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Chronic Cough and OSA: An Underappreciated Relationship

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Abstract

Chronic cough is increasingly being recognized as a process that has multiple initiating and perpetuating triggers. Obstructive sleep apnea has recently emerged as a possible disease that can lead to chronic cough. This review details the available clinical evidence that links these two disparate diseases and explores mechanistic bases of their relationship.

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References

  1. Morice AH, Kastelik JA (2003) Cough 1: chronic cough in adults. Thorax 58:901–907

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Irwin RS, Baumann MH, Bolser DC et al (2006) Diagnosis and management of cough executive summary: ACCP evidence-based practice guidelines. Chest 129:1S–23S

    Article  PubMed Central  PubMed  Google Scholar 

  3. Haque RA, Usmani OS, Barnes PJ (2005) Chronic idiopathic cough: a discrete clinical entity? Chest 127:1710–1713

    Article  PubMed  Google Scholar 

  4. Faruqi S, Molyneux ID, Fathi H, Wright C, Thompson R, Morice AH (2011) Chronic cough and esomeprazole: a double-blind placebo-controlled parallel study. Respirology 16:1150–1156

    Article  PubMed  Google Scholar 

  5. Shaheen NJ, Crockett SD, Bright SD et al (2011) Randomised clinical trial: high-dose acid suppression for chronic cough—a double blind, placebo-controlled study. Aliment Pharmacol Ther 33:225–234

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL (2006) Efficacy of speech pathology management for chronic cough: a randomized placebo controlled trial of treatment efficacy. Thorax 61:1065–1069

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Blondeau K, Dupont LJ, Mertens V et al (2007) Improved diagnosis of gastroesophageal reflux in patients with unexplained chronic cough. Aliment Pharmacol Ther 25:723–732

    Article  CAS  PubMed  Google Scholar 

  8. Sundar KM, Daly SE, Pearce MJ, Alward WT (2010) Chronic cough and obstructive sleep apnea in a community-based practice. Cough 6:2

    Article  PubMed Central  PubMed  Google Scholar 

  9. Morice AH (2010) The cough hypersensitivity syndrome: a novel paradigm for understanding cough. Lung 188(Suppl 1):S87–S90

    Article  CAS  PubMed  Google Scholar 

  10. Chung KF (2011) Chronic “cough hypersensitivity syndrome”: a more precise label for chronic cough. Pulm Pharmacol Ther 24:267–271

    Article  CAS  PubMed  Google Scholar 

  11. Morice AH, McGarvey LPA, Dicpinigaitis PV (2012) Cough hypersensitivity syndrome is an important clinical concept: a pro/con debate. Lung 190:3–9

    Article  PubMed  Google Scholar 

  12. Palombini BC, Villanova CA, Araújo E, Gastal OL, Alt DC, Stolz DP, Palombini CO (1999) A pathogenic triad in chronic cough: asthma, postnasal drip syndrome and gastroesophageal reflux disease. Chest 116:279–284

    Article  CAS  PubMed  Google Scholar 

  13. Katle EJ, Hatlebakk JG, Steinsvaq S (2013) Gastroesophageal reflux and rhinosinusitis. Curr Allergy Asthma Rep 13:218–223

    Article  PubMed  Google Scholar 

  14. Pratter MR (2006) Overview of common causes of cough. Chest 129:59S–62S

    Article  PubMed  Google Scholar 

  15. Katz PO, Gerson LB, Vela MF (2013) Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 108:308–328

    Article  PubMed  Google Scholar 

  16. Piromchai P, Kasemsiri P, Laohasiriwong S, Thanaviratananich S (2013) Chronic rhinosinusitis and emerging treatment options. Int J Gen Med 6:453–464

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Summary health statistics for U.S. adults: National Health interview survey 2011 Table 3,4. http://www.cdc.gov/nchs/fastats/asthma.html. Accessed 13 July 2011

  18. Brightling CE (2011) Eosinophils, bronchitis and asthma: pathogenesis of cough and airflow obstruction. Pulm Pharmacol Ther 24:324–327

    Article  CAS  PubMed  Google Scholar 

  19. Fox AJ, Lalloo UG, Belvisi MG, Bernareggi M, Chung KF, Barnes PJ (1996) Bradykinin-evoked sensitization of airway sensory nerves: a mechanism for ACE inhibitor cough. Nat Med 2:814–817

    Article  CAS  PubMed  Google Scholar 

  20. Birring SS, Ing AJ, Chan K, Cossa G, Matos S, Morgan MD, Pavord ID (2007) Obstructive sleep apnoea: a cause of chronic cough. Cough 3:7

    Article  PubMed Central  PubMed  Google Scholar 

  21. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177:1006–1014

    Google Scholar 

  22. Ojoo J, Everett CF, Mulrennan SA, Faruqi S, Kastelik KA, Morice AH (2013) Management of chronic cough using a clinical protocol: a prospective observational study. Cough 9:2

    Article  PubMed Central  PubMed  Google Scholar 

  23. Chan KKY, Ing AJ, Laks L, Cossa G, Rogers P, Birring SS (2010) Chronic cough in patients with sleep-disordered breathing. Eur Respir J 35:368–372

    Article  CAS  PubMed  Google Scholar 

  24. Sundar KM, Daly SE, Willis AM (2013) A longitudinal study of CPAP therapy for chronic cough patients with obstructive sleep apnoea. Cough 9:19

