An individual can experience a sore throat at night for several reasons. During the nighttime, certain conditions may cause a sore throat to develop, while others may cause an established sore throat to worsen at night.
The possible causes of a sore throat at night, along with their signs and remedies, are outlined in this article.
We also list several home remedies that can help avoid a nighttime sore throat, and provide recommendations on when to see a doctor.
Dehydration
Dehydration can make your throat feel scratchy and dry. People go without water for several hours while sleeping, and this can make them more vulnerable to dehydration and a sore throat.
The following factors can increase the risk of night-time dehydration:
- not drinking enough water throughout the day
- eating a salty meal before bedtime
- sleeping in a hot or humid environment
- getting less than 6 hours of sleep per night
- snoring
- breathing through the mouth during sleep
Treatment
Some home remedies that people can use to help battle the symptoms of nighttime dehydration are below:
- drinking plenty of clear liquids throughout the day
- sleeping with a glass of water by the bed and taking sips when waking up during the night
- getting at least 8 hours of sleep per night
Snoring and obstructive sleep apnea
Snoring can irritate the nose and throat, causing nighttime pain in the throat. Obstructive sleep apnea ( OSA) can occur in people who snore loudly or regularly.
OSA is a disorder in which a person stops breathing momentarily when they are sleeping. It happens in the airways as a result of a narrowing or blockage.
During the night, individuals with OSA can wake up several times and experience throat pain from snoring or labored breathing. Other probable OSA signs include:
- waking up unrefreshed in the morning
- feeling drowsy throughout the day
- falling asleep during the day
- being forgetful
- feeling irritable
- getting headaches
- experiencing depression
Treatment
The following strategies may help reduce snoring and OSA:
- avoiding drinking alcohol before bedtime
- avoiding nonessential medicines that can increase sleepiness
- avoiding sleeping on the back
- reaching or maintaining a moderate weight
An individual should see their doctor if the above techniques do not relieve OSA. One or more of the following therapies may be prescribed by the doctor:
- Continuous positive airway pressure (CPAP) device: A machine that pumps pressurized air through a face mask and into a person’s airways while they sleep. This helps keep the airways open, thereby reducing episodes of sleep apnea.
- Dental devices: Some people may benefit from a dental device that brings the bottom jaw forward. This may help keep the airways open.
- Surgery: If other treatment options are ineffective, a doctor may recommend surgery to remove excess tissue from the back of the throat or to remove or bypass airway blockages.
Allergies
Nasal congestion and postnasal drip can cause allergies. This is where mucus drains from the throat and from the nose. Itching, discomfort, and soreness may result from excess mucus in the throat.
Usually, the postnasal drip increases when a person lies down. As a consequence, at night or first thing in the morning, a sore throat can worsen.
At night, exposure to such allergens can also exacerbate the postnasal drip and throat discomfort. Examples include:
- feathers in pillows
- dust and dander in mattresses
- pollen from plants or trees near an open window
Treatment
Allergy treatment includes recognizing the allergens responsible for the symptoms and preventing them. This may involve:
- using hypoallergenic pillows and bedding
- clearing clutter from around the bed to reduce dust levels
- fitting wooden floors rather than carpets
- keeping the home dry and well ventilated to prevent mold
- investing in a HEPA filter, which may help remove potential allergens from the air
In order to help suppress the immune response that triggers allergy symptoms, people may also take antihistamines.
Viral infection
About 90 percent of all sore throats are viral infections. Those that induce the common cold and those that cause the flu are some of the most common viruses. Nasal congestion and postnasal drip can be caused by any disease, both of which can worsen a sore throat at night.
Other potential signs of common colds and flu include the following:
- sneezing
- cough
- chest discomfort
- body aches
- weakness or fatigue
The flu may cause additional symptoms, such as:
- fever
- chills
- headache
Treatment
Within 7-10 days, the common cold normally goes away. Most people who suffer the flu have only a mild illness that lasts 3-7 days. The symptoms are rarely serious enough to require medical attention in either case. Nonetheless, individuals could benefit from:
- taking an over-the-counter (OTC) pain reliever, such as acetaminophen or ibuprofen, to alleviate pain
- sucking on throat lozenges to soothe a sore throat
- taking an OTC nasal decongestant
- using a humidifier in the bedroom to help ease congestion and keep the throat lubricated
As soon as they experience symptoms, people who are at risk of developing flu complications should contact their doctor. Receiving antiviral drugs within 2 days of the onset of symptoms can help reduce the severity and duration of the symptoms and reduce the risk of complications.
