Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Sleep and breathing disorders

Abstract

Recent studies have suggested chronic cough is prevalent in patients with sleep-disordered breathing (SDB). We investigated the effect of continuous positive airway pressure (CPAP) on cough in patients with obstructive sleep apnoea (OSA) and chronic cough in a randomized controlled trial.
11 consecutive patients with OSA confirmed on polysomnography (respiratory disturbance index (RDI) >15/hour) and chronic cough > 2months were recruited. All patients underwent a CPAP titration study. 1 patient did not tolerate CPAP. 10 Patients were randomized to receive sham CPAP (4 cm H₂O) or CPAP at pressures determined by the titration study for 1 month. The primary outcome was objective 24-hour cough count via the Leicester Cough Monitor (LCM).
7 (5 males) patients received sham CPAP and 3 (2 males) received titrated CPAP. There were no significant differences between groups [mean(SD)] in age [56.3(7.1)yrs vs 63.7(5.1)yrs, p = 0.15], body mass index [36.3(9.3) vs 32.8(5.2), p = 0.57], RDI [45.9(30.0) vs 33.4 (17.4), p = 0.53] and baseline 24-hour cough count [307.6(275.9) vs 208.0(82), p = 0.57]. After 1 month there were no significant changes in 24-hour cough count in the sham CPAP group [307.6(275.9) vs 122.0(181.1), p = 0.07] but there was significant improvement in the titrated CPAP group [208.0(82.0) vs 42.3(53.1), p = 0.01]
These preliminary results suggest that CPAP may reduce objective cough severity in patients with cough associated with OSA and supports our previous study showing improved cough related quality of life following CPAP therapy. Further studies are needed to determine the mechanism of cough in OSA.

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Citations should be made in the following way:
K. Chan, G. Cossa, L. Laks, S. Birring, A. Ing (Campbelltown, Sydney, Australia; London, United Kingdom). Impact on objective cough severity by continuous positive airway pressure (CPAP) in subjects with chronic cough and obstructive sleep apnoea – A randomized controlled trial. Eur Respir J 2011; 38: Suppl. 55, 484

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