Why Is The Flu Worse At Night?

The symptoms of flu and other respiratory infections are never pleasant. Fever, chills, body aches, cough, and chest discomfort can all interfere with your daily activities. On top of that,  they get even worse in the evening and at night. Why is that and what can you do to sleep as comfortably as possible?

Why is the flu worse at night? 

Your immune system works hard during the day and at night, too. Some immune cells that promote inflammation are at the highest levels at night, particularly during slow-wave sleep. This heightened immune response is one of the major reasons why symptoms are getting worse at night. The fever gets higher at night, along with chills and feeling uncomfortable. Although this is the immune system’s response to kill the virus, the symptoms can certainly keep you awake at night. There are hormonal changes related to the sleep-wake cycle and these hormones work closely with the immune system. For example, the levels of stress hormone cortisol change during the first part of sleep, and this change also contributes to inflammation. Not sleeping well at night translates into more fatigue during the day, which further affects the immune system. 

Dehydration. Drinking fluids before bedtime will lead to interrupted sleep and frequent trips to the washroom. However, dehydration also causes sleep disturbances, fatigue, dry mouth, and headaches. Water is lost during urination, but also through sweating and during sleep. Breathing leads to dehydration and most of the water lost from breathing occurs at night. Furthermore,  poor sleep causes more dehydration, according to some research. Add fever and other flu signs and symptoms, which makes dehydration worse, and now you can easily understand why symptoms are getting worse at night. 

The body’s position. During the day you sit on a chair, stand up or walk- either-or, the body is in an upright position. This alleviates nasal congestion and helps drain excess mucus. On the other hand, lying down in bed at night interferes with the elimination of the mucus. Instead of draining, it collects in the airways causing more congestion and a stuffy nose. This makes you more likely to breathe through the mouth, making the throat drier. The results: more cough and more chest discomfort. 

Done working, but more time to think (and worry). During the day, you are too busy to think about your illness. Whether it is work or another project, your mind is focused on various tasks. In the evening and at night, however,  you are more aware of the symptoms and you may worry more. This could be another reason why you may have trouble falling asleep. 

The environment. If the air is too dry or cool, breathing can be affected. Add those fluffy pillows and blankets from the bedroom that tend to carry extra dust and irritate the airways- and here you have more reasons to feel worse at night. 

How to sleep better

  • Staying hydrated is very important to reduce the symptoms- and sleep better, too. Have some hot tea with lemon, ginger and honey for extra benefits. Here is a quick link between dehydration and sleep: one study found that people who sleep only 6 hours per night are significantly more dehydrated than those who slept 8 hours. 
  • You can use a Netty  pot  or inhale hot water to clear your airways and avoid nasal congestion. You can also take a hot shower before bedtime.
  • Change your thermostat to make sure the temperature and humidity in the bedroom is comfortable. Alternatively, you can  use a portable humidifier.
  • Use an extra pillow to keep your head and neck elevated. Make sure your neck is also raised, to reduce the risk of waking up with a sore neck in the morning. 
  • Keep  handy  some cough and cold remedies  close at your bedside. This way, if you wake up and need them to relieve the symptoms you don’t have to take a trip to your kitchen cabinet. 
  • Careful with the  medicine you take. Decongestants can keep you awake, while antihistamines make you sleepy.
  • Make sleep a priority. If possible, allow yourself to sleep an extra hour. Have a short nap during the day, too. Your immune system is working hard to fight the infection, and getting some more rest can help you recover quicker. 
  • It is best to sleep alone for a few days. This way you will avoid spreading the virus or get your partner awake when you toss and turn. 
  • Avoid drinking caffeine after 2-3 pm or alcohol in the evening, as both can interfere with your sleep. If you smoke, stop. Smokers tend to get more severe symptoms, and the symptoms may last longer. 
  • If you can’t fall asleep or stay asleep, do not try to force it. Find something to do like reading or listening to some music. However, avoid waiting TV or checking your phone, as the blue light will further affect your sleep 
  • Nasal strips do not help eliminate the mucus, but can ease congestion, as they allow more space for the airflow.Menthol based rubs, or diluted eucalyptus and peppermint oil  can be applied on the chest. 

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