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Lung diseases

Chronic morning cough for 3 years

08/21/2007

Question:

I am a 24 year old male. Aside from this particular problem, I have been told by my doctor that I am in good overall health. For the last 3 years or so, I have suffered from a chronic morning cough. As soon as I wake up every morning, I go into a severe coughing spasm that usually lasts for about 2 minutes, after which I continue coughing heavily for another 20 minutes or so. During the initial spasm, I cough continuously until I am forced to take a breath, and I have come close to passing out on occassion, but never have completely. This initial spasm produces an extremely large amount of mucus, almost to the point of being unable to control the flow - extreme amounts drip from my nose, and I cough up quite a bit as well. After the initial spasm, I continue coughing for another 20 to 30 minutes, and this is typically a dry cough, not producing anything. After this, I do not cough much at all for the rest of the day, and experience no lung capacity problems or any other signs of lung issues.

I am a smoker, and have been told that this is the cause - but is it the only cause? About a month ago, I began taking nasal decongestants before I went to bed. For a month, the cough almost completely disappeared. Now it appears that the decongestants are no longer helping, the cough is back. One coincidence that might be a contributing factor is that now I sleep with a fan blowing on me all night, when I didn`t before. Could this be causing a coughing problem?

I would appreciate any help... I am trying to quit smoking, but it is very difficult when I live in a house full of smokers. I just wanted to know if quitting smoking would get rid of the cough forever, or if there might be an underlying cause.

Answer:

Certainly this can be related to smoking. Smoking can cause an increase in sputum production and decreases your lung’s ability to clear these secretions. This morning cough may merely be your lung attempt to clear itself out. The first thing I would recommend would be to stop smoking. There are several ways to do this, as well as new medications to help with this.

Most chronic coughs are related to one of three things:

The decongestants may have stopped working because people build a tolerance to them after a while. A nasal steroid (and a anti-histamine) may help treat your nasal symptoms and subsequently your cough as well.

Lastly, although usually cough is a result of the above, occasionally it can be a symptom of a much larger problem and should not be ignored. You should discuss your symptoms with your doctor.

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Response by:

James   Knepler, MD James Knepler, MD
Formerly, Assistant Professor
College of Medicine
University of Cincinnati