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Sleep Better When You're Sick

Cold and flu symptoms can keep you from getting a good night's rest when you need it. WebMD talked to experts for advice on how to sleep better.

By Colette Bouchez
WebMD Feature

Reviewed by Louise Chang MD

A hacking cough, a throbbing head, a sore throat, and a nose so stuffed it feels as if you'll never breathe free and clear again. You've got a cold -- or maybe even the flu -- and all you want to do is crawl in bed and sleep.

Until you get there. That's when you realize your symptoms are turning any chance for a solid night's rest into the impossible dream.

"It's true that many cold and flu symptoms seem to get worse at night, and they can interfere with sleep just at the critical time when your body needs rest the most," says WebMD sleep expert Michael Breus, PhD, director of TheSleepDoctor.org.

But how and why does this happen?

In addition to the pure discomfort of the symptoms themselves, Breus explains that increased mucus production, along with overall congestion, forces us to breathe through our mouth instead of our nose. When we lie down, congestion can seem worse.

Tufts University sleep expert Edwin Trayner, MD, explains that mouth breathing also irritates airways, causing us to cough more often, which in turn can also disrupt sleep.

"Plus, when we are sick our body releases certain cytokines [immune factors] into the bloodstream, some of which are mediators of sleep. So that can also have a disrupting influence," says Trayner, director of the sleep disorders center at Caritas St. Elizabeth's Medical Center in Boston and an assistant professor at Tufts University School of Medicine.

The end result, say experts, is you toss and turn all night. And even if you do fall asleep, you wake up feeling drained and tired, with cold and flu symptoms seemingly worse.

For Better Sleep, Choose Cold Drugs Wisely

Although many of us turn to cold medicines at night, they may not always help you sleep better. In fact, depending on what you choose, it might actually make things temporarily worse.

"Everybody can react to these medicines differently. For some they can bring on sleepiness, but others may find it makes them feel jittery and nervous and actually keep them from falling asleep or staying asleep," says Nicholas Popovich, PhD, professor of pharmacy administration and department head at the University of Chicago at Illinois College of Pharmacy.

Among the ingredients Popovich says are most likely to keep you up at night: pseudoephedrine, a decongestant commonly found in cold pills and some cough medicines. This can make some people jittery.

Another common ingredient, diphenhydramine, found in Benadryl and many other all-purpose cold and allergy medications, can have a paradoxical effect -- making some sleepy, others not.

"Until you know how you personally react, it's best to avoid them after 6 p.m., particularly if you have to be at work the next day," says Popovich.

Fortunately, there are other things you can try. To unclog that stuffy nose before bedtime, Popovich recommends a topical nasal spray decongestant.

"The effects are mostly localized, so you're less likely to get that jittery feeling," he says. If you find you are still sensitive to the effects, he recommends a saline nasal spray, which is purified salt water.

"This will have no negative impact on your ability to sleep, and it can help flush out and irrigate your nose and make breathing somewhat easier -- and that means you'll sleep better," he says.

Sleep expert Michael Thorpy, MD, also recommends localized nasal sprays, along with external nasal strips designed to keep breathing passages open from the outside.

"If you put one of these strips on the bridge of your nose before bedtime you may find you get a better night's rest, not only because you are less stuffy and more comfortable, but also because you will be breathing better so your sleep will be more restful," says Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center and professor of neurology at Albert Einstein College of Medicine in New York City.

What about those nighttime liquid cold medicines that promise you'll sleep like a baby? Breus doesn't recommend them, mostly because of their alcohol content.

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