Chronic Cough and Obstructive Sleep Apnea

In many cases, having a cough is a common but minor symptom of the common cold or flu. 

While the coughing goes away on its own, in some situations a cough can become chronic, which could indicate there’s an underlying medical problem.

In this article, we’ll explain when a cough is something to be concerned about, and we’ll explore its relationship to a common sleep disorder.

What is chronic cough? 

Most physicians define chronic cough as a cough that lasts more than 8 weeks. In children, a cough is categorized as chronic if it lasts more than 4 weeks. 

Approximately 10% of the adult population is affected by chronic cough, although the causes vary from person to person. When a cough becomes chronic, it is often a symptom of other health issues, with the most common being:

  • Allergies and asthma. 
  • Acid reflux or GERD. 
  • Post nasal drip. 

These conditions account for the vast majority of chronic cases, up to 90% of them. Other causes include sinus infections, pneumonia, bronchitis, COPD, taking certain blood pressure medication, and lung cancer

How chronic coughing affects your health

Chronic cough is more than just an annoyance. When a cough becomes chronic, different parts of the body are put under strain, which over a period of time can have a negative impact on your health.

For example, you may have problems getting a good night’s sleep and feel fatigued during the day. Dizziness, hernia, loss of bladder control, night sweats, a sore and inflamed throat, and hoarseness are other problems that can appear when a cough becomes a constant in your life. 

Given the impact this symptom can have on your health, it is important to find and treat the root cause as soon as possible. 

On that note, research shows that chronic cough may also be a symptom ofobstructive sleep apnea, also known as OSA. Since OSA is a serious condition, anyone whose coughing symptoms can’t be explained by any of the factors listed above should consider the possibility that they may have this sleep disorder.

What is Obstructive Sleep Apnea?

This is a sleep disorder that affects up to 30% of adult males and up to 15% of adult females in North America. 

As its name suggests, obstructive sleep apnea is characterized by an obstruction in the upper airways, which interferes with normal breathing when a person is asleep. Usually, this obstruction is caused by the throat muscles, which relax excessively and collapse into the back of the throat blocking the airways. 

When this happens, breathing pauses for a few seconds, until the person wakes up gasping or choking. OSA episodes happen multiple times throughout the night. In severe cases, they can occur up to 30 times per hour, whereas in mild cases the person will experience between 5 and 15 events. 

Is obstructive sleep apnea serious?

Untreated OSA does present serious health risks. Some common complications include high blood pressure, imbalances in oxygen levels, insulin, and glucose, and a higher risk of developing cardiovascular diseases like stroke and heart failure. 

In addition, OSA causes changes to mood and concentration levels, and insufficient or restless sleep leads to chronic daytime fatigue, which can increase the risk of suffering accidents. 

This is even more concerning considering that up to 90% of people who have OSA aren’t aware of it.

OSA Diagnosis and testing

Diagnosing OSA requires specialized studies and tests. Usually, calling your healthcare provider will be the step, as they’ll be able to refer you to a sleep specialist . 

To determine whether you have OSA, the specialist will ask you to undergo a sleep study, which measures your heart rate and oxygen levels while you’re asleep in order to detect sleep disruption patterns associated with OSA.

Sleep studies can be done at a hospital or at a dedicated sleep center, but it’s also possible to get tested at home. At-home testing typically involves wearing some sensors around your finger, chest, and abdomen, as well as a device similar to an oxygen mask. In most cases, at-home tests only last one night.

The results are then reviewed by a sleep specialist, who can confirm or rule out a diagnosis after taking your medical history and checking your throat, mouth, and neck for any physical abnormalities.

Treatment options for Obstructive Sleep Apnea

If a sleep study confirms you have OSA, you’ll be advised about the treatment that’s more likely to address the symptoms. There are several treatment options, which are recommended based on the severity of your sleep disorder. These range from CPAP therapy to mandibular devices. Let’s look at each option in detail. 

Mandibular devices and oral appliances

In mild cases, you can get relief and improve your sleep by wearing an oral appliance or mandibular device.

These are similar to retainers, and are worn at night to keep the tongue and jaw in a position that allows for normal breathing and prevents snoring.

Oral OSA appliances are custom-made devices, which require taking an impression of your teeth to get a good fit.

CPAP therapy 

Continuous Positive Air Pressure therapy (CPAP) is the most common treatment option for moderate and severe OSA. 

CPAP requires using a special machine, which pumps pressurized air into your airways via a face mask. The constant flow of air prevents the throat muscles from blocking your airways, and reduces the number of breathing interruptions you experience every night.

Some studies have found that in some cases, CPAP can also help improve chronic cough. Conversely, if CPAP makes you cough, there are adjustments that can make CPAP more comfortable – this should be discussed with your sleep specialist.

Surgical treatment

If all else fails, or in cases where OSA is caused by physical abnormalities, surgery may be the best option. Surgical interventions may include tonsil or extra tissue removal, or repairing abnormal facial or neck structures.

Don’t ignore chronic cough

If a cough has become chronic, see a doctor asap to determine what’s causing it. Remember that this issue could be a symptom of obstructive sleep apnea, which must be treated promptly to prevent further complications.