7 reasons you wake up with sore throat

Do you sometimes wake up with sore throat and want to know some of the reasons this happens? In this post, we talk about seven reasons why you may wake up with sore throat. First, what is a sore throat?

What is sore throat?

Painful swallowing, feeling of lump in the throat and feeling dryness or itching in the throat are all referred to as sore throat. However, medically, sore throat refers to pain in the throat.

Sometimes people go to bed and wake up feeling pain in their throats. For some, this feeling goes away later in the day but persists in some others. In those in whom it persists, there may be other symptoms such as fever, headaches and nasal congestion.

This article will explore various reasons that might make you wake up with a sore throat. Different structures in the throat may be irritated to give that feeling of soreness in your throat. These structures include the pharynx, larynx, vocal cords and tonsils.

Reasons you wake up with sore throat

Dry throat

Your throat might become dry at night while sleeping because you are breathing through your mouth, or you are sleeping in an air conditioned room. Dry weather conditions may also account for this.

Mouth breathing may be as result of nasal congestion from a viral infection such as the flu. It may also be due to obstruction in your airways from swelling of the tissues in your throat such as tonsillitis.

People who have obstructive sleep apnea (OSA)-a condition in which there is frequent cessation of breathing during sleep because the tube connecting the nose and mouth to the lungs is blocked by body tissues- may also experience sore throat due to dryness of the throat. In this case, in addition to sore throat, they may also have headache, fatigue and daytime sleepiness.

wake up with sore throat
Why do we wake up with sore throat Photo credit: Zay Win Htal/Shutterstock

Burns from hot food

You might sustain burns in your throat from hot food or drinks taken the before going to bed. The hot food or drink irritates your throat and makes it sore by morning when you wake up.

Smoking

Cigarette smoking, use of e-cigarettes and vaping exposes the throat to chemicals that cause irritation and subsequently sore throat.

This irritation of tissues in the throat may also cause an increase in the production of mucous by the cells in the throat in attempt to get rid of the harmful substances. In addition, these chemicals can cause death of cells in the throat.

There is an increase in risk of throat cancer and abnormal growths (polyps) with smoking. Sore throat is one of the symptoms of throat cancer.

Acid reflux

Gastro-oesophageal reflux disease is a condition in which stomach contents which includes gastric acid escapes through the oesophageal sphincter into the oesophagus/gullet and up to the throat. The oesophageal sphincter is the junction between the end of the gullet and beginning of the stomach. The contraction of the muscles of the sphincter should keep it tightly closed when you are not swallowing.

When you’re asleep, your muscles including those of the oesophageal sphincter are relaxed resulting in reflux of stomach contents into the oesophagus and sometimes up to the throat. The escape of stomach contents into the gullet is more likely when you go to bed with a full stomach immediately after eating. Because gravity is eliminated while you’re lying flat to sleep, this happens more often.

Secondly, your stomach produces more acid at night while you’re sleeping thereby increasing the acidity of the stomach content. This implies that reflux of acidic stomach contents badly irritates the throat and makes it sore.

Thirdly, you swallow much less saliva in your sleep. Saliva has some neutralising effect on the acidic stomach contents, hence less swallowing of saliva means more acidic gastric fluid concentration.  The acid irritates your throat, makes it feel sore.

Allergies

People who have allergies to pollen and dust mites may wake up with sore throat. Pollen in the environment increases in certain seasons and worse if your home is surrounded by many trees, and you sleep with your windows open.

Presence of dust mites and molds in your bedroom and bedsheets/pillows may cause throat irritation, thereby increasing mucous production and worsening postnasal drip. You have postnasal drip if you constantly feel there is phlegm coming down the back of your throat and the urge to clear your throat and swallow it.

Voice overuse 

This is a common cause of waking up with sore throat in public speakers and singers. Overusing your voice may irritate the vocal cords and larynx and may be the reason you sometimes wake up with sore throat.

Infections

Infectious causes of sore throat are of concern because I of the grave consequences of a complicated infection. It may become complicated by infection of other tissues in the head and neck region. Complications arise if not recognized and treated promptly with appropriate antimicrobials.

Viral and bacterial infections of the throat structures can cause sore throat. Viral infections most commonly cause sore throat. Sore throat is a symptom of COVID-19 infection which is a more severe viral infection that may be fatal.

Bacterial infection may also cause sore throat associated with swelling/ redness of the tonsils/pharynx and deposition of pus in the throat (pharyngo-tonsillitis). The most common bacteria causing pharyngotonsilitis (Streptococcus species) may also cause infection in the heart and kidneys if antibiotics are not commenced immediately or treated with inappropriate doses of antibiotics.

How to avoid waking up with sore throat

Waking up with sore throat can be discomforting and worrisome. Here is a list of things you can do to avoid it.

  1. Use air humidifier in your bedroom at night.
  2. Take sips of water at intervals in the night.
  3. Take a Steam hot shower
  4. Avoid taking acidic foods such as citrus fruits-oranges, lemons-just before bed time
  5. Have dinner early. At least 2-3 hours before bed time
  6. Raise the head of your bed to reduce acid reflux
  7. Use hypo allergic pillows and change your pillows frequently
  8. Avoid use of dusty rugs in your bedroom that harbour dust mites and moulds.
  9. Rest your voice
  10. Quit smoking
  11. Avoid very hot foods and drinks
  12. Take antihistamines and nasal decongestants

Treatment of sore throat

When sore throat persists or is associated with fever, headaches, nasal congestion and/or cough, then it is more likely to be from infection.

 Most viral infections are self-limited meaning it will resolve spontaneously after the course of infection and may not need antiviral medications. Only supportive treatments like antihistamines, over the counter analgesics and lozenges may suffice. However, more serious viral infection such as COVID-19 may require the use of antivirals and other medications.

Bacterial infections of the throat are treated with antibiotics after a throat swab is obtained for testing. The drug of choice is determined by the sensitivity pattern of the offending organism as shown in result of throat swab culture.

In summary, waking up with sore throat may be due to minor conditions like dry throat and resolves in few hours. On the other hand, it may be from serious causes such as infections and cancer.

Consult your doctor if it is associated with other symptoms and /or persists for more than 12 to 24 hours.

About the author

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Doctor

Grace is an internist currently practising in Nigeria. She has gained experience practising both in the private and public health sectors over the last ten years. She is passionate about giving patients adequate information about their health conditions. She believes that a large part of the management of chronic diseases lies with patients' understanding of their illnesses and the need for lifestyle modifications and medications.