Nocturnal Cough

A cough serves as both a symptom and a reflex action, a crucial defense mechanism ensuring the expulsion of mucus, harmful substances, and infections from the larynx, trachea, and broader bronchial passages. Interestingly, women tend to experience chronic coughing more frequently, accompanied by an elevated sensitivity in their cough reflex compared to male. The distressing presence of a nocturnal cough can disrupt sleep patterns and cause discomfort. According to the insightful publication by StatPearls on the NCBI Bookshelf, the origins of a nocturnal cough can be classified into three categories: respiratory, non-respiratory, and systemic. To comprehensively evaluate a nocturnal cough, one must consider its intensity, severity, frequency, and sensitivity. During a general examination, aspects like clubbing (potentially indicating vasculitis, sarcoidosis, or malignancies), pedal edema, and lymphadenopathy warrant careful assessment. Mandatory for all cases is a chest x-ray, a diagnostic imperative. A chronic cough accompanied by a seemingly normal chest x-ray could be attributed to ACE inhibitor therapy, postnasal drip, gastroesophageal reflux disease (GERD), or asthma, which collectively account for a substantial 90% of cases. Whenever feasible, sputum examination becomes an essential part of the diagnostic process.
The approach to treating upper airway cough syndrome hinges on discerning its underlying cause, with specific emphasis on encouraging smokers to discontinue their habit. Treatment strategies encompass the use of first-generation antihistamines, antibiotics, nasal saline irrigation, and nasal pump sprays containing glucocorticoids, sometimes combined with decongestants like pseudoephedrine. For a comprehensive understanding of potential differential diagnoses and complications, additional information can be accessed through the provided link.