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October 30, 2012, last updated March 1, 2015

By Alison Turner,  Featured Columnist


We all get a small cough from time to time – but have you
ever had a cough that lasts for longer than eight weeks?  If
so, then what you had was not a normal cough, but chronic
cough, a condition that, according to a study conducted
this year by Swedish experts at the University of
Gothenburg and the Central Hospital in Skovde, affects
over 6% of the population.   


Interestingly, the same study also found that chronic cough
is nearly twice as common in women than it is in men.  
Unlike the usually milder seasonal cough, chronic cough is
not to be ignored: in some cases the condition can disturb
sleep patterns, lead to light-headedness, and even result in
vomiting and rib fractures.

A chronic cough can also interfere with
swallowing or lead
to the introduction of mucous into your lungs, where it can
cause an infection and lead to pneumonia.

How can we treat chronic cough?  If you're coughing too
much, one of the trickier tasks is figuring out the cause – a
step that you want to take, if you want to work on
treatment.  Causes of chronic cough range from tobacco
use, to acid reflux, to taking certain medications.  Check out
the list below of ten common causes of chronic cough, and
strategies suggested by experts from around the world on
how to treat the condition.


























1.
Obstructive Sleep Apnea and Chronic Cough  

It’s a lucky person who sleeps perfectly each and every
night: for those of us (most of us) who aren’t so lucky, we
sometimes struggle with a solid night of rest.  


Indeed, almost all of us have what are called “apnea
episodes” during sleep, also known as a pause in
breathing.  

However, if these pauses happen for more than ten
seconds, you may have a condition called
"sleep apnea",
which could lead to more serious symptoms such as
irritation, forgetfulness, depression , and, according to
research hot out of the lab, chronic coughing.

In 2012, Dr. Krishna Sundar and other researchers with
the University of Utah  gathered data from 28 non-smoking
patients who had cough for more than two months.  


These patients were also evaluated for obstructive sleep
apnea, data which showed that 75% of the patients with
chronic cough showed an increased risk for obstructive
sleep apnea.  


The team concludes that “obstructive sleep apnea is highly
prevalent in patients with chronic cough,” and that therapy
that works to treat both conditions may better improve the
patient’s cough.


Don't know if you have sleep apnea? Two of the clearest
signs are daytime drowsiness or waking up twice or more
during the night, according to a 2012 study led by Dr.
Nisha Aurora from Johns Hopkins University.


Treatment for sleep apnea includes avoiding alcohol or
sedatives near bedtime, avoiding sleeping on
your back,
and losing weight.  A machine called a CPAP (continuous
positive airway pressure) or surgery may be prescribed in
more serious cases.
(Read more about natural remedies for
sleep apnea.)

2.  
Smoking: The Fast Lane to Chronic Cough

If you have ever seen a doctor with concerns about your
cough, she surely asked you if you are a smoker.  A report
published by researchers at the Imperial College London in
the UK states that tobacco smoke is “one of the most
common inhaled irritants, and reliably evokes airway
irritation and coughing in both animals and human non-
smokers.”   

In 2010, a group of Finnish researchers that included
Vuokko Kinnula with the Department of Medicine at the
University of Helsinki,   evaluated how smoking affects
respiratory problems specifically in the young.  Retrieving
data from 1130 military draftees in Northern Finland
between the ages of 18 and 21, the team found that the
prevalence of chronic cough was particularly high in daily
smokers (40.7%), and even in “occasional smokers”
(26.9%), when compared to non-smokers, only 12% of
whom suffered from chronic cough.  The report concludes
that this high association between young smokers and
chronic cough is “posing a serious risk to [the young
smokers’] future health.”

Unfortunately, the UK researchers mentioned above found
that while it may seem like smoking is decreasing in the U.S.
or the U.K., worldwide smoking is actually on the increase,
as is the “global burden of chronic respiratory diseases,”  
such as chronic cough.

3.  
The Environment Could Be a Cough-Causing Irritation

The difference between clear, crisp mountain air, and the
darker, smoggier, city stuff that some of us are forced to
breathe, is not difficult to discern: research from Sweden
suggests that if, somehow, we didn’t notice environmental
irritants around us, a cough may be a sign that they’re
there.

In 2011, experts at the University of Gothenburg in
Sweden, including Ewa Ternesten-Hasséus with the
Department of Allergology,  looked into how environmental
irritants (such as chemicals and scents) affected the
chronic cough of 119 patients.  Results showed that a
“reduced quality of life” was most pronounced in “chemical-
sensitive individuals,” and that the majority of patients with
chronic cough “claimed that environmental factors induced
coughing,” and that “cough is a substantial burden to the
patient, influencing daily living and quality of life.”
We are not all blessed with the chance to live in clean air –
but maybe getting away from man-made chemicals as often
as we can is worth the extra travel.

4.
Asthma and Chronic Cough

For those of you who have asthma, or know someone who
has asthma (by now it is likely that we are all involved),
you know what asthma is: a condition that causes the lungs
to swell, and makes breathing difficult.  Coughing is also a
symptom of asthma,  a connection that is found by
researchers in Japan to be quite common.

In 2010, a large group of researchers from multiple
institutions in Japan, including Akira Yamasaki with the
Division of Medical Oncology and Molecular Respirology at
Tottori University in Yonago,  investigated the causes of
cough in 124 patients in a rural region in Japan.  

Here's a shocker: They found that asthma was “the most
common reason” for chronic cough.  

Asthma is often exacerbated by triggers, such as pet hair,
dust, changes in weather, or chemicals in the air or food.  
Avoiding these triggers (if, that is, you know what they
are) is a good first step to reduce your episodes of asthma
and any consequential cough.  There are also medications
available by prescription from your doctor. (Read more
about
natural remedies that help asthma attacks.)

5.
Gastro Esophageal Reflux Disease (GERD) and Chronic
Cough
 

Most of us have sampled the burning sensation that is
heartburn, and most of us have also experienced cough: it
turns out that the two experiences may not be unrelated.  
Heartburn is one symptom of
gastro esophageal reflux
disease (GERD), a condition in which stomach acid flows
back up through the esophagus.  This (admittedly
unpleasant) contact between what should be in your
stomach and your esophagus, can occur in some people up
to 50 times a day , and can lead to chronic coughing.

In 2006, Dr. Richard Irwin with the University of
Massachusetts Medical School  reviewed literature up to
2004 that was relevant to cough and gastro esophageal
reflux disease (GERD).  He found that GERD is “one of the
most common causes of chronic cough,” so much so that
he recommends anti-reflux medical therapy to all patients
with chronic cough who display GERD symptoms.  

Fortunately, there may be hope for sufferers of acid reflux.  
In many cases, the condition can be remedied through
lifestyle choices, such as eating smaller meals, and waiting
three to four hours after a meal before lying down.

6.
Elderly and ACEI and Chronic Cough: Sigh

Continue reading page 1 page 2




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Eating smaller meals can help reduce chronic cough
caused by GERD.