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European Journal of Pediatrics

, Volume 154, Issue 4, pp 320–325 | Cite as

Chronic night cough and asthma severity in children with stable asthma

  • E. W. Hoskyns
  • C. S. Beardsmore
  • H. Simpson
Pneumology Original Paper

Abstract

The relationship between night cough and other indices of asthma severity was studied in 21 children with clinically stable asthma and persistent night cough. Overnight cough was quantified and related to symptom scores, oxygen saturation (SaO2) during sleep, evening and morning peak flow recordings and daytime tests of lung function. In the index group the median number of coughing episodes was 23 (range 1–158). Only 4 children had counts of <10 overnight, similar to the comparison group of 12 children all of whom had counts of <10. There was a trend towards the association of overnight cough with reduced evening peak flow (r=−0.407,P=0.07) and reduced SaO2 (r=−0.36,P=0.10). Abnormalities in daytime tests of lung function were observed in 13 children. There was no relationship between night cough and daytime indices of lung function abnormality although children with more severe daytime abnormalities also had significant night cough. Conversely, five children with chronic night cough had normal daytime function.

Conclusion

Night-time cough in children with asthma is not simply a reflection of daytime lung function status, whereas, overnight SaO2 correlates well. Other factors need to be explored to explain the variability of night-time cough in these children.

Key words

Children Cough Asthma Night 

Abbreviations

FEV1

forced expiratory volume

MEF25

maximal expiratory flow at 25% vital capacity

PF

peak flow

Raw

airways resistance

RV/TLC

residual volume/total lung capacity ratio

SaO2

oxygen saturation

TGV

thoracic gas volume

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References

  1. 1.
    Choudry NB, Fuller RW, Anderson N, Karlsson J-A (1990) Separation of cough and reflex bronchoconstriction by inhaled local anaesthetics. Eur Respir J 3: 579–583Google Scholar
  2. 2.
    Clough JB, Williams JD, Holgate ST (1992) Profile of bronchial responsiveness in children with respiratory symptoms. Arch Dis Child 67: 574–579Google Scholar
  3. 3.
    Editorial (1988) Cough and wheeze in asthma: are they interdependent? Lancet I: 447–448Google Scholar
  4. 4.
    Eschenbacher WL, Boushey HA, Sheppard D (1984) Alteration in osmolarity of inhaled acrosols cause (sic) bronchoconstriction and cough, but absence of a permeant anion causes cough alone. Am Rev Respir Dis 129: 211–215Google Scholar
  5. 5.
    Fujimura M, Sakamoto S, Kamio Y, Matsuda T (1992) Cough receptor sensitivity and bronchial responsiveness in normal and asthmatic subjects. Eur Respir J 5: 291–295Google Scholar
  6. 6.
    Galvez RA, McLaughlin FJ, Levison H (1987) The role of the methocholine challenge in children with chronic cough. J Allergy Clin Immunol 79: 331–336Google Scholar
  7. 7.
    Gustaffson PM, Kjellman NI, Tibbling L (1986) Oesophageal function and symptoms in moderate and severe asthma. Acta Pediatr Scand 75: 729–736Google Scholar
  8. 8.
    Gustaffson PM, Kjellman NI, Tibbling L (1992) A trial of ranitidine in asthmatic children and adolescents with or without pathological gastro-oesophageal reflux. Eur J Respir Dis 5: 201–206Google Scholar
  9. 9.
    Hoeger PH, Niggemann B, Haeuser G (1994) Age related IgG subclass concentrations in asthma. Arch Dis Child 70: 179–182Google Scholar
  10. 10.
    Hoskyns EW, Heaton DM, Beardsmore CS, Simpson H (1991) Asthma severity at night during recovery from an acute asthmatic attack. Arch Dis Child 66: 1204–1208Google Scholar
  11. 11.
    Irwin RS, Curley FJ, French CL (1990) Chronic cough. Am Rev Respir Dis 141: 640–647Google Scholar
  12. 12.
    McFadden ER (1975) Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma. N Engl J Med 292: 555–559Google Scholar
  13. 13.
    Phelan PD (1978) Postnasal drip and chronic cough (letter). Lancet II: 1309Google Scholar
  14. 14.
    Sheppard D, Rizk NW, Boushey HA, Bethel RA (1982) Mechanism of cough and bronchoconstriction induced by distilled water aerosol. Am Rev Respir Dis 127:691–694Google Scholar
  15. 15.
    Thomson AH, Pratt C, Simpson H (1987) Nocturnal cough in asthma. Arch Dis Child 62:1001–1004Google Scholar
  16. 16.
    Waalkens HJ, Gerritsen J, Koeter GH, Krouwels FH, van Aalderen WMC, Knol K (1991) Budesonide and terbutaline or terbutaline alone in chukdren with mild asthma: effects on bronchial hyperresponsiveness and diurnal variation in peak flow. Thorax 46:499–503Google Scholar
  17. 17.
    Weng T-R, Levison H (1969) Standards of pulmonary function in children. Am Rev Respir Dis 99:879–894Google Scholar
  18. 18.
    Zapletal A, Paul T, Samanek M (1976) Pulmonary elasticity in children and adolescents. J Appl Physiol 40:953–963Google Scholar
  19. 19.
    Zapletal A, Paul T, Samanek M (1977) Die Bedeutung heutiger Methoden der Lungenfunktionsdiagnostik zur Feststellung einer Obstruktion der Atemwege bei Kindern und Jungendlichen. Z Erkr Atmungsorgane 149:343–371Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • E. W. Hoskyns
    • 1
  • C. S. Beardsmore
    • 1
  • H. Simpson
    • 1
  1. 1.Department of Child Health, Leicester UniversityLeicester General HospitalLeicesterUK

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