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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cough syncopes are rare but may be one of the cause of sudden loss of consciousness. We recorded under video-EEG monitoring a typical syncope triggered by voluntary coughing (video) and Valsava maneuvre in a patient referred for the diagnosis of generalized tonic-clonic seizures. There were no signs of active epilepsy. The attacks were associated with overweight, obstructive sleep apnea and heavy consumption of cigarettes. [Published with video sequences].
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PMID:Cough syncope misinterpreted as epileptic seizure. 1878 92

Epilepsy and obstructive sleep apnea (OSA) are two relatively common disorders known to coexist and potentially exacerbate each other. Vagus nerve stimulation (VNS) is a currently used, adjunctive treatment for partial epilepsy and is generally well tolerated with few associated side effects. Some of the more common side effects include hoarseness of voice, laryngeal irritation and cough, especially after VNS current increases and the first few weeks of treatment. VNS therapy also affects respiration during sleep and has been shown to worsen preexisting obstructive sleep apnea/hypopnea syndrome (OSAHS) by increasing the number of apneas and hypopneas. Consistent sleep related decreases in airflow and effort coinciding with VNS activation have been documented, with apneas and hypopneas found to be more frequent during VNS activation than during nonactivation. VNS may also interfere with effective CPAP titration. The purpose of this case study was to examine the effects of VNS cycling on CPAP titration for OSA in a patient with medically intractable epilepsy. We found that adequate CPAP titration could not be achieved in the presence of the patient's standard VNS on/off cycling mode. However, when the patient was restudied with his VNS device turned off, a nasal CPAP pressure of 13 cm H2O resulted in effective treatment of his severe OSAHS. We suggest that polysomnography before VNS implantation should be considered in order to identify patients with OSA.
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PMID:Vagus nerve stimulation, sleep apnea, and CPAP titration. 1885 6

Injury to the cervical and upper thoracic spinal cord disrupts function of inspiratory and expiratory muscles, as reflected by reduction in spirometric and lung volume parameters and static mouth pressures. In association, subjects with tetraplegia have decreased chest wall and lung compliance, increased abdominal wall compliance, and rib cage stiffness with paradoxical chest wall movements, all of which contribute to an increase in the work of breathing. Expiratory muscle function is more compromised than inspiratory muscle function among subjects with tetraplegia and high paraplegia, which can result in ineffective cough and propensity to mucus retention and atelectasis. Subjects with tetraplegia also demonstrate heightened vagal activity with reduction in baseline airway caliber, findings attributed to loss of sympathetic innervation to the lungs. Significant increase in airway caliber following inhalation of ipratropium bromide, an anticholinergic agent, suggests that reduction in airway caliber is not due to acquired airway fibrosis stemming from repeated infections or to abnormal hysteresis secondary to chronic inability of subjects to inhale to predicted total lung capacity. Reduced baseline airway caliber possibly explains why subjects with tetraplegia exhibit airway hyperresponsiveness to methacholine and ultrasonically nebulized distilled water. While it has been well demonstrated that bilateral phrenic nerve pacing or stimulation through intramuscular diaphragmatic electrodes improves inspiratory muscle function, it remains unclear if inspiratory muscle training improves pulmonary function. Recent findings suggest that expiratory muscle training, electrical stimulation of expiratory muscles and administration of a long-acting beta(2)-agonist (salmeterol) improve physiological parameters and cough. It is unknown if baseline bronchoconstriction in tetraplegia contributes to respiratory symptoms, of if the chronic administration of a bronchodilator reduces the work of breathing and/or improves respiratory symptoms. Less is known regarding the benefits of treatment of obstructive sleep apnea, despite evidence indicating that the prevalence of this condition in persons with tetraplegia is far greater than that encountered in able-bodied individuals.
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PMID:Pulmonary function and spinal cord injury. 1944 29