    Article  PubMed Central  PubMed  Google Scholar 

  25. Faruqi S, Fahim A, Morice AH (2012) Chronic cough and obstructive sleep apnoea: reflux-associated cough hypersensitivity? Eur Respir J 40:1049–1050

    Article  PubMed  Google Scholar 

  26. Brzecka A, Pawelec-Winiarz M, Piesiak P, Nowak E, Jankowska R (2011) Suppression of chronic nocturnal cough during continuous positive airway pressure (CPAP) treatment in a patient with asthma and obstructive sleep apnoea syndrome. Pneumonol Alergol Pol 79:121

    PubMed  Google Scholar 

  27. Mermigkis C, Bouloukaki I, Antoniou KM et al (2013) CPAP therapy in patients with idiopathic pulmonary fibrosis and obstructive sleep apnea: does it offer a better quality of life and sleep? Sleep Breath 17:1137–1143

    Google Scholar 

  28. Guglielminotti J, Tesniere A, Rackelboom T et al (2007) Cough reflex sensitivity is decreased in female obese patients with obstructive sleep apnea. Respir Physiol Neurobiol 158:83–87

    Article  PubMed  Google Scholar 

  29. Boyd JH, Petrof BJ, Hamid Q, Fraser R, Kimoff RJ (2004) Upper airway muscle inflammation and denervation changes in obstructive sleep apnea. Am J Respir Crit Care Med 170:541–546

    Article  PubMed  Google Scholar 

  30. Pacheco A, Cobeta I (2013) Refractory chronic cough, or the need to focus on the relationship between the larynx and the esophagus. Cough 9:10

    Article  PubMed Central  PubMed  Google Scholar 

  31. Sundar KM, Daly SE (2011) Chronic cough and OSA: a new association. J Clin Sleep Med 7:669–677

    PubMed Central  PubMed  Google Scholar 

  32. Smith JA, Houghton LA (2013) The oesophagus and cough: laryngo-pharyngeal reflux, microaspiration and vagal refluxes. Cough 9:12

    Article  PubMed Central  PubMed  Google Scholar 

  33. Kahrilas PJ (2010) Obstructive sleep apnea and reflux disease: bedfellows at best. Chest 137:747–748

    Article  PubMed  Google Scholar 

  34. Kuribiyashi S, Massey BT, Hafeezullah M et al (2010) Upper esophageal sphincter and gastroesophageal junction pressure changes act to prevent gastroesophageal and esophagopharyngeal reflux during apneic episodes with obstructive sleep apnea. Chest 137:769–776

    Article  Google Scholar 

  35. Eastwood PR, Katagiri S, Shepherd KL, Hillman D (2007) Modulation of upper and lower esophageal sphincter tone during sleep. Sleep Med 8:135–143

    Article  PubMed  Google Scholar 

  36. Lee CH, Hong SL, Rhee CS, Kim SW, Kim JW (2009) Analysis of upper airway obstruction by sleep videoflouroscopy in obstructive sleep apnea: a large population-based study. Arch Otolaryngol Head Neck Surg 135:168–172

    Article  PubMed  Google Scholar 

  37. Nguyen AT, Jobin V, Payne R, Beauregard J, Naor N, Kimoff RJ (2005) Laryngeal and velopharyngeal sensory impairment in obstructive sleep apnea. Sleep 28:585–593

    PubMed  Google Scholar 

  38. Carpagnano GE, Spanevello A, Sabato R, Depalo A, Turchiarelli V, Foschino-Barbaro MP (2008) Exhaled pH, exhaled nitric oxide, and induced sputum cellularity in obese patients with obstructive sleep apnea syndrome. Transl Res 151:45–50

    Article  CAS  PubMed  Google Scholar 

  39. Sariman N, Levent E, Cubuk R, Yurdu S, Aksungar FB (2011) Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients. Sleep Breath 15:341–350

    Article  PubMed  Google Scholar 

  40. Ioachimescu OC, Teodorescu M (2013) Integrating the overlap of obstructive lung disease and obstructive sleep apnoea: OLDOSA syndrome. Respirology 18(3):421–431

    Article  PubMed  Google Scholar 

  41. Niimi A, Nguyen LT, Usmani O, Mann B, Chung KF (2004) Reduced pH and chloride levels in exhaled breath condensate of patients with chronic cough. Thorax 59:608–612

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  42. Matsumoto H, Niimi A, Tabeuna RP et al (2007) Airway wall thickening in patients with cough variant asthma and nonasthmatic chronic cough. Chest 131:1042–1049

    Article  PubMed  Google Scholar 

  43. Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB (2009) Sleep habits and susceptibility to common cold. Arch Intern Med 169:62–67

    Article  PubMed Central  PubMed  Google Scholar 

  44. Besedovsky L, Lange T, Born J (2012) Sleep and immune function. Pflugers Arch 463:121–137

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors (KMS and SED) report no conflict of interest in relation to the content of the manuscript.

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Correspondence to Krishna M. Sundar.

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Sundar, K.M., Daly, S.E. Chronic Cough and OSA: An Underappreciated Relationship. Lung 192, 21–25 (2014). https://doi.org/10.1007/s00408-013-9534-9

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  • DOI: https://doi.org/10.1007/s00408-013-9534-9

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