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Cold & flu health centre

Sleep better when you’re ill

Cold and flu symptoms can keep you from getting a good night's rest when you need it. We talked to experts for advice on how to sleep better.
WebMD Feature
Medically Reviewed by Dr Rob Hicks

You feel rotten all day and can't wait to get a good night's rest, but as soon as your head hits the pillow, you're coughing and spluttering and you can't get to sleep.

So why do we feel more congested at night if we have a cold or the flu?

"It's related to posture," explains Dr Ron Eccles, director of the Common Cold Centre at Cardiff University. "You're more prone to block up when you're lying down than when you're standing up because there is an increase in pressure in the veins in the nose when you're lying down."

When you're standing up, your heart has to pump blood against gravity, up to your head, but when you lie down, the blood flows easier, engorging the veins in your nose.

This wouldn't be so bad if it wasn't for our tendency to automatically start breathing through our noses when we fall asleep, says Dr Eccles. "And it's quite difficult if your nose is blocked because you go into a gasping type of breathing," he says. "If you've got a blocked nose, you'll wake up many times and that's part of the tiredness associated with the common cold or flu, because you don't get a good night's sleep."

For better sleep, choose cold medicines wisely

Many people buy over-the-counter remedies (medicine you can buy without a prescription) when they're ill. But not all medicines will help you to sleep better at night. In fact, some may keep you awake.

"Some of the medicines that open up your airways and sinuses for you to breathe are the same ones that tend to have a mild stimulant action," says Said Dajani, a community pharmacist and board member of the Royal Pharmaceutical Society. "In other words, if you take them just before you go to sleep, they can keep you awake or give you a disturbed sleep."

Cold and flu medicines to avoid are those that contain pseudoephedrine or ephedrine. These medicines are called "vasoconstrictors" because they make the blood vessels in your nose, throat and sinuses smaller, which help you breathe better. But they are also mild stimulants. "If you have to take them, take them at least two hours before bed time," advises Mr Dajani.

It's best to take these "decongestant" pills during the day, and different medicines, such as painkillers or antihistamines that have a drowsy action, at night. But avoid over-the-counter painkillers that contain caffeine, because caffeine is also a stimulant. Some medicines contain paracetamol (a mild painkiller) and caffeine. Caffeine is added to the pills because it boosts the effect of the painkiller.

Some medicines contain a very small dose of alcohol. Most people won't be affected by the alcohol in medicine, but some might be. "If you are, it will help you sleep better but you will wake up with what we call in the trade a drug hangover," says Mr Dajani. "So it's strongly advised that if you know you are sensitive to alcohol, you should avoid taking it."

In general, alcohol should be avoided because it causes the nose to block up, particularly at night time. "One whisky at night time won't have an effect, but if you have three or four units you will find that your nose is blocking up at night time," warns Dr Eccles.

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