In November 2007, a 30-year-old obese woman was admitted to our hospital with a complaint of persistent dry cough. Her chest-X-ray and computed tomography revealed multiple infiltrative shadows with air bronchograms in all lung fields. The bronchoalveolar lavage fluid revealed small bodies of Cryptococcus species. Cryptococcal serum antigen was also positive. To examine the cause of her snoring, polysomnography was done and revealed obstructive sleep apnea syndrome. The patient was given a diagnosis of primary pulmonary cryptococcosis with obstructive sleep apnea syndrome. After 12 months of treatment with fluconazole, the infiltrative shadows disappeared. Pulmonary cryptococcosis should be considered in the differential diagnosis of pulmonary multiple infiltrated shadows in patients without immunological abnormalities.
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PMID:[Primary pulmonary cryptococcosis with multiple infiltrative shadows complicated by obstructive sleep apnea syndrome]. 1960 35

Cough and sleep are vital functions. The effects of cough on sleep and vice versa are important for a number of reasons. Sleep disruption is common in patients with cough and is often the reason why they seek medical attention. Sleep suppresses cough and the biological mechanisms for this action are poorly understood. Cough has recently been reported as a presenting symptom of obstructive sleep apnea. It is uncommon for healthy people to cough at night; however, approximately 50% of patients with chronic cough report sleep disruption due to cough. Cough frequency is much lower at night than during the day. There is reduced exposure to tussive stimuli at night and decreased cough reflex sensitivity. Cough is more difficult to induce in REM sleep compared to slow-wave sleep. Studies of anesthetized humans have shown that the cough reflex is suppressed; however, the expiratory reflex is less affected. The sleep-cough interaction has implications for the physician. The measurement of cough frequency with 24-h ambulatory cough monitors in patients with chronic cough suggests that the presence or absence of nocturnal cough is not helpful in establishing the etiology. Nocturnal cough may be a useful outcome parameter for clinical trials of antitussive drugs since it is under less voluntary control than daytime cough. Most antitussive drugs are sedatives. This suggests that part or all of their action may be through an effect on cortical neural pathways. Unexplained chronic cough has recently been reported as a presenting feature of obstructive sleep apnea. Patients are likely to be female and report gastroesophageal reflux and rhinitis. Continuous positive airway pressure therapy is effective in alleviating cough. Greater awareness of this condition is needed.
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PMID:Cough and sleep. 1982 13

The outcome of patients with idiopathic pulmonary fibrosis (IPF), which represents the most common type of idiopathic pulmonary pneumonias, is poor. Breathlessness and coughing are usually progressive and about 50% of he patients die within 3 years after diagnosis. The effect of medical treatment in terms of survival is disappointing. Most of the currently available studies only focus on daytime diagnostics and therapy. The role of sleep quality and sleep disordered breathing in IPF is only investigated in a small number of papers, which can be summarized as follows: sleep fragmentation in IPF is very common. The reasons might be coughing, nocturnal oxygen desaturations, and increased respiratory drive. Sleep disorders in IPF have a profound impact on the quality of life. Oxygen desaturations often appear during sleep and can be predicted by the PaO(2) during wakefulness. There are no evidence-based recommendations concerning the indication for oxygen therapy and non-invasive ventilation during sleep in IPF. Obstructive sleep apnea (OSA) has no increased incidence with the exception of the IPF patients with an increased body mass index. If, however, OSA is present in IPF oxygen desaturations are more profound. The therapy of sleep disorders and sleep disordered breathing in IPF is individual. But in the absence of an effective treatment of IPF, optimization of sleep and life quality by the treatment of sleep disorders seems to be a primary goal. Further studies are needed to determine special sleep-related treatment effects.
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PMID:Sleep and breathing in idiopathic pulmonary fibrosis. 2013 32

