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.
Coughing is an essential defense mechanism that aids in clearing excessive lower respiratory tract secretions while also helping to protect the lungs from potentially toxic and hazardous foreign chemicals. However, it can also be a sign of a serious condition. This is where knowing and understanding types of cough is very helpful.
In this article, we will go through the key terms that doctors use to categorize coughs, explain and describe all cough types, as well as their meaning.
We can identify cough types based on their intrinsic characteristics such as productivity, time of day when they happen, sound, and duration. We often see more than one name for a single type of cough. The next section aims to cover all the types as well as their names so you can more easily and clearly communicate your cough type to your doctor.
Cough productivity refers to the production of mucus or phlegm when coughing. Depending on whether there is mucus or phlegm, coughs are generally classified into dry (unproductive) or wet (productive).
This is the type of cough that mostly produces dry air; it is also known as non-productive cough. Dry coughs frequently result from irritated or inflamed airways. As your body tries to remove the pathogen from your airways during the first few days of a respiratory infection, you could suffer from a dry cough.
There are numerous potential underlying reasons for dry coughs, including exposure to allergens, toxins, respiratory infections, and specific medications.
A tickly cough is a type of dry cough. It comes on as an irritating, ticklish feeling at the back of the throat that causes relentless coughing. Other symptoms that may accompany a tickly cough include:
They typically result from viral diseases like the flu or the common cold or from environmental factors like pollution or climate. Even if you don't have mucus in your lungs, the bronchial tubes can be inflamed, which generates a tickling sensation that makes you cough.
A hacking cough is a severe type of dry cough that makes a loud rough sound. One of its characteristics is that you continuously cough and feel as though something is stuck in your throat. You may experience a dry, hacking cough after inhaling some irritants, such as dust, smoke, or powder.
A hacking cough is most frequently caused by viral infections of the nose and throat, a disorder, such as an allergy, or an infectious condition, like viral laryngitis.
Wet cough is one that produces mucus or phlegm. It is also known as a productive cough. Wet coughs are caused by infections from microorganisms such as bacteria or viruses such as those that cause a cold or flu.
The most common symptom of wet coughs is mucus production. The mucus produced can be clear, white, yellow, green, or brown. Additionally, your chest may feel tight or produce a rattling sound when you breathe. Other symptoms that may accompany a wet cough include:
Determining what causes someone to cough can help a healthcare provider identify an illness that requires treatment. The time of day you cough or coughing after an activity can be an indication of a pattern.
A daytime cough as the name suggests typically occurs any time of day; morning, afternoon, or evening. A morning cough can occur for a variety of reasons, but not all of them are a cause for alarm.
Some of the causes of daytime coughs include:
On the other hand, a nighttime cough occurs during the night hours. While a cough at night is frequently brought on by the same factors that make you cough during the day there are reasons why some people mainly cough at night. These include:
Additionally, due to the fact that at night the airways are more sensitive and irritable, some conditions such as asthma can also elicit nightly coughing.
Clinicians frequently regard a given cough's distinctive sound1 as a helpful diagnostic trait. The auditory characteristics of respiratory sounds can be objectively evaluated via acoustic analysis to diagnose the underlying condition. Below are some types of cough sounds.
Wheezing2 is often described as a high-pitched sound with high-pitched whistling when breathing. Imagine the wind blowing through a tunnel or a dog’s squeaky toy sounds. The airways (narrowed due to inflammation) make musical or squeaky noises. Wheezing may be brought on by blockages or constricted airways.. The wheezing can often be heard without a stethoscope, but sometimes medical equipment is required.
A wheezing cough is typically triggered by asthma, allergies, viral infection, and, in some cases, more severe health conditions such as heart failure.
A wheezing cough can affect all ages, but it can be especially worrying when it occurs in infants. It is, therefore, essential to diagnose the underlying problem and treat the underlying cause.
Some common causes of a wheezing cough in adults include:
Some common causes of a wheezing cough in infants include:
Croup is an infection of the upper airways most often caused by a virus. Parainfluenza viruses (HPIVs) are the most common cause of croup, but influenza viruses, adenoviruses, enteroviruses, and the respiratory syncytial virus (RSV) can cause it as well.
The congestion brought on by the swelling of the upper airways produces the distinctive “barking” cough that sounds like a seal. Swelling in and around the voice box also causes a raspy voice and squeaky breathing noises.
Croup coughs can begin abruptly, frequently in the middle of the night. Children, typically younger than five years old, are particularly susceptible to croup. Most children with croup will also experience stridor, which is a loud, agitated inhalation (breathing in).
Whooping cough is also referred to as pertussis which is a very contagious respiratory illness commonly caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia, which line a section of the upper respiratory system and resemble tiny hairs. Toxins released by the bacteria damage the cilia and enlarge the airways.
