Dr Krishna Sundar Previews His Discussion on Management of Chronic Cough

Chronic cough is frustrating for both patients and their family members, especially during the pandemic, so there is a need for these patients to be appropriately evaluated and treated, explained Krishna M. Sundar, MD, FCCP, clinical professor, Pulmonary Division, the Department of Medicine, and medical director for the Sleep-Wake Center at the University of Utah, when discussing this year’s CHEST meeting.

Transcript

What will your talk on multispecialty management in unexplained chronic cough encompass?

I'm doing, I think, 1 of the 4 talks in that. So chronic cough is a pretty common problem in primary care and subspecialty clinics. These are patients that have been coughing for a few months or longer, and then there is something called chronic refractory cough. So most of the chronic cough patients get treated for acid reflux disease, asthma, and rhinosinusitis, any sinus problems. If they still persist with cough, then they undergo further investigated workups and further evaluation by specialists. Some of these patients have been coughing for decades, 5 years, 10 years, many years, and it’s frustrating for them and their family members, and especially during this COVID-19 [coronavirus disease 2019] period. Normally, everybody shies away from anybody who’s coughing. So, again, even before COVID-19 there was clearly a need for these cough patients to be appropriately evaluated and treated. So beyond the routine therapies, look for a cause for cough, such as acid reflux or postnasal drip.

This session actually looks at therapies beyond the usual ones that have been shown to be of some benefit. So one of the sessions, it’s on behavioral speech therapy, which looks at working the laryngeal function in these patients to see if it improves cough. My talk looks at management of comorbid sleep apnea, so they have coexisting sleep apnea. Sleep apnea is an extremely common problem, and there is a prevalence, again, a significant prevalence. Again, at least a third of these patients may have sleep apnea. And if we can treat that, there seems to be a benefit in terms of cough.

So my portion is dedicated to the role of treating coexisting sleep apnea in these patients and looking at the science behind it to see why it may be effective in these patients.