Waking Up With Sore Throat: What to Know

Medically Reviewed by Sabrina Felson, MD on July 12, 2023
6 min read

Is your throat dry, scratchy, or itchy? Is it painful to swallow? These are signs of a sore throat. You may think you’re coming down with a viral infection. But if you’re not feeling sick and don’t have a fever, but continue to wake up with a sore throat, there might be other things causing it.

Signs and symptoms of a sore throat can vary depending on what’s causing it.

Possible causes include:

Dehydration. Your body doesn’t do well if you don’t drink enough water or if you sweat too much too quickly. Dehydration can also happen if you’re taking medications that make you urinate more or lose water weight. At night, when you go for hours without water, you might wake up with a dry mouth and a scratchy throat that makes it hard to swallow.

Other signs of dehydration include:

Feeling thirsty is a sign you’re already dehydrated. The best way to treat dehydration and dry throat is to drink plenty of water. You can also use rehydration mixes or powders that add electrolytes back into your system.

The amount of water you need each day depends on your age, height, weight, and the local weather. The standard recommendation is eight glasses of water per day, but ask your doctor about what’s right for you.

Snoring and sleep apnea. Everybody snores at some point in their life. Loud, harsh-sounding snores happen when your throat muscles relax and the air flowing through your windpipe vibrates the tissue around it.

The constant vibration in your airway from snoring is a common cause of a sore throat. Snoring is also closely connected with mouth breathing, which can make your mouth dry and your throat scratchy when you wake up.

Although snoring is common, chronic snoring can be a sign of sleep apnea, a serious sleep disorder where your breathing can start and stop several times during the night. There are different types of sleep apnea, but the most common type is obstructive sleep apnea (OSA). About 22 million Americans have it.

When you have OSA, your throat muscles relax and block your airway when you lie down. This makes it hard to breathe. Waking up with a sore throat or a dry mouth is one of the telltale signs.

Other symptoms include:

Feeling sleepy during the day

  • Loud snoring
  • Waking up abruptly gasping and choking
  • Headache
  • Difficulty concentrating
  • Feeling moody or irritable
  • High blood pressure
  • Nighttime sweats
  • Low sex drive

If your snoring is too loud or you’re waking up with a sore throat and a dry mouth, tell your doctor. They may do a sleep study to monitor your heart, lung, and brain activity and run some tests to confirm it. Your doctor may choose to do the study in a lab or at home.

Treatment options include lifestyle changes like losing weight, regular exercise, or cutting back on smoking and alcohol. If you snore a lot, try sleeping on your side -- back sleeping makes it worse. Your doctor may also prescribe medications for allergies or sleeping pills so that you can get restful sleep.

If your sleep apnea is severe, you may need a continuous positive airway pressure (CPAP) machine that helps to keep your airway open while you sleep. In some cases, you may need surgery.

Allergies. If you’re allergic to environmental allergens such as pollen, mold, animal dander, or dust mites, being around them can irritate your nose and airways. This could lead to an itchy or scratchy sore throat. Most allergy medications (antihistamines) are available over the counter and can ease some of the irritation. If you’re not sure what you’re allergic to, ask your doctor.

Viral infections. Viruses that cause infections like the common cold or the flu are often the cause for a sore throat.

Other viral infection symptoms can include:

Usually, viral infections go away in 5-7 days without treatment. Antibiotics don’t work for a viral infection. If you have pain or high fever, a mild pain reliever like acetaminophen (Tylenol) can help ease the symptoms. If the sore throat is severe and lasts for more than a week, let your doctor know.

Strep throat. A bacterial infection can also cause a sore throat very quickly. The most common cause is a bacteria called Streptococcus pyogenes, which causes strep throat.

Other symptoms include:

  • Difficulty swallowing
  • Fever
  • Red, swollen tonsils. They can also have white patches or streaks of pus on them.
  • Tiny red spots on the roof of the mouth
  • Swollen lymph nodes in the neck

If you have strep throat, your doctor will give you a course of antibiotics to treat it.

Acid reflux. This is a digestive disorder that happens when your stomach acid comes back up your esophagus into your throat. The medical term for it is gastroesophageal reflux disease (GERD). Other symptoms can include heartburn, a hoarse voice, or a sore throat that feels lumpy when you wake up in the morning.

If you’re having acid reflux, tell your doctor. You can also take over-the-counter medications to ease your digestion issues.

Tumors. You may have a sore throat if you have a cancerous lump or tumor near or in your throat, on your tongue, or near your voice box (larynx).

Other symptoms may include:

  • Hoarseness in your voice
  • Difficulty swallowing
  • Noisy breathing
  • Blood in your saliva

If you have any of these symptoms, tell your doctor right away. You may need to start cancer treatments.

HIV infection. Human immunodeficiency virus (HIV) is a type of viral infection. It can give you a sore throat or flu-like symptoms in its early stages. If you’re HIV positive, you may have a severe sore throat much of the time. This may be due to a fungal infection called oral thrush that can happen due to lack of immunity.

If you suspect HIV infection and you have a sore throat, get tested right away. HIV infections can be controlled with regular medications, but the earlier you find out, the better. Treatment and medication also reduce your chances of passing the virus on to other people.

If you wake up with a sore throat frequently or it lasts more than a week or two, you should let your doctor know. They may do some tests or do a throat swab to find out what’s causing it. Depending on your diagnosis, the doctor will decide on a treatment plan.

If your sore throat makes it difficult to breathe or swallow or you feel a lump in your throat, get it checked out as soon as possible. If you have a viral or bacterial infection along with a fever higher than 101 F, see your doctor about it. You can take over-the-counter pain medications to ease the fever and help you feel better.

If your sore throat is a symptom of sleep apnea, besides sleep study tests, the doctor may refer you to an ear, nose, and throat specialist to rule out any structural blocks that may be causing your sleep issues.

While severe sore throats may need medical attention, there are things you can do at home to ease the symptoms.

You can:

  • Suck on ice chips or popsicles to soothe your throat. You can also try hard candies or lozenges.
  • Use a humidifier if there’s dry air where you sleep.
  • Gargle with salt water to curb the itching in your throat.
  • Drink warm beverages and plenty of fluids to stay hydrated.
  • Use honey to ease coughs for adults. Children can have honey if they’re over 1 year old.