There are many reasons a person may experience a sore throat at night. Some conditions can cause a sore throat to develop during nighttime, while others may cause an existing sore throat to worsen at night.
This article outlines the potential causes of a sore throat at night, along with their symptoms and treatments.
We also list some home remedies that may help prevent a sore throat at night, and offer advice on when to see a doctor.
Dehydration can make the throat feel dry and scratchy. During sleep, people go several hours without water, and this can make them more prone to dehydration and a sore throat.
The following factors may increase the risk of dehydration at night:
- 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
- breathing through the mouth during sleep
Below are some home remedies people can try to help combat the effects of nighttime dehydration:
- 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 can irritate the throat and nose, causing throat pain at night. People who snore loudly or frequently may have obstructive sleep apnea (OSA).
OSA is a condition in which a person temporarily stops breathing while they are asleep. It occurs as a result of a narrowing or blockage in the airways.
People with OSA may wake up multiple times during the night and experience throat pain from snoring or labored breathing. Other possible signs of OSA 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
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
If the above strategies do not alleviate OSA, a person should see their doctor. The doctor may recommend one or more of the following treatments:
- 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.
Postnasal drip typically increases when a person is lying down. As a result, a sore throat may worsen at night or first thing in the morning.
Exposure to certain allergens at night may also worsen postnasal drip and sore throat. Examples include:
- feathers in pillows
- dust and dander in mattresses
- pollen from plants or trees near an open window
The treatment for allergies involves identifying and avoiding the allergens responsible for the symptoms. 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
People can also take antihistamines to help suppress the immune response that causes allergy symptoms.
Viral infections account for around 90% of all sore throats. Some of the most common viruses are those that cause the common cold and those that cause the flu. Either illness can cause nasal congestion and postnasal drip, both of which may worsen a sore throat at night.
Other possible symptoms of both common cold and flu include:
The flu may cause additional symptoms, such as:
The common cold typically goes away within 7–10 days. Most people who get the flu experience only mild illness lasting 3–7 days. In either case, the symptoms are rarely severe enough to warrant medical treatment. Nonetheless, people may 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
People who are at risk of developing complications of flu should notify their doctor as soon as they develop symptoms. Receiving antiviral medications within 2 days of the onset of symptoms can help lessen symptom severity and duration and reduce the risk of complications.
Strep throat can cause intense pain that persists throughout the day. However, the pain may worsen at night due to increased postnasal drip or pain-relieving medications wearing off during the night.
Other possible symptoms of strep throat include:
- pain when swallowing
- red, swollen, or pus-streaked tonsils
- tiny red spots on the roof of the mouth
- swollen lymph nodes in the front of the neck
The treatment for strep throat is a course of antibiotics. These medications will help reduce symptom duration and severity, as well as the risk of serious complications.
Gastroesophageal reflux disease (GERD) is a condition where stomach acid and other stomach contents frequently come up into the esophagus. The esophagus, or food pipe, is the tube that connects the mouth and stomach.
Stomach acid can burn and irritate the lining of the esophagus, causing a sore throat.
GERD symptoms typically worsen at night and when a person lies down. This may happen for the following reasons:
- 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
- bad breath
- tooth erosion
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:
Very rarely, a persistent sore throat may be a sign of throat cancer, such as laryngeal or hypopharyngeal cancer. Laryngeal cancer is cancer of the larynx, or voice box. Hypopharyngeal cancer develops in the part of the throat that sits behind the larynx.
Both types of cancer can cause a persistent sore throat. However, a person may notice the symptoms more at night, when their mind is quiet and they can pay more attention to their body.
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
People with laryngeal cancer may also develop a hoarse voice.
The treatment options for laryngeal and hypopharyngeal cancers differ depending on the stage of the cancer and the person’s overall health. Some possible treatment options 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
It is not always possible to prevent the conditions that can cause a sore throat. However, the following nighttime strategies may help a person 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
Throat pain at night may go away following certain strategies and home treatments. However, a person should see a doctor if they experience severe, persistent, or frequent throat pain at night or at any other time of the day.
People should also see a doctor if they experience any of the following symptoms:
- a sore throat that does not improve after 1 week
- a sore throat with fever, chills, or other possible signs of infection
- persistent cold or flu symptoms
- a lump or mass in the neck
People should also see a doctor if they have a weakened immune system due to an underlying medical condition or as a result of taking certain medications.
A sore throat at night is uncomfortable and can make sleeping difficult. There are many conditions that can cause or worsen a sore throat at night. Some are relatively benign and clear up following a period of home treatment. Others are more serious and require medical intervention.
Anyone who experiences a severe or persistent sore throat should see their doctor, especially if other symptoms are present. A doctor will work to diagnose the cause and provide appropriate treatment.