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Why do Common Cold Symptoms Seem to get Worse at Night?

Malcolm Tatum
Updated Mar 03, 2024
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Anyone who has dealt with the common cold knows that the aches, pains, and general discomfort seem to increase during the evening hours. Some people understand that the common cold symptoms are simply more noticeable at night, when there are fewer distractions to pull attention away from the discomfort. However, the fact is that there are one or two factors that may contribute directly or indirectly to an increase in the severity of common cold symptoms during the night.

One factor that may contribute to the additional discomfort of cold symptoms in the evening hours is the fact that the body is now horizontal rather than vertical. Standing or even sitting in an upright position during the daytime distributes the usual amount of pressure or gravity that is constantly applied to the body. When people are lying down in a prone position, that pressure is distributed differently, and may result in additional pressure on the sinus cavities. This phenomenon will certainly increase the level of discomfort experienced by the cold sufferer.

Another aspect of our body function that may play a role in the severity of common cold symptoms is our natural body rhythm or cycle. Sometimes referred to as the circadian cycle, this process adjusts the production of hormones based on the time of day. Hormones that are producing antibodies that fight infection are more active during daylight hours, and slow down production at night. This means that our natural defenses are somewhat weaker at night, and may result in an upswing in the severity of the symptoms of colds.

There are ways to help to minimize the impact of these enhanced common cold symptoms during the evening hours. There are several excellent over the counter nighttime cold systems that will help to alleviate such issues as stuffy noses, headaches, coughs, and general body aches. While the symptoms will not be completely masked, these cold systems will usually control the discomfort of most common cold symptoms and allow the sufferer to get some much needed rest.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Malcolm Tatum
By Malcolm Tatum , Writer
Malcolm Tatum, a former teleconferencing industry professional, followed his passion for trivia, research, and writing to become a full-time freelance writer. He has contributed articles to a variety of print and online publications, including The Health Board, and his work has also been featured in poetry collections, devotional anthologies, and newspapers. When not writing, Malcolm enjoys collecting vinyl records, following minor league baseball, and cycling.

Discussion Comments

By anon990261 — On Apr 13, 2015

Indeed, lying down or being up and about has little to do with symptoms getting worse at night. I have a cold that has been going for about a week, and like another commenter above, every night at almost exactly 9 p.m., the cough suddenly gets much worse. For the last few days, I have been almost cough free during the daytime, but 9 p.m. comes and bang, the cough returns.

By anon355271 — On Nov 14, 2013

@anon12916: Actually it's the opposite. The body's natural defenses are heightened, and histamine levels are higher. This means an increased inflammation and immune response, which means worse symptoms because the body is fighting harder.

By anon324460 — On Mar 11, 2013

Yes, everyone likes to consume a glass of boiling water. In fact I might go do that now, since drinking boiling water is such a revolutionary idea!

By anon323816 — On Mar 06, 2013

Nope. My cold symptoms *always* gets worse at night, whether I'm lying down or not. I am nocturnal, so it's not just indicative of my body needing rest. I feel fine until 9pm or so at night, no matter how long I've been awake for, then my nose stuffs up, my throat aches and my fever returns.

By tigers88 — On Dec 12, 2012
I like to drink a glass of boiling water, lemon juice and organic honey before I go to bed. It is delicious, soothing, and apparently has medicinal properties.
By ZsaZsa56 — On Dec 11, 2012

When I am sick, sometimes I will wake up in the middle of the night and feel like I have gotten much worse. My throat will burn, my head will ache, and my muscles will feel like they are made of dried up leather.

But it helps to have a glass of water next to the bed. You should be staying hydrated anyway, but the water also helps to refresh you a little when you are jarred out of your sleep. It is not a perfect solution, but it helps a little.

By anon218748 — On Sep 30, 2011

My little boy is three years old and he has a cough and a fever and a runny nose and headaches a lot but it gets really bad at nighttime. What can I do? I have tried everything.

By anon167324 — On Apr 12, 2011

I have a cold now. Yesterday at around 4:30 after school I had a fever. This was probably due to the fact I was running around like a loon in P.E. I assume activity heats the body and something retains the heat. that's why I seem to have a fever after exercise. not sure though.

