Would a warm drink at night help break up the fluids in his chest?

A fellow caregiver asked...

My husband is 54 years old. He has congestive heart failure, COPD, diabetes and high blood pressure. He cannot sleep at night due to shortness of breath, fluid backups and constant coughing. He also has a rattling in his chest. I feel helpless because there is nothing I can do to help him. We try the inhalor which works for a moment. He uses direutics to try and pull the fluids off his body. For some reason, his blood pressure and sugar level is elevating. He is very conscious of his diet; so we do not know what is causing these to elevate. I have heard that you shouldn't drink cold water at night; that before you go to bed, you should have something warm to drink to break up the fluids in your chest. Does this help? Is there anything else we can do to make his condition better.

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

You sound like you are very worried about your husband, which is understandable. He is young, and has many serious health conditions. First of all, I hope that he is seeing his primary care provider frequently, and they are aware of his problems. If the above symptoms are new, you should let his doctor know right away, as he could have a respiratory infection or pneumonia. You mention that his blood sugar is high and his blood pressure is also out of control. This signifies to me that he is under stress from his illnesses, and he needs more medical intervention to help him gain some control.

With that being said, several thoughts pop into my head when I read your letter, which I have listed below: 1) It sounds like his COPD is not under control. He may need a stronger inhaler, or even nebulized breathing treatments to help his breathing and cough. He may need to see a pulmonologist for more help with his COPD. 2) One of the best ways to control CHF is to watch his fluid and salt intake. This will help him prevent excess fluid from going into his lungs. You can weigh him daily and see if his weight increases more than 2 pounds in one day. If this happens, you can call his doctor's office, as he may need more diuretics to get that extra fluid weight off. 3) Sleep apnea can cause difficulty with sleeping and breathing at night. Is your husband overweight? If so, he may have sleep apnea. Ask his primary health provider if he is at risk, as he may need to be tested for this.

I know you would like to help your husband as much as you can. So, I suggest: 1) Get him to stop smoking if he is a smoker. There is nothing better he could do to help his lungs or heart than this. 2) Watch his diet. Again, salt and extra fluids could make his heart failure worse. Also, he needs to watch his sugar and carbohydrate intake to help keep his blood sugar under better control. 3) If he is making alot of phlegm with his cough, he could try an over the counter medication like Mucinex twice a day to see if that helps him stop coughing so much. 4) He should avoid dairy products if they make him cough/produce phlegm. 5) Hot tea may help him relax before bed, and may soothe his cough, but I think this would only help for an hour or so. Cold water can cause constriction of the throat, which may be irritating and contribute to cough. 6) Have him sleep in bed with his head elevated by placing several pillows behind his back. This may help his breathing and cough.

I hope this helps. Good luck!