Why do I wake up with a sore throat?

If your throat is sore when you wake up but feels better after a drink and an hour or two, the cause is usually something that happened while you slept. Dry air and breathing through your mouth are the most common culprits, followed by snoring, reflux and allergies.

What usually causes a morning sore throat?

Cleveland Clinic's list of causes for a sore throat in the morning includes dry air, mouth breathing, acid reflux, allergies, postnasal drip, snoring or sleep apnea, smoking or vaping, dehydration, sleeping position and poor air quality. Several of these often overlap. A blocked nose from allergies, for example, can push you into breathing through your mouth all night.

If the soreness comes with fever, body aches, cough or a runny nose and lasts all day, an infection is more likely. Mayo Clinic notes that viruses such as the common cold and flu cause most sore throats.

How do dry air and mouth breathing make it worse?

Mayo Clinic says dry indoor air can make the throat feel rough and scratchy, and that breathing through your mouth can also cause a dry, sore throat. It adds that an ongoing stuffy nose can lead to mouth breathing.

Cleveland Clinic explains the same link: when your nasal passages aren't clear and you breathe through your mouth, your throat loses moisture. If you also wake up with a parched mouth, mouth breathing is a likely suspect. Our guide to waking up with a dry mouth goes into this in more detail.

Cleveland Clinic's otolaryngologist Dr. Michael Benninger puts it simply: if you're breathing through your mouth, there's a reason, and that reason is often congested airways. For short-term relief, he suggests a nasal decongestant at bedtime for a few days. For longer-term relief, he recommends a steroid nasal spray or nasal strips, and notes that you might end up snoring less as a bonus. If you use a decongestant spray, read about decongestant spray rebound so a few days doesn't turn into a few weeks.

He also suggests a humidifier if the air is dry, which tends to be more of a problem in winter, and drinking extra water during the day. A full night's sleep is a long time to go without a drink, so going to bed already dehydrated makes a dry, irritated throat more likely. A couple of generous sips before bed is enough, without causing extra bathroom trips.

Could a fan, an open window or your voice be to blame?

A fan, an open window or your voice can sometimes be to blame for a morning sore throat. Dr. Benninger says whether an open window causes a sore throat depends on the air quality. Cool air from outside can help people breathe better unless it's very dry, but if you have seasonal allergies, sleeping with the window open could be adding to your symptoms. Fans can dry the air in some circumstances, and he suggests pointing yours away from you so it still circulates air and makes soothing background noise.

If you have asthma or bad allergies, or live somewhere with poor air quality, he recommends an air filter and keeping windows and doors closed where you can. Smoking and vaping are another source of irritation, since they put chemicals onto the lining of the throat and can dry it out.

Your voice can matter too. A long meeting, a two-hour phone call or a lot of cheering can be enough to inflame the vocal cords. If your sore mornings line up with the days after you've talked a lot, that may be the pattern.

Can snoring cause a sore throat?

Yes, snoring can cause a sore throat. Snoring makes the soft tissue in your throat vibrate, and Cleveland Clinic lists snoring and sleep apnea as causes of a sore throat on waking.

Mayo Clinic lists waking in the morning with a dry mouth or sore throat among the symptoms of obstructive sleep apnea. Other symptoms it lists include loud snoring, pauses in breathing that a partner notices, waking up gasping or choking, morning headaches and excessive daytime sleepiness.

A sore throat on its own is not a reason to worry about sleep apnea. But if it comes with loud snoring and gasping, or you feel exhausted after a full night in bed, talk to a doctor. Our guide to snoring vs. sleep apnea explains the difference.

Can acid reflux cause a sore throat at night?

Yes, acid reflux can cause a sore throat at night, and it's easy to miss. Cleveland Clinic describes laryngopharyngeal reflux (LPR) as reflux that reaches the throat, with symptoms such as hoarseness, frequent throat clearing, chronic cough and chronic sore throat. Some people get it at night because the muscles that normally keep stomach contents down relax a little when they lie down.

