Night cough in a population-based sample of children: characteristics, relation to symptoms and associations with measures of asthma severity

Abstract

Nocturnal cough in asthma is a common but poorly understood phenomenon. The aims of this study were to determine the relationship between recorded night cough, reported night cough and current wheeze in a population-based sample of children previously identified as wheezy, and to examine the relationship of nocturnal cough to current symptoms, markers of asthma severity and environmental exposure.Children were reassessed in the early school years by measuring current symptoms, ventilatory function, bronchial reactivity, peak flow variability, respiratory symptom diaries and home monitoring of overnight cough, transcutaneous arterial oxygen saturation, room temperature and humidity. Night studies were performed on 59 asymptomatic children and 41 children with current wheeze.Cough occurred more frequently in current wheezers compared to asymptomatic children (16 out of 41 (39%) vs 11 out of 59 (19%)), and more cough episodes were recorded (median 3.5 vs 2.0). Night cough was not associated with bronchial reactivity, peak flow variability, degree of morning dip, mean overnight arterial oxygen saturation, ventilatory function, maternal smoking or treatment of asthma. However, it was associated with lower overnight air temperature.Although night cough is more common in current wheezers, there is poor agreement between recorded and reported night cough. Objective tests of asthma severity are of little use in predicting its presence in this age group. The sleeping environment deserves further study. Eur Respir J., 1996, 9, 65- [7]. This work has shown that these cyclical phenomena reach a bathysphase (lowest point) during the night [7][8][9][10]. The timing of nocturnal cough does not tally with the bathysphase of these same measures, possibly indicating an imprecise relationship between cough and other measures of asthma severity. Clarification of the precise relationships between nocturnal cough and measures of respiratory function are further hampered by the poor reporting of nocturnal cough, particularly in children [11,12]. In addition, most reported studies have concerned children with severe asthma and/or asthmatics undergoing therapeutic trials to reduce night cough [13]. Finally, it has been recognized that the analysis of factors important in determining night cough may be confounded by environmental exposures, such as tobacco smoke [14], pollutants [15] and dampness [16].We have studied night cough in a population-based cohort of children aged 4-7 yrs, who had previously been identified as having wheeze in the preschool years, with the following aims: 1) to determine the relationship between recorded night cough and recent wheeze (within the last year); 2) to compare the reported frequency of night cough with that actually recorded at night; 3) to define the nature and timing of nocturnal cough in those with and without wheeze in the preceding year; and 4) to determine whether factors, such as lung function, bronchial reactivity and environmental exposure, predict, or are associated with, nocturna...

Dampness, food habits, and sick building syndrome symptoms in elementary school pupils

“…Home dampness is reflected in evening and night exposure, and nocturnal cough is common in asthmatic patients [30]. The adverse effect of school dampness on respiratory symptoms has also been reported [31].…”

Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents

“…9,18 That noted, subjective reporting of cough by children and their parents has been shown to be imprecise. [33][34][35][36][37][38] These studies, however, were performed on children with chronic cough, asthma, or cystic fibrosis as opposed to the acute cough that was evaluated in this study. In addition, in this investigation, each parent served as his or her own control, because their answers were compared with their own responses from the previous night.…”

Cough * 2: Chronic cough in children

“…23 Several epidemiological studies have shown that chronic isolated and non-specific cough improves with time without treatment. [24][25][26] …”