The second stage of whooping cough, about two weeks3 into the beginning of the infection, is characterized by paroxysmal coughing. This violent and rapid coughing happens until the lungs are empty of air. At this point, you have to inhale, gulping air with the “whooping” sound that gives this condition its common name. These coughing fits can cause you to be very tired and lead to vomiting.
If you have a less severe or lesser condition, the "whoop" may not always be there.
Infants and young children whose immunities are still adjusting to their surroundings are frequently affected by whooping cough. Additionally, those who have never gotten the pertussis immunization are more vulnerable. Teenagers and adults, especially those who have had the pertussis vaccine, typically experience a milder infection.
Your doctor will want to determine how long your cough has lasted. The three common descriptions of cough duration4 are acute, subacute, and chronic.
When a cough lasts three weeks or less, it is considered acute.5 Most frequently, a viral infection of the upper respiratory system (e.g., the common cold) or lower respiratory system (e.g., acute bronchitis) is the culprit. As described above, coughing like this can either be productive (produces mucus) or nonproductive (dry, no mucus). The flu, pneumonia, and COVID-19 can also cause an acute cough.
Subacute coughs typically last between three and eight weeks before the cough eventually resolves, usually on its own.
The most common cause of a subacute cough is postinfectious cough.6 The causes of postinfectious cough are:
If a subacute cough9 has a known cause, treating this is the best way of getting rid of the cough. If the reason for the cough is unknown and it persists, it is treated as a chronic condition.
Everyone periodically coughs, but one sort of cough that frequently raises concern is a chronic cough – a persistent cough that lingers. In adults, a cough is considered chronic if it lasts longer than eight weeks; in children, the limit is four weeks. For many people with a persistent cough, it can last for months or even years. For others, it can return seasonally or it can happen in specific circumstances, such as chronic cough in pregnancy.
Coughing is often caused by another condition. When this is the case, we identify cough by what is causing it. The next section will explore some common causes of cough.
A nagging cough isn’t always a sign of something severe. It could be upper airway cough syndrome (UACS, formerly known as postnasal drip syndrome/PNDS),10 one of the most common causes of chronic cough11 in adults.
Broadly speaking, UACS is a chronic cough12 featuring odd sensations in the upper airway. It is a chronic upper respiratory tract irritation that comes with hypersensitive cough receptors.
Some definitions of UACS, describe a tickly cough with milder symptoms during the day, that worsen in the mornings and at night. Some reports describe a feeling of something in the throat or the presence of mucus. Regardless, a strange sensation in the throat is pivotal to the diagnosis.
Several glands in your airways are constantly creating mucus. The main function of this mucus is to lubricate the airway and filter out extraneous objects that would otherwise find their way into the respiratory tract.
This includes allergens. Some examples of common allergens and irritants are:
The majority of the time, the amount of mucus produced is small and it is unconsciously swallowed.
However, occasionally, the mucus production is excessive and slowly trickles down your throat from your nostrils, building up and irritating you. This drip of abundant mucus causes ongoing irritation, and a persistent cough develops.
While it’s usually not dangerous, it can be an annoyance.
GERD happens when stomach acid backs up in your throat (in your esophagus, to be exact). This condition can happen occasionally or persistently, depending on the severity of the disease. Having acid in your esophagus can lead to heartburn and other symptoms, as well as tissue damage if it persists.
Even though it’s normal to have acid reflux from time to time, GERD is diagnosed through an esophageal pH test to measure the pH or amount of acid that flows into the esophagus from the stomach during a 24-hour period.
There are many causes of GERD, and most of them are related to people’s eating habits although in some cases, it is caused due to a faulty digestive system.
GERD often afflicts those who are experiencing one or more of the following conditions:
There are various symptoms of GERD, but the most common one is heartburn. Heartburn is usually described as the discomfort or burning sensation in your chest. It tends to worsen when you bend over, lie down, or after eating food.
However, not everyone with GERD experiences heartburn. There are also other symptoms such as:
While asthma commonly comes with coughing and a whistling or wheezing sound in the chest, there is a type of asthma referred to as Cough Variant Asthma (CVA) where the only symptom is chronic cough.
Asthma coughing can happen both during the day and at night (which can make it difficult to fall or remain asleep). Exercise-induced asthma is common in those with CVA, where exercising causes the cough to get worse. Additionally, coughing may worsen due to exposure to asthma triggers, allergen-inducing factors like dust, potent smells, or cold air.
Cough-variant asthma can develop at any point in life, although it's most frequent in young children with childhood asthma. Cough-variant asthma may then cause "classic" asthma to develop.
Neurogenic means originating from the nervous system. A neurogenic cough is a persistent cough that develops after an infection that has damaged the nerves that supply the larynx. This can lead to the nerves becoming overactive or oversensitive13 after recovery from the infection.
