Pneumonia/Insomnia

[Andrea1189]

About four weeks ago I started having signs of a sinus infection.  After a week and a half I saw the doctor, was diagnosed with both sinusitis and bronchitis and it appeared my asthma was in control, this was a Friday.  (I have had asthma my entire life and at the first signs of a sniffle and some tightness I immediately start a prednisone taper and Xopenex nebulizer). I was prescribed azithromycin and told to continue with my xopenex and prednisone.  I also took cough syrup, sudafed and motrin.  Saturday I was significantly worse and over the weekend it esciladed.  My temperature would go from 96.2 to 100.5 and back down over a 30min period.  Monday I went back to the doctor and she heard "crackling" and a lack of air movement in my lower left lung.  She diagnosed me with community acquired pneumonia. I was prescribed Robitussin with codeine to help me sleep, although all it really did was tire me slightly.  After another week of feeling completely miserable I started to breath better, my nose dried out, and my cough produced less and less green mucus.  Sleeping then was hard, but I was able to take my meds, settle down, sleep for about two hours, wake up again from coughing and repeat.  Now the coughin is much more dry as another week has passed, the nose has basically stopped and the breathing is better.  However, now I can not sleep.  Almost not at all.  Every time I am about to sleep I cough and the cycle repeats.  I have gotten no more than about 4-5 hours of sleep a night since I started being sick.  I was able to nap when I actually felt worse, but now I have a dry cough that keeps me from sleeping.  What should I do? What is causing this?  I have tried taking Benedryl to help me sleep, it has not helped.  

[National Jewish Health]

I can't tell if you received antibiotic therapy for the community acquired pneumonia (CAP) but all you describe suggests that you are on the road to recovery, with the exception of your dry cough, and the misery of sleeplessness.  This scenario of persistent cough following a respiratory infection is common, especially in people with asthma.  The infection perpetuates the bronchial hyperreactivity of asthma and keeps the cough going; the cough now, to some degree due to asthma.

This might be a good time to increase your asthma therapy and ask your doctor for a stronger cough suppressant, both to be continued until the cough is better controlled and finally subsides spontaneously.