By anon166498 — On Apr 08, 2011

Um, prone vs. lying? Prone means the same thing as lying down. I am with the immune system ramping up and producing more mucus. Think it is more likely the cause.

By anon166317 — On Apr 07, 2011

Cortisol levels drop at night and then your immune system amps up to repair the body and fight disease, causing more mucus to be produced.

By anon143110 — On Jan 15, 2011

Every time I had pneumonia, the flu or cold, I always felt worse at night, very often a lot worse. Right now it's 3:30 am and I'm having a cold. My nose is more congested (during the day it wasn't that bad) and I have overall worse feeling.

By anon142057 — On Jan 12, 2011

My understanding is that it is the action of the immune system working that is causing the symptoms in the first place, so to say that symptoms worsen at night due to the immune system working less just doesn't make sense.

However, one thing I do know is that your body does most of its healing during the night, so it would make sense to say that symptoms worsen at night due to an increase in immune activity. H

By anon140482 — On Jan 07, 2011

I have always experienced an increase in cold symptoms and or fever between 4:00pm and 5 p.m. my entire life.

Also, I have had to drag myself to the gym at 4:00 p.m. all the years I exercised.I think it has to do with our biological day clock. Certain hormones are peaking at different times, i.e., highest sex drive upon awakening. Lowest afternoon. (I'm 67 so factor that in.)

Anyway, others have told me the same thing about colds and fevers.

By anon129476 — On Nov 23, 2010

I have a totally opposite theory. I think that during the day stress hormones are up, and like taking prednisone and other steroids, it depresses the immune system. When you're relaxing there's less need for stress hormones and your immune system response is allowed to rear its head.

I read that it's the immune system's activity that causes most of the symptoms of a cold, and people with more active immune systems will feel worse than someone with a less active immune system.

Lookin up is the immune system more active at night or day will give some links that show an experiment where it's proposed that the immune system is more active at night.

By anon129450 — On Nov 23, 2010

When I have a cold, like right now, I start feeling worse at almost precisely 4 p.m. every night (it is now 4:21 which is why I'm here). There is something to this and I haven't really found a reasonable explanation yet. I've noticed this my entire life, since I was a kid. It doesn't matter whether I'm horizontal or vertical. Ach, fever goes up too.

By anon124055 — On Nov 04, 2010

Use a neti pot with saline to clear your sinuses while taking a nice steamy shower right before bed and you'll feel so much better!

By anon122378 — On Oct 27, 2010

This is just an off-hand thought, but maybe the increased cough reflex at night is instinctual to protect people from drowning in their own phlegm at night while they sleep.

By anon67441 — On Feb 24, 2010

I don't know -- I've just had a cold for about a week now, and i just got a fever.

my symptoms are coughing, chills, and I'm tired! it's just a 100.4 fever. at night i cough a lot and it keeps me up for hours! What is going on?

By anon57594 — On Dec 24, 2009

I caught a cold one week ago - not severe but for the past four nights, I've started coughing and my nose starts running at 11 p.m., almost like clockwork and then until 2 a.m. when I can finally fall asleep. I wake up at about and the same thing until about 10 a.m. What the hell is this?

By anon40991 — On Aug 12, 2009

My cold symptoms become worse in the evening before I even go to bed. I start sneezing and my nose starts to run.

By anon12916 — On May 15, 2008

I actually go for the argument that says the body's natural defenses are down. Sounds more convincing than my initial response: the force of the moons affect on earth and its alignment with my bed, pulls all the crap out of me at night and makes me sicker thus making it highly impossible for me to feel great about finally going to bed after a long day at work......

By anon9452 — On Mar 06, 2008

Cannot buy the prone vs lying argument. When I sleep in the day, the coughing isn't nearly as apparent as when I'm asleep in the night. And as to the circadian thing... well if I go to bed at 10pm, I hr later I start a coughing fit. The same as if it's 11, 12am or even 3:30am. Not while I'm awake.

In the day, the symptoms are usually just about the same lying or standing.

Malcolm Tatum

Malcolm Tatum


Malcolm Tatum, a former teleconferencing industry professional, followed his passion for trivia, research, and writing...
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