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Strong cough at night

Question
Hello,
I have a 6-year-old daughter with CF and she is coughing for nearly 2 months, at day time less and at night time very much. What can I do for relief? She is taking antibiotics for the whole year with only few pauses, thus steadily. From the cough blocker noscapin she gets stomach ache.
Many thanks for your answer, I am just again sitting at her bedside....
Many greetings!
H. H.
Answer
Hello,
you report, that your 6-year-old daughter coughs for about 2 months at night very much and partly without interruption. At daytime, the cough would be not as strong. You report furthermore, that your daughter gets nearly continously an antibiotic therapy.
There are different reasons for an urge to cough that is mainly at night very strong. In most cases, such an urge to cough is caused by secretions, that run dowm from the nose region along the pharynx when lying down and by this trigger the cough. Furthermore, such an urge to cough can be caused by a reflux of gastric acid into the esophagus.
Additionally an allergic reaction can trigger the cough. With regard to an allergic cause you shoud check, if you did any changes in the bedroom of your daughter about 2 months ago (other bed clothes, carpet, curtains). It should also be discussed with the CF center, if there are any blood values, that point at an allergy.
A tendency to reflux is mostly caused by a weakness of the entrance of the stomach, that is there from birth on. Therefore it is rather improbable, that a reflux is the reason for the urge to cough. In single cases however, such a reflux manifests only after several years of life, so that in case the complaints persist and there are hints for a reflux (sour mouth smelling in the mornings, tendency to sour burping etc) this cause should be clarified further.
The most frequent reason is the pharynx secretion. You should talk to your physicians of your CF center, if a nasal inhalation of antibiotics would make sense. As far as your daughter tolerates it, a so-called nasal shower could be helpful before going to sleep. In the end it has to be paid attention to the fact, that the air in the bedroom is not too dry. Strong rush airing about half an hour before going to bed is often helpful during heating period. However, depending on the outside temperature and air humidity (the colder it is outside, the dryer is the air), airing at cold winterimes can lead to a decrease of the indoor humidity. Therefore one should pay attention to the room air humidity e.g. by usage of an hygrometer and avoid heating in the bedroom as well as reducing airing at cold wintertimes to the necessary extent for keeping a good room climate.
We hope to have helped you and your daughter with this advice.
Yours sincerely,
Dr. H.-G. Posselt
03.02.2014