what is the difference between a cough and a sneeze

Sneezes and coughs have a common purpose. Above all, these forceful processes remove something that is disturbing the body. So why do we cough or sneeze rather than the other? Indeed, sneezes and coughs have distinct causes. 

Understanding Our Sneeze

A sneeze starts when a substance irritates part of the upper airways. For example, when something touches the hairs on the sensitive nasal mucosa, a sequence is triggered that results in sneezing.

During a sneeze our eyes close, the tongue moves upwards within the mouth, and a few muscles contract to produce the force needed for the sneeze. A combination of air and mucus might come out from the nose. Since it pushes out material within the respiratory system, sneezing can also spread infections.

A sneeze has several possible causes: exposure to allergens such as pollen and mold, infections, or pollutants. Interestingly, some people can even sneeze when looking up at the sun or having an orgasm

Understanding Our Cough

Similar to a sneeze, the cough is also a reflex that clears the respiratory pathways, commonly the lower airways. Foreign particles irritate the fine hairs or mucosa within the respiratory system, causing the forceful contraction of the related muscles that results in a cough.

Infections, smoking, exposure to allergens, and even some medications can cause a cough. In addition, some conditions such as heart failure or stomach acid reflux can also cause a cough.

Coughs that extend beyond eight weeks are described as chronic coughs. Following an infection, one of the lingering remnants is often a cough. Inflammation and irritation due to a chronic cough can further prolong the extent of a cough. Conditions such as asthma or a postnasal drip can also lead to chronic cough.

Cough vs a Sneeze

The irritants are mostly the same for both a cough and a sneeze. So what determines whether our bodies cough or sneeze? It has mostly to do with where the affected area is. 

A sneeze is the expulsion of an irritant through the nasal passage. Most importantly, a sneeze is related to the irritation of the upper nasal passages. The sneeze reflex is fundamentally the result of a stimulus to a specific nerve ending, the trigeminal nerve. This nerve branches off from the fifth cranial nerve. 

On the other hand, cough results from irritation or inflammation to the respiratory tract or surrounding structures such as the esophagus or heart. The biological feature responsible for the cough reflex is the vagus nerve. It branches off the tenth cranial nerve and has endings covering the airway surface (epithelium)

The final route cranial nerves take in the brain
Picture courtesy Wikimedia Commons

There are many more intricacies to both the cough and sneeze than are highlighted. However, even a basic understanding of their differences and similarities clearly shows how intertwined their functions are.

Tracking Our Coughs & Sneezes

Although coughs and sneezes result from a similar pathway within our body, there is often a significant difference between the cough and the sneeze. 

Symptom tracking provides an effective means to understand what the underlying cause might be. It is also instrumental in telling whether the therapeutic strategy is associated with improvements or not. Most often both the cough and the sneeze are related to an underlying allergic or infectious process. However, if a cough persists long after sneezing has stopped, it requires further investigation.

Beyond noticing a cough or a sneeze, a more holistic picture is essential. Signs such as shortness of breath, fever, chest pain, fatigue, and any blood or mucus production with a cough, can complete the picture, enabling a proper diagnosis. This complexity is why physicians don’t diagnose based on only one complaint, on a single symptom, or an isolated test result.

A sneeze or a cough that occurs as a reflex and is a one-time event is rarely a cause for concern. These incidents are the body’s way of protecting itself and taking care of its survival. However, further investigation is crucial when they are persistent, especially when an underlying cause is unknown. 

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