Chronic cough can be the sole presenting symptom for patients with obstructive sleep apnoea. We investigated the prevalence, severity and factors associated with chronic cough in patients with sleep-disordered breathing (SDB).We invited 108 consecutive patients who had been referred for evaluation of SDB to complete a comprehensive questionnaire on respiratory and sleep health, which included the Leicester Cough Questionnaire (cough specific quality of life; LCQ), Epworth Sleepiness Scale (ESS) and the Mayo Clinic gastro-oesophageal questionnaire. Chronic cough was defined as cough for a duration of .2 months.33% of patients with SDB reported a chronic cough. Patients with a chronic cough had impaired cough related-quality of life affecting all health domains (mean¡SEM LCQ score 17.7¡0.7; normal521). Patients with SDB and chronic cough were predominantly females (61% versus 17%; p,0.001) and reported more nocturnal heartburn (28% versus 5%; p50.03) and rhinitis (44% versus 14%; p50.02) compared to those without SDB. There were no significant differences in ESS, respiratory disturbance index, body mass index, or symptoms of breathlessness, wheeze, snoring, dry mouth and choking between those with cough and those without.Chronic cough is prevalent in patients with SDB and is associated with female sex, symptoms of nocturnal heartburn and rhinitis. Further studies are required to investigate the impact of continuous positive airway pressure therapy on cough associated with SDB to explore the mechanism of this association.
Chronic cough is a common reason for presentation to both general practice and respiratory clinics. In up to 25% of cases, the cause remains unclear after extensive investigations. We report 4 patients presenting with an isolated chronic cough who were subsequently found to have obstructive sleep apnoea. The cough improved rapidly with nocturnal continuous positive airway pressure therapy. Further studies are required to investigate the prevalence of coexistence of these common conditions.
A 40% rebound in SWS, but only a 20% rebound in REM sleep on the pressure titration study, is predicted by abnormal sleep architecture and sleep fragmentation prior to the commencement of treatment.
An overnight increase in CO2 and evening hypoxaemia are independent mortality predictors in SDB. A low minimum SpO2 identifies patients in whom morning and evening arterial blood gases are beneficial.
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