What will relieve my night coughs AND put me to sleep?

September 11, 2021 10:26 AM

Two problems: Nagging night-time cough and inability to get to sleep within a reasonable time. I know about Benadryl and its generic equivalents (preferable) but I don’t have a cold or the flu. Yesyesyes, I know about drinking water and sleeping slightly elevated. I am not interested in valerian or melatonin. I’m retired, so I no longer need to be “sharp” in the mornings. A little fuzz-head the next morning is fine by me. What do you prescribe, pill lovers of Metafilter?
posted by BostonTerrier to Health & Fitness (27 answers total)

lifelong bad sleep here. regular aerobic exercise at least four hours before bed is useful to me.

drugs: i have nerve issues so i take pregabelin on top of my melatonin - I'm out like a light in 30 minutes ( which is super not how it used to go). i have a friend that took ambien. said he had to be sitting in bed in pjs when he took it - it knocked him out. then he slept a solid eight (within a few minutes) and woke up with alertness.

with ambien, apparently sleep walking, sleep eating, and sleep sexing can be a thing. ask your MD.

i also have friends who swear on weed as the ticket to good sleep. dunno.

bad sleep is the worst - good luck :-)
posted by j_curiouser at 10:48 AM on September 11, 2021

Robitussin Maximum Strength Nighttime Cough DM is generally the first widely-available line of defense here. It's two proven cough preparations, dextromethorphan and doxylamine, the latter being a sleepy-making antihistamine that tends to help with both coughing and getting to sleep. In my experience it works as advertised but is less popular than other medications because it can leave you groggy. This generic costs just four bucks at my local Walgreens.
posted by I EAT TAPAS at 11:12 AM on September 11, 2021 [5 favorites]

Doxylamine succinate, which has the added advantage of being an old antihistamine (not, you'll correctly guess, a non-drowsy one) and does knock back the early-morning coughing I'm prone to in allergy season. I take a half on work nights, but look forward to the bliss of a whole one on Friday nights usually so I can truly zonk out.

Unisom has two different formulas, one is the doxy and the other is diphenhydramine (benadryl). Pretty much every drugstore brand has their own much cheaper doxylamine succinate. For frustration purposes I strongly recommend finding it in a bottle and not paper-backed individual bubbles, generally you need to buy around a 96 count package to get the bottle. It's dirt cheap, in the store brand, so not a huge worry.
posted by Lyn Never at 11:13 AM on September 11, 2021 [6 favorites]

If you don't know for sure that the cough is lingering from an illness, try an antacid (an actual pill, not Tums or something) plus sleeping on your left side and/or elevating the head of your bed a bit. For some folks this cough indicates acid reflux.

(IANAD.)
posted by wintersweet at 11:15 AM on September 11, 2021 [15 favorites]

When I'm not able to sleep due to a headache, cough, allergies, etc., I take Alka-Seltzer Plus Night fizzy tablets: https://www.alkaseltzer.com/plus/cold-flu/products/night-powerfast-fizz-lemon-effervescent-tablets. I usually take them about a half hour before bed. When I wake up in the morning I feel less fuzzy than if I had taken Benadryl.

I will note that most any Alka-Seltzer cold/flu product will knock me out, unless it specifically says "Day / Non-Drowsy." So maybe just regular Alka-Seltzer cold or flu would work too in your situation.
posted by ralan at 11:24 AM on September 11, 2021

Since I have an allergy, I take an antihistamine tablet every night. I think it helps me to fall asleep as well as control the allergy.

Once when on a job in Italy, I caught a flu, and the pharmacy gave me this: TACHIFLUDEC. It worked like a miracle, I fell asleep and woke up the next morning ready to go. Since then I have alway bought several packages each time I am in Italy, but I don't use it on a daily basis, more like once or twice a year.

When my grandmother was struggling with sleeplessness and some pain, a family friend who is an anesthesiologist recommended a cognac or whiskey before bedtime.

