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. 2010 Apr 15;6(1):2.
doi: 10.1186/1745-9974-6-2.

Chronic cough and obstructive sleep apnea in a community-based pulmonary practice

Krishna M Sundar  1 , Sarah E Daly, Michael J Pearce, William T Alward
Affiliations

Chronic cough and obstructive sleep apnea in a community-based pulmonary practice

Krishna M Sundar et al. Cough. .

Abstract

Background: Recent reports suggest an association between unexplained chronic cough and obstructive sleep apnea (OSA). Current guidelines provide an empiric integrative approach to the management of chronic cough, particularly for etiologies of gastroesophageal reflux (GERD), upper airway cough syndrome (UACS) and cough variant asthma (CVA) but do not provide any recommendations regarding testing for OSA. This study was done to evaluate the prevalence of OSA in patients referred for chronic cough and examine the impact of treating OSA in resolution of chronic cough.

Methods: A retrospective review of chronic cough patients seen over a four-year period in a community-based pulmonary practice was done. Patients with abnormal chest radiographs, abnormal pulmonary function tests, history of known parenchymal lung disease, and inadequate followup were excluded. Clinical data, treatments provided and degree of resolution of cough was evaluated based on chart review. Specifically, diagnostic testing for OSA and impact of management of OSA on chronic cough was assessed.

Results: 75 patients with isolated chronic cough were identified. 44/75 had single etiologies for cough (GERD 37%, UACS 12%, CVA 8%). 31/75 had multiple etiologies for their chronic cough (GERD-UACS 31%, GERD-CVA 5%, UACS-CVA 3%, GERD-UACS-CVA 3%). 31% patients underwent further diagnostic testing to evaluate for UACS, GERD and CVA. Specific testing for OSA was carried out in 38/75 (51%) patients and 33/75 (44%) were found to have obstructive sleep apnea. 93% of the patients that had interventions to optimize their sleep-disordered breathing had improvement in their cough.

Conclusions: OSA is a common finding in patients with chronic cough, even when another cause of cough has been identified. CPAP therapy in combination with other specific therapy for cough leads to a reduction in cough severity. Sleep apnea evaluation and therapy needs to considered early during the management of chronic cough and as a part of the diagnostic workup for chronic cough.

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References

    1. Irwin RS, Baumann MH, Bolser DC, Boulet LP, Braman SS, Brightling CE, Brown KK, Canning BJ, Chang AB, Dicpinigaitis PV, Eccles R, Glomb WB, Goldstein LB, Graham LM, Hargreave FE, Kvale PA, Lewis SZ, McCool FD, McCrory DC, Prakash UB, Pratter MR, Rosen MJ, Schulman E, Shannon JJ, Smith Hammond C, Tarlo SM. American College of Chest Physicians (ACCP) Diagnosis and management of cough executive summary: ACCP Evidence-based clinical practice guidelines. Chest. 2006;129:1S–13S. doi: 10.1378/chest.129.1_suppl.1S. - DOI - PMC - PubMed
    1. Grabczak EM, Dabrowka M, Krenke R, Domeracka-Kolodziej A, Domagala-Kulawik J, Arcimowicz M, Hamera M, Chazan R. Does the established cause of chronic cough depend on the diagnostic approach? J Physiol Pharmacol. 2008;59(suppl 6):285–96. - PubMed
    1. Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis. 1990;141:640–7. - PubMed
    1. Chan KKY, Ing AJ, Laks L, Cossa G, Rogers P, Birring SS. Chronic cough in patients with sleep disordered breathing. Eur Respir J. 2010;35:368–372. doi: 10.1183/09031936.00110409. - DOI - PubMed
    1. Lee KK, Birring SS. Cough and sleep. Lung. 2009. in press . - PubMed

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