The Cold Facts About the Urge to Cough

Coughing is a simple brainstem-mediated reflex, but the urge to cough follows a complex pathway across higher-order brain regions.

Afferent signals sent from the respiratory tract via the limbic system satisfy the urge to cough, while several other factors such as respiratory afferent activity, respiratory motor drive, and affective state mediate cognitive awareness of the urge to cough. Meanwhile, sleep, general anesthesia, congenital central hypoventilation syndrome, and aspiration pneumonia may reduce a person’s urge or ability to cough.

All of these factors are science-based, but patients deal with cough with no thought about how these things happen. For them, cough is an intensely personal experience, and they deal with it through various management strategies.

At the March 2016 American Academy of Allergy, Asthma & Immunology meeting, a team of researchers characterized the urge to cough in patients who developed the most annoying of conditions: the common cold.

The researchers created an online survey in April 2015 to collect demographic data, urge-to-cough attributes and impact, and participants’ management choices. They invited participation from those who had a common cold in the past 3 months but did not have a history of chronic cough.

The 2708 participants who met the survey criteria reported that talking, cold air, and changing positions were the most common reasons their urge to cough increased. The top complaints were uncontrollable urge to cough (62%), throat clearing (40.4%), and sore throat (36.5%).

Treatment approaches varied. Around three-quarters of the participants had tried OTC therapy for their cough. One in 6 respondents sought medical attention, 86% of them received medical advice, and 96% followed the advice they received.

Recommendations from health care providers included prescription medications (66.5%), OTC medications (45.7%), herbal remedies (15.1%), and home remedies (12.6%).

Almost every participant who had the common cold reported cough, and most used some type of medication for this symptom.

All of this information could help researchers in the area of antitussives target mechanisms that create the urge to cough and develop new products, the researchers concluded.