Adenoidal hypertrophy is probably the most frequent pathology in the pediatric population. This disorder manifests with several symptoms such as bilateral nasal obstruction, rhinorrhea, cough, snoring, hyponasal speech, hypopnea, and sleep apnea. When tonsillar hypertrophy is also present, obstructive sleep apnea syndrome can manifest. To date, nasal endoscopic examination is the standard technique to diagnose and estimate adenoid mass. Adenoidectomy is considered the surgical treatment of choice to resolve nasopharyngeal obstruction due to adenoidal hypertrophy. At present, several pitfalls of adenotomy (i.e., alteration of the immunological system, postoperative bleeding, and recurrence of adenoids) are object of criticism. For this reason, some researchers have tested the efficacy of topical nasal steroids in decreasing the severity of nasal symptoms and adenoidal mass. Herein, we review the literature on conservative treatments including also our personal experience.
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PMID:Can adenoidal hypertrophy be treated with intranasal steroids? 2019 84

Sleep hypoventilation is seen in patients with neuromuscular disease, as well as in those with obesity hypoventilation syndrome (OHS), which is defined as the combination of obesity, chronic hypercapnia, and hypoxemia during wakefulness that is aggravated during sleep. In 90% of cases, OHS is accompanied by obstructive sleep apnea. The diagnosis of OHS is based on hypoventilation and pulmonary hypertension that cannot be explained by alterations in pulmonary function. The mortality of patients with OHS is greater than is that of obese patients without hypoventilation. The principal neuromuscular diseases associated with OHS are the muscular dystrophies. The progression to chronic respiratory failure results from respiratory muscle weakness and impaired airway secretion clearance, causing atelectasis and pneumonia. With a decrease of greater than 50% in respiratory muscle strength, there is a reduction in VC. Cough peak flow < 160 L/min is associated with impaired airway secretion clearance, and values near 270 L/min indicate the need for assisted cough techniques. Obstructive sleep apnea usually worsens sleep hypoventilation. Noninvasive ventilation during sleep can improve survival, symptoms, and hypoventilation during wakefulness, as well as being able to improve pulmonary function in patients with neuromuscular disease. Patients with OHS can require oxygen therapy.
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PMID:[Sleep hypoventilation]. 2094 82

There has been significant progress in the field of cough in the past 10 years. Obstructive sleep apnoea, tonsillar enlargement and environmental fungi have recently been described as causes of chronic cough. The advances in the assessment of gastro-oesophageal reflux (GOR) have led to a greater understanding of the relationship between cough and GOR and are likely to change the approach to managing patients with GOR-cough. The investigation of the phenotype of patients with idiopathic chronic cough has provided novel insights. Patients with an idiopathic chronic are predominantly female, have an onset of cough around the menopause and have a high prevalence of organ specific autoimmune disease, particularly hypothyroidism. The presence of bronchoalveolar lymphocytosis suggests there is homing of inflammatory cells from primary sites of autoimmune inflammation to the lungs. A heightened cough reflex is a key feature of most patients with chronic cough and has led some investigators to suggest that chronic cough be recognised as a unique entity called Cough Hypersensitivity Syndrome (CHS). A number of subjective and objective tools have been developed recently to assess cough severity. Antitussive drug development is an emerging and exciting area of cough research.
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PMID:New concepts in the management of chronic cough. 2125 71

Sleep disruption is a common feature both in the patients with chronic cough and in the patients with obstructive sleep apnea syndrome (OSAS). There is increasing body of evidence that chronic nocturnal cough may be related to OSAS. We describe a 59 years old, obese man (BMI 38,6 kg/m(2)) with asthma and chronic nocturnal cough not responding to the optimal anti-asthmatic treatment. On the basis of nocturnal polysomnography moderate form of the OSAS has been diagnosed and the treatment with continuous positive airway pressure (CPAP) has been started. All the nocturnal symptoms, including cough, disappeared. The effect of CPAP in preventing nocturnal cough persisted at the follow-up visit after a year since diagnosis. This case indicates that nocturnal cough may be an important symptom of the OSAS and CPAP treatment - by abolishing sleep apneas and hypopneas - may also prevent chronic cough during sleep.
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PMID:[Suppression of chronic nocturnal cough during continuous positive airway pressure (CPAP) treatment in a patient with asthma and obstructive sleep apnea syndrome]. 2135 Oct 63


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