Dr Krishna Sundar: Airway Collapse, Upper Airway Trauma Contribute to the Co-occurrence of Chronic Cough, Sleep Apnea

January 16, 2021

There is a greater prevalence of acid reflux disease in patients with both of these conditions, and treating the sleep apnea in turn may improve the acid reflux, which then may improve the cough, stated Krishna M. Sundar, MD, clinical professor, Pulmonary Division, Department of Medicine, and medical director, Sleep-Wake Center, University of Utah.

There is a greater prevalence of acid reflux disease in patients with both of these conditions, and treating the sleep apnea in turn may improve the acid reflux, which then may improve the cough, stated Krishna M. Sundar, MD, clinical professor, Pulmonary Division, Department of Medicine, and medical director, Sleep-Wake Center, University of Utah.

Transcript

How are chronic cough and sleep apnea interrelated?

During sleep apnea, there's collapse of the upper airway. So there's constant closing and reopening of the upper airway. So there is a fair degree of upper airway trauma, which may cause damage to the nerve endings in the airway. These nerve endings may be important in sort of mediation or may be important in sort of leading to what we call neuropathic changes, which we now think form the basis of this chronic cough. So that's one explanation.

The other thing is that these patients tend to have more acid reflux disease. So if we treat the sleep apnea, that acid reflux gets better and that may improve the cough.

And thirdly, there may be also some effect of when somebody goes on CPAP [continuous positive airway pressure], the mask and machine at night, there is some degree of lung inflation, which may have direct effects on the cough.