cough

I am 53 yrs old and I have been coughing when I lay down for probably over 10 yrs.  I have to take benedryl or some other antihistimine to get some sleep. Most nights I have to get up and cough and spit up the fleng.  I have been to the ENT'S and did the antiacids and perscribed allergy meds. and nothing seem to stop the coughing.  I have bought the wedge pillow and it doesn't help either.  I am very tired and would like to get a good nights sleep and so would my husband.  And is it bad to take benedryl every night?

[David Tinkelman, M.D.]

It is understandable that your doctors should consider Gastroesophageal reflux Disease (GERD) and/or allergy to be the cause of your cough given that, by your description, your cough occurs exclusively or nearly so, only at night while you are in bed.  The cough could then be related to your position (lying down) or your location (your bedroom.)

The first step would be for your doctors to do whatever testing might be necessary to confirm the diagnosis and provide specific treatment for the presumed diagnosis or, without further testing, provide optimal treatment for GERD.  That treatment would involve placing the head of your bed on 4-6” blocks and the administration of what is called a proton-pump inhibitor drug.  Antacids alone will not control GERD but may be used to supplement other drugs.

If your doctors decide that allergy may be a cause, environmental control for the most common allergens in the bedroom (house dust mite, animal dander and cockroach) would be the first step.

There are many causes of chronic cough.  It is possible that neither GERD nor allergy is the cause of your cough.  If that proves to be the case, I would suggest that you and your doctor arrange for consultation at the nearest Cough Clinic, most likely to be located at the nearest academic medical center.

Good luck