LPR is sometimes called silent reflux because the usual signs of reflux, like heartburn, may not be there. So a sore, scratchy throat with a hoarse voice in the morning can be reflux even if you've never had heartburn.

Cleveland Clinic's suggestions include not lying down for three hours after eating, eating smaller meals, avoiding rich, spicy and acidic foods, and sleeping on your left side. It explains that lying on your left side keeps the valve at the top of the stomach in an air pocket above the stomach contents, while lying on your back can leave it sitting in them. Loose clothing around the waist, cutting back on alcohol and stopping smoking can help too.

LPR is more common than many people think. Cleveland Clinic says providers estimate that more than half of people who complain of chronic hoarseness have it. If you're getting reflux symptoms regularly, talk to your doctor, because Dr. Benninger notes it may be a condition like gastroesophageal reflux disease (GERD).

What about allergies and postnasal drip?

Mayo Clinic says allergies to things like dust, pollen, mold and pet dander can cause a sore throat, and that mucus dripping down the back of the throat, called postnasal drip, can make it worse. Cleveland Clinic adds that when you lie flat, mucus has nowhere to go, and that even a slight elevation of your head helps it drain. If allergies leave your nose stuffy at night, that can also push you into breathing through your mouth.

How do you work out which cause is yours?

You can usually work out the cause of a morning sore throat from what comes with it:

• A parched mouth as well points toward mouth breathing or dry air.
• A hoarse voice and frequent throat clearing, especially after a late meal, point toward reflux.
• A stuffy or runny nose, worse in certain seasons or around pets or dust, points toward allergies and postnasal drip.
• A partner who hears loud snoring points toward snoring, and gasping or pauses in breathing point toward sleep apnea.
• Soreness that only shows up in winter or with the heating on points toward dry air.

Several can overlap, so it's fine to work on more than one at a time.

What can you try at home?

At home, start with the cause of your sore throat that fits best:

• If the room feels dry, try a humidifier and drink more water during the day.
• If your nose is blocked at night, deal with the congestion first. A nasal strip is an easy, drug-free way to make nasal breathing easier, and Dr. Benninger recommends strips for longer-term relief. How to apply nasal strips has tips on getting a good fit.
• If your mouth falls open even when your nose is clear, mouth tape is a simple way many adults keep their lips closed overnight. The Sleep Foundation notes that people who tape report benefits such as less dry mouth, though the research is still limited and most of those reports are anecdotal. Only do this if you can breathe comfortably through your nose. Take the nose test first, use a porous tape made for skin, and see how to start mouth taping.
• If reflux seems likely, leave a gap of three hours between eating and lying down.

If you want to try mouth tape, our pick is the Titan Bamboo Silk Mouth Tape.

What soothes a sore throat in the morning?

Warm salt water gargles, ice and lozenges can soothe a sore throat in the morning while you work on the cause. The NHS suggests gargling with warm salty water, made by dissolving half a teaspoon of salt in a glass of warm water and spitting it out afterwards. Children shouldn't try this. Sucking ice cubes, ice lollies or hard sweets can help too, and a pharmacist can suggest medicated lozenges.

Cleveland Clinic's advice for throat irritation from reflux includes drinking plenty of water and avoiding drying things like caffeine, alcohol and menthol cough drops. It says herbal teas with marshmallow or honey can be soothing. The NHS adds that you don't normally need antibiotics for a sore throat, because they won't usually help unless there's a bacterial infection.

When should you see a doctor?

Mayo Clinic advises adults to see a healthcare professional for a sore throat along with any of these:

• A bad sore throat that lasts longer than a week.
• Trouble swallowing or breathing, or trouble opening the mouth.
• A fever higher than 101 F (38.3 C).
• Blood in mucus, a lump in the neck or swelling in the neck or face.
• Hoarseness that lasts more than two weeks.
• Sore throats that keep coming back.

Cleveland Clinic also recommends getting checked if a sore throat that isn't from a virus lasts all day, or if symptoms go on for more than two weeks, especially if you smoke, have acid reflux or drink heavily.

Read next

• Is mouth taping safe?
• Why do I wake up with a dry mouth?
• Why are allergies worse at night?

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.