Sleep is an active biological process that plays an indispensable role in recovery from any viral illness, including COVID-19. During sleep, the immune system increases its production of infection-fighting proteins called cytokines and optimizes the function of T-cells, which target and eliminate pathogens. Adequate rest is a biological necessity for mounting a robust defense and facilitating the healing process. However, common COVID-19 symptoms like persistent coughing, nasal congestion, fever, and heightened anxiety often fragment sleep and prevent the rest the body requires. Prioritizing strategic adjustments to your sleeping posture, medication timing, and environment can significantly improve sleep quality and support recovery.
Positional Strategies for Respiratory Comfort
Adjusting sleeping posture can dramatically improve nighttime breathing and reduce coughing fits. Lying flat on the back allows postnasal drip and mucus to pool at the back of the throat, triggering the cough reflex and worsening congestion. The National Health Service suggests avoiding a flat back position if a cough is present, favoring a side or upright posture.
Elevating the head and torso helps gravity encourage sinus drainage and relieve pressure on the airways. This is achieved by using a wedge-shaped pillow or stacking several pillows to raise the upper body from the waist up. The goal is to create a gentle incline (a semi-Fowler position), avoiding craning the neck, which causes discomfort and pain.
For those experiencing unilateral congestion, where one nostril is more blocked than the other, side sleeping can be beneficial. Lying on the side with the more congested nostril facing upward can help facilitate drainage through the elevated sinus cavity. If a coughing fit interrupts sleep, sitting up momentarily and taking slow, controlled breaths can help halt the spasm.
A non-pharmacological method to soothe an irritated throat before bed is consuming a small amount of honey. A teaspoon of honey works as a demulcent, coating the throat lining to reduce irritation and calm the cough reflex. This remedy can be useful just before lying down to ensure a smoother transition into sleep.
Strategic Use of OTC Aids and Hydration
Managing symptoms with over-the-counter (OTC) medications requires careful timing to maximize relief during the main sleep window. Pain relievers and fever reducers, such as acetaminophen or ibuprofen, reduce body aches and lower a fever that might otherwise interfere with sleep onset. Taking a dose 30 to 60 minutes before bedtime ensures the medication’s peak effect covers the early hours of sleep.
Confirm the active ingredients in any multi-symptom cold or flu formulas to avoid unintentional double-dosing. Many combination products already contain acetaminophen, and taking an additional standalone dose can exceed the recommended daily limit and cause liver damage. Nighttime cold formulas often include an antihistamine or a sedating ingredient to promote sleep, which should be chosen over daytime formulas containing stimulants like pseudoephedrine.
Hydration works alongside medication to manage respiratory symptoms. Drinking plenty of fluids, such as water, broth, or electrolyte solutions, helps thin the thick mucus associated with congestion. Thinner secretions are easier to clear, reducing the likelihood of a cough or postnasal drip awakening you.
Targeted hydration is important to maintain comfort without causing excessive trips to the bathroom, which interrupt sleep continuity. Consuming warm liquids, like decaffeinated tea, before bed can be soothing for a sore throat and help with mucus clearance. Limit intake in the hour or two immediately preceding sleep to minimize the need to wake up during the night.
Optimizing the Sleep Environment
The physical environment of the bedroom should be adapted to support a body fighting a viral infection. Maintaining a cool room temperature, typically between 60 and 67 degrees Fahrenheit, is optimal for sleep and helps manage fever. If a fever is present, use lighter blankets and clothing to allow the body to regulate its temperature more effectively.
A cool-mist humidifier or vaporizer introduces moisture into the air, which soothes irritated airways and helps break up congestion. Increased humidity prevents the nasal passages and throat from becoming overly dry, reducing the severity of a dry, hacking cough. Humidifiers should be cleaned regularly according to manufacturer instructions to prevent mold or bacteria growth.
Even when feeling unwell and isolated, maintaining a loose but consistent sleep schedule helps anchor the body’s internal clock, or circadian rhythm. While daytime napping may be necessary for recovery, these naps should be limited to 20 to 30 minutes and taken earlier in the day. Excessive or late-day napping can disrupt the drive for sleep at night, making it harder to fall asleep when needed.
Illness, especially when accompanied by fever, can heighten sensitivity to light and noise. Ensuring the bedroom is as dark as possible, using blackout curtains or an eye mask, can promote the production of the sleep hormone melatonin. Similarly, a quiet environment, perhaps supplemented with a white noise machine, can mask disruptive household sounds and support uninterrupted rest.