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Asthma

Why do I cough in the morning?

05/18/2009

Question:

I am a 29 year old female who gave up smoking (mostly!) about 6 years ago, although i admit when i am extremely stressed, mostly due to work, i will smoke a packet, probable equivalent to one a year, maybe two if i am extremeley stressed.i was diagnosed with mild asthma at the age of nine, it gave me now problems until about three years ago, when during the winter months i will cough violently, but also have an extraordinarily runny nose as well, at which point i visit the doctor who gives me a seretide puffer which controls my symptoms well.three years ago, i started working in child care and had low immunity to the level of things you can catch from kids and cought pnuemonia that year.my main question is even when we are not in the winter months, i wake up most mornings, couphing.it prodices mucous when i cough and i feel a bit short of breath, as i would in winter when my asthma plays up all the time.is this normal.i only use seretide in winter, when the coughing/runny nose are bad and don`t use my ventolin when the cough is only in the morning as i was told its not good to use it a lot, only when really needed, as it can loose its effectiveness.anything to worry about?should i use my ventolin without worrying im using it to much and should i be on seretide at times even when my asthma is only producing a morning cough?

Answer:

Even in the normal state a person's lung function is at its lowest in the morning. In patients with asthma or tobacco induced lung disease, they often have symptoms first thing in the morning. Smoking can cause emphysema which is physical destruction of the lung tissue or chronic bronchitis which is due to the effects on the airways and results in daily sputum production, often in the morning. Asthmatics who smoke are often more symptomatic then those who do not. Your symptoms may be due to either asthma or tobacco injury to your lungs. I would suggest you visit an asthma specialist for a full evaluation including measurements of your lung function. Once an evaluation is completed then the appropriate therapy can be prescribed.

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Response by:

John G Mastronarde, MD John G Mastronarde, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University