So that is three different ideas. You should really see your doctor about the cough, maybe it is something serious.
posted by mumimor at 11:25 AM on September 11, 2021 [1 favorite]

Have you checked yourself for snoring or sleep apnea or other sleep disorders?
posted by kschang at 11:30 AM on September 11, 2021 [4 favorites]

For the cough, can you get codeine? In Canada, codeine-acetaminophen can be bought over the counter (but you have to ask a pharmacist); make sure it doesn't have caffeine in the mix as well.

Codeine is a prodrug that is slowly (or quickly or not at all, it depends on genetics) metabolized into morphine, which is an excellent antitussive.

Part of the original marketing for heroin was for its ability to suppress coughing (from tuberculosis, air pollution [smog from burning coal]).
posted by porpoise at 11:47 AM on September 11, 2021 [1 favorite]

I've taken both trazodone & ambien for falling asleep sleep before, and had decent experiences on both. I switched from trazodone to ambien because it was leaving me a little groggy in the mornings but if that's not a concern for you, I'd definitely recommend it - it's cheap, low side-effects, and zonks me right out.
posted by augustimagination at 11:47 AM on September 11, 2021

Another vote for antihistamine. Dust mites abound in bedrooms. If there's a chance you have a dust allergy, buy new pillows.
posted by wryly at 12:01 PM on September 11, 2021 [1 favorite]

My nagging nighttime cough turned out to be acid reflux--turns out that it can present itself in ways other than the obvious flood of acid in the throat that I'd experienced before. An acid controller at night (generic Pepcid AC) pretty much eliminated the problem, as long as I'm not working against myself by eating lots of fatty and acidic foods too close to bedtime.

If you try the acid controller and it works, please do talk to your doctor about it, chronic reflux can have some concerning sources and some concerning long-term impacts it's worth checking for.

I've also found I sleep much better with an air purifier with a HEPA filter in my bedroom.
posted by rhiannonstone at 12:17 PM on September 11, 2021 [7 favorites]

Check and see if it's the acid reflux, they're right that it's a thing.

Delsym, for over the counter, for regular coughs, when you don't need or can't take the additional cold medications.

I've been prescribed Vicodin for a very severe cough once, but it was (truly) literally a non-stop cough that I could not fall asleep through, and I have a health issue that make coughing - especially a lot of coughing - very, very painful due to way a cough increases cerebral spinal fluid pressure. I was surprised at the Rx, and my doc explained it as basically the same thing as tylenol with codeine liquid that is given to kids, just in pill form. It was basically his last resort before tossing me in the hospital, where I didn't want to be. I also got quite a lecture about considering myself from then forward as someone who absolutely MUST get a flu shot...
posted by stormyteal at 12:36 PM on September 11, 2021 [1 favorite]

It may also be worth putting a HEPA filter in your bedroom, and run a humidifier if the immediate humidity in your bedroom (which can be quite different from outside humidity, so don't just go by that, get a cheap hygrometer or weather station with an internal hygrometer in the base station) is frequently under 30% .
posted by Lyn Never at 12:41 PM on September 11, 2021

Benzonatate by prescription, in a little pearl that looks like a vitamin e tablet. Similar to the Robatussen gel caps but much better. Codeine never on me. These do.

Agree with reflux investigation, humidifier, and allergy questions.
posted by answergrape at 12:51 PM on September 11, 2021 [2 favorites]

My doc just recommended doxylamine to me for my problems sleeping - chronic pain related rather than coughing - and so far so good. However the pharmacist stressed that you shouldn't take it more than 10 days in a row (which is fine, I'm only planning to use it on nights when the pain gets really bad) but I looked it up to find it why. Turns out long-term use has bad effects on brain function and could increase your chances of dementia, so better to stick to occasional use. (One cite though there are plenty more.)
posted by Athanassiel at 2:04 PM on September 11, 2021

Yes, a liquid cough medicine with doxylamine and dextromethorphan sounds like what you need. The liquid form allows you to take less than the dose you'd get in caplets, which is handy, because a full dose can leave you pretty spacey the next day. You can buy a generic dye-free version at CVS.

