Cough Frequency: Chronic Cough as an Indicator for Health and Disease

The Hyfe Mind

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July 21, 2020
CoughPro is not a medical product. It is a wellness app intended only for users to obtain a better understanding of their cough. It is not intended to diagnose, monitor, or treat any illness.

We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.

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Coughing is one of our daily reflexes assisting us with tackling germs and other environmental irritants. Today, with the looming COVID-19 pandemic, having a cough is considered a serious indicator of an underlying illness, and it needs more attention, such as its frequency.

Cough on its own has several different traits which assist in indicating whether there might be an underlying disease or not. For one, coughs can be categorized as either a wet cough or a dry cough. A wet variant produces phlegm which can range in consistency and color. A dry cough is categorized when there is no phlegm produced.

Even after breaking it down to its basic variants, there are other things to consider when analyzing a cough. These include:

  • Understanding how many times coughing occurs throughout the day
  • Whether a cough occurs more at night or during the day
  • Tracking a cough after certain activities such as eating or sleeping

These factors make tracking cough frequency, especially with lingering nagging coughs, an essential marker for overall health.

How Many Coughs per Day is Normal?

Research on cough frequency estimated about 18.6 coughs/day as normal among healthy adults.

Several factors contribute to your cough frequency throughout the day. For one, women were observed to have a higher 24-hour cough frequency than men. This higher frequency is because women's cough receptors are more sensitive. There are many factors contributing to this simple statistic. One of which is that women are more likely to report coughs. Often this is because the other concerns might coincide with a cough, such as stress urinary incontinence. 

Another factor that can increase the reporting of coughs is direct environmental exposure. For instance, those who live in polluted cities or houses with minimal ventilation are more likely to observe coughs throughout their day. With time this cough frequency can increase because of the pollutants and allergens the cough receptors are exposed to.

An additional consideration to make for cough frequency is if the cough had a recent onset (acute) or it has been a persistent cough over a significant period (chronic). With acute coughs, the 24-hour cough frequency can often be higher because of the ongoing respiratory tract infection that has possibly resulted in the cough. Until the infection clears, the cough frequency can remain high.

With chronic coughs (which last more than eight weeks), the 24-hour cough frequency can be lower, but it is often persistent throughout the weeks. Therefore, in a clinical setting, such information as the duration of cough, the number of coughs per day, and the cough consistency help to narrow down a possible cause efficiently.

What Does It Mean If I Cough Frequently?

Coughing frequently throughout the day and for an extended period is an indication of underlying disease. If you are coughing significantly throughout the day and for a long time, consult with a healthcare provider.

frequent and persistent cough is a direct indication of an underlying disease. If your cough has lasted for a short duration, less than three weeks, it is called an acute cough. This cough is frequently an indication of an underlying infection. Being newly exposed to irritants and allergens also cause acute bouts of cough throughout the day.

subacute cough lasts between three and eight weeks. This variant of cough is often a remnant cough from a previous infection. This type of cough may have a lower frequency throughout the day, but it is still a persistent part of the day.

chronic cough, as mentioned above, is a cough that has lasted beyond eight weeks. The lingering effects of a recent infection can cause a chronic cough. Such as observed with COVID-19, a chronic cough is a part of a post-COVID syndrome. Continuous exposure to allergens and pollutants is also a notable cause for increased frequency chronic cough. Conditions such as a postnasal drip, GERD, and asthma are also common causes for increased coughing throughout the day.

On average, with any respiratory tract infection, it is common to have a cough be persistent for the first couple of weeks and decrease in frequency as the infection wanes. If your cough has lasted beyond eight weeks, ruling out the usual suspects of chronic cough as well as a possible underlying respiratory disease would be ideal.

How Is Cough Frequency Measured?

Recording a cough manually seems tedious and is likely to fail to accurately capture the different facets of a cough. To begin with, there can be a bias in the simple fact of what is precisely a cough suitable for recording.

Certain coughs might not classify as a cough for some but should ideally be recorded. And with manual recording, it is often easy to forget to register several of the coughs in the day, reporting a value below the true cough frequency. Such visual analog scales to record coughs have been used in the past, but have had to undergo several changes to journal coughs efficiently.

The lack of reliability of manual recording propelled today's technology to bridge this gap, enabling easier cough recording with minimal effort required. With smart devices available at almost every fingertip, being able to journal a cough and its different facets has become relatively effortless. In addition, cough recording is now continuous. Factors such as cough consistency, environment exposure, current symptoms, and medications taken are all included with the cough data.

Measuring your 24-hour cough frequency this way also gives a better idea of how the cough has progressed for a few days. In addition, this assists your healthcare provider with having a more holistic picture of the possible causes for the cough and approaches to treat the cough as well.

Regular cough recording can also note whether cough frequency is increasing or decreasing or, in some cases sustaining. Respiratory health research also benefits tremendously from this information to discover how various health conditions have alternate cough frequencies, easing diagnosis over time.

Can Cough Frequency Be Used For Overall Health?

Living during the COVID-19 pandemic, the often overlooked cough has become an important diagnostic tool for understanding and predicting disease. For example, suppose you analyzed cough frequency in the clusters where COVID-19 originated. In that case, it could have helped project how serious the pandemic would have become.

On an individual level, marking cough frequency can help identify how cough relates to either infection or environmental exposures. For example, exposure to smoke, pollutants, or underlying infection can exacerbate your chronic cough frequency if you have conditions like COPD or bronchitis.

Along with cough frequency, smart devices pick up acoustic variations such as crackles in pneumonia and wheezing with asthma. However, the human ear can often miss these sounds and are diagnostic points for these conditions.

Since it is rare for coughs to be present during a doctor's visit, pre-recording a cough can assist with a better understanding of overall health. In coughs associated with stomach acid reflux, coughs are common at night when lying down. Displaying such a cough in a clinical setting would be slightly difficult. Similarly, in conditions such as heart failure, coughs occur at night. They are often coupled with breathlessness which is not often recorded when sitting upright. 

Conclusion

While coughing is just a small indication among a wide variety of signs for a particular disease, it can be a crucial diagnostic tool to understanding disease type and progression.

It is often challenging to see cough and assess 24h cough frequency in clinical practice since doctor visits occur for a short duration. This short time for observation is why cough tracking through smart devices becomes crucial in diagnosis. Cough frequencies, when optimally recorded, can also help develop customized treatment strategies.

Considering a global perspective, having a database of cough frequencies enables the fine-tuning of disease diagnosis and optimizes treatment strategy. This dataset becomes paramount in respiratory conditions like tuberculosis and COVID-19 to limit disease spread.

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