Clinical examination of neurogenic cough is difficult since it is a sensory phenomenon and hence subjective. Therefore, it is typically a diagnosis of exclusion14 where other causes of cough must first be investigated before diagnosing a chronic cough as neurogenic.
Patients with neurogenic cough may be more sensitive to chemical, thermal, mechanical, and other stimuli because of their nerves’ hyperreactive state. Other common triggers of a sensory neuropathic cough15 include:
It is possible for a cough to be accompanied by other symptoms like globus (the feeling of something in your throat), throat pain, throat clearing, dysphonia (hoarse, raspy, or strained voice), dyspnea (shortness of breath), choking, and/or stridor (loud inhalation).
Tiny hair-like cells called cilia line our airways and catch any toxins we inhale. These cells then push the harmful substances away from the lungs towards the mouth so we can expel them.
Therefore you have to work harder to filter toxins if you smoke. This inhibits your lungs’ ability to remove harmful substances, which then settle in the lungs, causing inflammation and triggering coughing as the body tries to clear the lungs. Smokers’ coughs are also less effective19 at removing irritants than those of non-smokers.
Chronic cough has been linked to cumulative smoke exposure and its evidence is overwhelming, for example in a 34-year longitudinal study20 smoking cigarettes was substantially linked to coronary heart disease in males aged 45 to 64, but not in women or older men.
Smokers’ cough symptoms are case-by-case, and how it affects any individual varies. But in general, the main symptoms are a nagging cough that tends to be worse in the morning and lessons during the day.
Symptoms progress the longer one smokes. During the early stages, the cough is mostly dry, but it may produce sputum later on. Additionally, the phlegm may be colorless, speckled with blood, yellow-green, or brown.
While these aren’t the only symptoms, they are the most common. Other symptoms include:
In some cases, your doctor might suspect a cough has been brought on as a side-effect of taking a particular medicine. This is very unlikely if you have a persistent cough or one that lasts longer than eight weeks.
The most prevalent drugs with chronic cough as a side effect25 are angiotensin-converting enzyme inhibitors26 (ACE-I). They are widely used to reduce blood pressure in people with cardiovascular conditions such as myocardia. Other medications reported to cause a chronic cough include:
Therefore, a crucial step in the diagnosis and treatment of chronic cough is checking out your history regarding any medications that can cause chronic cough. You can check your medication on Drugs.com, and must talk to your PCP before stopping any medication that you think is causing a cough.
Habit cough also known as psychogenic cough, tic cough,30 or somatic cough syndrome, is a diagnosis that can only be made after ruling out everything else. This is a cough that has no physical cause but is maintained subconsciously by the person’s psyche. This occurs when a person has a habit of clearing their throat by coughing, even when there is no phlegm or mucus present.
The best way to identify31 a habit cough is by observing its total absence as soon as the cougher falls asleep.
Psychogenic cough can cause interference with daily activities, such as the cougher avoiding social situations for fear of judgment, and a propensity for secondary problems, such as school absence. Psychogenic cough is most effectively treated through psychotherapy or other behavioral approaches and does not respond to medication.
COVID-1932 is caused by the virus named SARS-CoV-2. It is a member of the coronavirus family, which also includes other viruses that cause more serious (but less common) disorders including the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), and those that cause the common cold.
Coronaviruses, like many other respiratory viruses, spread quickly through droplets that are emitted from the mouth or nose during breathing, coughing, sneezing, or speaking.
According to CDC,33 people with COVID-1934 have reported experiencing a wide range of symptoms, from minor discomfort to serious sickness. Two to 14 days after virus contact, symptoms may start to show. Anyone can experience minor to major symptoms. People who exhibit the signs below may have COVID-19:
Long COVID35 is the term given to the long-term effects of COVID-19. It is also referred to in other contexts as long-term effects of COVID, long-haul COVID, post-acute sequelae of SARS CoV-2 infection (PASC), post-acute COVID-19, and chronic COVID.
Long COVID symptoms vary from person to person. People with post-COVID conditions experience a wide range of symptoms in diverse combinations that fluctuate over time. Most patients' symptoms gradually improve over time. However, for some people, post-COVID conditions can last months, if not years, after the initial COVID-19 illness and can lead to disability.
There are many other causes of cough, including:
To decide if you should visit a doctor, consider the type of cough, how long it has persisted, your age, and your health. Consider consulting a healthcare professional if any of the following are present:
Coughing complexities can be categorized as either acute or chronic. Acute complications of coughing include:
Chronic complications include:
While there are many cough treatments available, they will vary depending on the type of cough or the underlying cause. Your physician will prescribe treatment based on if the cough is a result of an infection, allergy, medical condition, etc.
If your symptoms last longer than a few weeks or your symptoms worsen, follow up with your doctor for diagnosis and treatment.
It can be difficult to describe a cough with words. When describing the frequency, tone, volume, length, and other unseen characteristics of a cough, human language often falls short.