Adding: I agree with the previous commenter that this is not something to be used every night. I'm not sure whether those claims about dementia correlated with anticholinergic drugs have really been substantiated, but best to be cautious.
posted by Artifice_Eternity at 2:23 PM on September 11, 2021

Anxiety keeps me awake. Atarax (generic: hydroxyzine) helps me sleep. Requires RX, old and cheap.
posted by Jesse the K at 2:28 PM on September 11, 2021

At first I was going to suggest reflux as the most likely cause. Your username, however, makes me wonder if pet allergies may be relavant? I've had both reflux and cat allergies, and they are hard to disentagle, since both are worse when going to bed (assuming you have pet allergies and they are allowed in bed).

Antihistamines may help (somewhat) with both, but you really should figure out which it is.

IANAD, but if you want relief now, take a doxylamine succinate AND a proton-pump-inhibitor (Nexium, etc.) tonight. If it works, do it again for a few nights. If it's still working, try eliminating one or the other. Take notes.
posted by soylent00FF00 at 4:06 PM on September 11, 2021 [1 favorite]

For me, the persistent cough is an asthma symptom, and the thing that makes it go away is a steroid inhaler.
posted by yarntheory at 4:45 PM on September 11, 2021

For me, I have cough varient asthma that's been hell these last few years. I take a combo inhaler. I use regular Robitussin DM if I can't get the cough to quiet down enough.

I'm a shitty sleeper. The thing that works best for me is Trazodone. Old. Cheap. Generic. Needs an Rx. It's an old antidepressant that's crappy as an AD, but wonderful as a sleep aid. It can be taken every night. I've been taking it for probably 25 years and I haven't developed a tolerance. It has a wide dosage range (25-400+ mg). So the doctor usually starts low and increases. I know a lot of people who have used it and take a small amount.

If I'm having an extra bad sleep night (pain, anxiety, etc), I take 2 generic Benadryl.
posted by kathrynm at 5:14 PM on September 11, 2021 [1 favorite]

TACHIFLUDEC. It worked like a miracle, I fell asleep and woke up the next morning ready to go

I was curious if Tachfludec was something not available in the USA, since I can't purchase a similar compound (Ambroxol).

The active ingredients translate to: "paracetamol (aka acetaminophen) 600 mg, ascorbic acid 40 mg and phenylephrine hydrochloride 10 mg"

So... newer formulation Sudafed with a side of Tylenol and Vitamin C. All available here.
posted by JoeZydeco at 6:42 PM on September 11, 2021 [1 favorite]

When I was pregnant, I had a lot of coughing related to acid reflux. I took Claritin, Zyrtec and Zicam.
posted by Toddles at 7:08 PM on September 11, 2021 [1 favorite]

Oh, I also had an albuterol inhaler.
posted by Toddles at 7:09 PM on September 11, 2021

Nighttime coughing (as others have noted) is often a symptom, rather than the whole problem. Go talk to a doctor—get it properly worked up. If the cough is from reflux or asthma, for example, cough syrup will likely do nothing.
posted by ocherdraco at 9:44 PM on September 11, 2021 [1 favorite]

Just nthing that it could be acid reflux even if you have no other symptoms. I had no other symptoms, but it still turned out to have done some damage to my gastrointestinal system.
posted by MexicanYenta at 2:41 AM on September 12, 2021 [1 favorite]

Your cough could be symptoms of acid reflux or allergies, it could also be symptoms of edema or heart issues causing edema. I gently advise you to consider seeing a doctor and try to figure out the root cause of these symptoms, to make sure you aren't dealing with something more serious.
posted by They sucked his brains out! at 4:38 AM on September 12, 2021

Seconding a cough variant asthma and/or allergies. My asthma originally presented as a nighttime cough. It is worth getting tested.
posted by theBigRedKittyPurrs at 1:41 PM on September 12, 2021