Throat strep
Strep throat is a bacterial infection caused by the bacteria group A Streptococcus (group A strep) in the throat and tonsils. The disorder is prevalent among children but not very prevalent among adults.
Strep throat, which lasts during the day, may cause severe pain. However, owing to increased postnasal drip or pain-relieving drugs wearing off during the night, the pain can worsen at night.
Some potential strep throat signs include:
- pain when swallowing
- red, swollen, or pus-streaked tonsils
- tiny red spots on the roof of the mouth
- fever
- swollen lymph nodes in the front of the neck
Treatment
A course of antibiotics is the treatment for strep throat. These drugs can help reduce the duration and severity of the symptoms, as well as the possibility of significant complications.
Gastroesophageal reflux disease
Gastroesophageal reflux disease ( GERD) is a disease in which stomach acid and other contents of the stomach also touch the esophagus. The tube connecting the mouth and stomach is the esophagus, or food pipe.
Stomach acid can make the lining of the esophagus burn and irritate, causing a sore throat.
Usually, symptoms of GERD worsen at night and when a person lies down. For the following reasons, this can happen:
- increased concentration of stomach acid at night
- lack of swallowing while asleep
- decreased likelihood of escaped stomach acid falling back into the stomach while a person is lying down
Besides a sore throat, symptoms of GERD include:
- pain when swallowing
- difficulty swallowing
- pain in the chest or upper abdomen
- respiratory problems
- nausea
- vomiting
- bad breath
- tooth erosion
Treatment
In order to alleviate nighttime GERD, a person can try the following:
- avoiding overeating, especially in the evenings
- avoiding eating anything within 2–3 hours of going to bed
- raising the head of the bed by 6–8 inches by placing blocks under the bedposts
- wearing loose clothing when eating and sleeping to avoid squeezing the stomach and pushing stomach acid up into the esophagus
Some OTC and prescription medications that may help alleviate GERD include:
- antacids
- H2 blockers
- proton pump inhibitors (PPIs)
- prokinetics
Cancer
A recurrent sore throat may very rarely be a symptom of cancer of the throat, such as laryngeal or hypopharyngeal cancer. Cancer of the larynx, or speech box, is laryngeal cancer. In the part of the throat that lies behind the larynx, hypopharyngeal cancer grows.
A recurrent sore throat can be caused by both kinds of cancer. However, at night, when their mind is quiet and they can pay more attention to their body, a person can notice the symptoms more.
Other possible symptoms of laryngeal and hypopharyngeal cancers include:
- pain when swallowing
- difficulty swallowing
- persistent cough
- difficulty breathing
- ear pain
- lump or mass in the neck
- unexplained weight loss
A hoarse voice can also grow in people with laryngeal cancer.
Treatment
Depending on the stage of the cancer and the general health of the individual, the treatment options for laryngeal and hypopharyngeal cancers vary. Such treatment options that could be possible include:
- surgery to remove the tumor
- radiation therapy to help shrink tumors or destroy cancer cells
- chemotherapy to help destroy cancer cells
- targeted therapy, which uses drugs to target specific genes and proteins involved in cancer cell growth and survival
- immunotherapy, which uses drugs that help a person’s own immune system identify and destroy cancer cells
Prevention
Not always preventable are the causes that can cause a sore throat. However, the following nighttime strategies can help a person to find relief:
- using a humidifier in the bedroom to help keep the throat lubricated
- sleeping with a glass of water by the bed and taking sips when waking at night
- taking sinus, allergy, or cold medications before going to bed to reduce postnasal drip
- investing in hypoallergenic pillows and bedding
- avoiding using sleep sprays and perfumes, which may irritate the throat and activate certain allergies
- sleeping with the window closed to reduce exposure to allergens, pollution, and other irritants
- sleeping with the head of the bed slightly elevated to ease acid reflux and GERD
When to see a doctor
Following some strategies and home remedies, throat pain at night can go away. However, if they have serious, constant, or regular throat pain at night or at any other time of the day, a person should see a doctor.
If they have any of the following symptoms , people can also see a doctor:
- A sore throat that does not, after 1 week, improve
- With fever , chills or other potential symptoms of infection, a sore throat
- Persistent signs of cold or flu
- In the neck, a lump or mass
People may also see a doctor if, due to an underlying medical condition or as a consequence of taking those drugs, they have a compromised immune system.
Summary
At night, a sore throat is painful and can make it difficult to sleep. There are several things that can cause a sore throat at night or make it worse. After a time of home care, others are relatively benign and clear up. Others are more severe and requires medical attention.
Anyone who has a serious or recurrent sore throat, especially if other symptoms are present, should see their doctor. A doctor will work to diagnose the cause and provide appropriate treatment.
