Coughing, especially with chronic cough, can dramatically disturb one’s general quality of life. Coughs have several possible underlying causes, of which the most common include infection or exposure to allergies.
Approximately 10% of adults have impaired quality of life due to a chronic cough. A fraction of these chronic coughers does not know what the underlying cause for their cough is, piling onto their frustrations. A key aspect to managing their cough then becomes understanding how it is produced and navigating through the incessant need to cough.
Why Do I Have a Chronic Cough?
Coughing is a reflex action with the purpose of clearing respiratory pathways. However, with chronic coughs, the underlying cause of maintaining it usually differs from the initial reflex that triggered the cough.
The most common causes of chronic cough are:
- Stomach acid reflux
- Postnasal drip
People with these conditions suffer constant irritation to the cough reflex centers, which leads to a nagging cough. Also, this constant irritation causes inflammatory changes, resulting in what is known as laryngotracheitis, which can cause coughs even without a trigger.
Some conditions also result in changes in cough sensitization. This means post-infection or continuous stimulation of cough receptors can result in a lowering of the cough threshold. This makes it easier for a cough to be triggered.
Many lifestyle habits such as smoking, constant exposure to pollution, and certain occupations can further worsen a chronic cough. In such instances, in addition to exploring possible management for a troubling chronic cough, altering your lifestyle habits is a cornerstone in treating your persistent cough.
Is It Better to Cough or Not To Cough?
An initial approach toward managing your chronic cough will always be prescriptions for treating underlying causes. For this, you might receive antibiotics, cough suppressants, and anti-allergens, along with an array of lifestyle changes to relieve your symptoms and hopefully eliminate the cause.
However, for many with a chronic cough, medications provide little-to-no assistance. As pointed out earlier, a subset of these coughs does not have an underlying cause for which doctors would prescribe medications. For these instances, benefits have been found in behavioral cough suppression therapy.
A personal account narrated how a French pulmonary therapist was able to assist with negating the urge to cough. With this technique, the focus is shifted away from the urge to cough by training individuals to opt for alternate techniques such as quick rapid breathing. Other cough distractors involve swallowing or sucking on a lozenge. During each episode, you should make mindful efforts toward reducing attempts to cough.
While this may not be successful 100% of the time, during each coughing episode, an effort should be made to move a step closer to naturally suppressing a cough. To negate each cough, the focus should be placed on other aspects such as airflow or producing sound. Those who experience chronic cough can reap benefits from regular visits with a speech-language therapist, who can assist with developing and teaching the appropriate techniques.
Your pulmonary therapist will advise you to continue these techniques at home, to train your reflexes to protect them from repetitive coughing. Simultaneously, therapists will aim to encourage healthier coughing practices which can help protect cough receptors, airways, and the lungs.
How Do I Train Myself To Cough Better?
To master healthier coughs, a similar technique to cough suppression is employed.
The key is to master your technique to minimize unnecessary coughing and prevent damage to your respiratory pathways.
Both coughing and not coughing are attempted in controlled settings with clinical supervision. At first, individuals will attempt to control their coughs without external provocation.
Initially, your pulmonary therapist will encourage you to take deeper breaths and focus on exhaling. With each subsequent breath, your exhalation will become more forceful after the first few repetitions. Finally, when you can control your exhalation, they will encourage you to lean forward and cough.
Slowly, over sessions, a stimulus is given so that cough suppression can continue to be maintained while the reflex is triggered.
To train yourself to cough better, you will also need to control aspects of increasing laryngeal irritation. These can include dehydration, foods that irritate, and forceful episodes of talking or coughing.
Studies have showcased the benefit of combining education, controlled breathing techniques, cough suppression, and professional counseling for those with a chronic cough that do not respond to standard medications.
It is essential to understand that cough/not cough therapy doesn’t work for everyone who has a chronic cough. However, it can provide hope when everything else has failed.
Initial investigation should always involve consulting with your healthcare provider to understand possible underlying causes for the cough.
In many instances, your doctor may suggest cough suppression therapy to you as a last resort, which makes understanding your diagnosis and alternate therapeutic options mandatory on an individual level.