06
      I am afraid that the Widal blood test is not always a good way to exclude enteric fevers and we have to look at the entire clinical picture. Your doctor will have more information than I have and from the little I know of your case, it is impossible for me to make a decision as to whether your symptoms are due to a simple viral infection or the residue of typhoid. If you are not happy with your current doctor's diagnosis, you could seek a second opinion locally.


  • Frank Cox's photo avatar
    Frank Cox — 07.02.2018 00:18
    Try a NetiPot. Clean with fresh didtilled eater and teaspoonfil chlorox for 30 minutes. Rinse twice. Fill agsin, add salt packet and follow instructions. Do NOT use tap ester amoebas can live in tzp water dedpite chlorine. They can cause an infection that does not respond to antibiotics. Can be untreatble..


  • mark's photo avatar
    mark — 24.11.2017 12:52
    jen why does the ear get plugged at night but goes away in the morning


    • Dr Jen Tan's photo avatar
      Dr Jen Tan — 24.11.2017 15:12
      Hello Mark, There are a number of causes of an blocked or plugged ear at night. One is negative middle ear pressure or poor drainage of fluid within the Eustachian tube. In some cases inflammation and swelling of the tube can happen during a cold or it could be caused by ear, throat or sinus infections. Allergies rhinitis and hay fever, also cause extra mucus in and around the tube and this can also lead to this kind of clogging. I would suggest that you reduce white sugar, flour and dairy from your diet and try the herbal remedy Plantago to see if it helps resolve this issue for you. If you suffer from nasal congestion as well you could add in Sinuforce nasal spray. I hope the information on the page is helpful to you and if you require further assistance let me know.


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More info

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Echinaforce® Echinacea Hot Drink. Soothing and palatable hot drink.
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