<p>Characteristics of Asthma-related Nocturnal Cough: A Potential New Digital Biomarker</p>

Abstract

The nature of nocturnal cough is largely unknown. It might be a valid marker for asthma control but very few studies characterized it as a basis for better defining its role and its use as clinical marker. This study investigated prevalence and characteristics of nocturnal cough in asthmatics over the course of four weeks. Methods: In two centers, 94 adult patients with physician-diagnosed asthma were recruited. Patient-reported outcomes and nocturnal sensor data were collected by a smartphone with a chat-based study app. Results: Patients coughed in 53% of 2212 nights (range: 0-345 coughs/night). Median coughs per hour were 0 (IQR 0-1). Nocturnal cough rates showed considerable interindividual variance. The highest counts were measured in the first 30 min in bed (4.5-fold higher than rest of night). Eighty-six percent of coughs were part of a cough cluster. Clusters consisted of a median of two coughs (IQR 2-4). Nocturnal cough was persistent within patient. Conclusion: To the best of the authors' knowledge, this study is the first to describe prevalence and characteristics of nocturnal cough in asthma over a period of one month, demonstrating that it was a prevalent symptom with large variance between patients and high persistence within patients. Cough events in asthmatics were 4.5 times more frequent within the first 30 min in bed indicating a potential role of positional change, and not more frequent during the early morning hours. An important next step will investigate the association between nocturnal cough and asthma control.

Predictors of Airway Hyperresponsiveness in Symptomatic Children with Normal Spirometry and Suspicious of Possible Asthma

“…Nocturnal cough is highly prevalent in adult patients with asthma [32], and a high frequency of nocturnal cough is shown to be significantly related to the presence of AHR [33]. While our findings confirm the importance of wheezing and nocturnal cough as predictors of AHR, Yavuz et al [10] found that, in spite of a quite similar patient selection, there is neither a significant association of AHR with wheezing nor with nocturnal cough.…”

Novel predictors of airway hyperresponsiveness in children with respiratory symptoms without obstructive pattern

“…Nocturnal cough is highly prevalent in adult patients with asthma (27) and a high frequency of nocturnal cough is shown to be significantly related to the presence of AHR (28). While our findings confirm the importance of wheezing and nocturnal cough as predictors of AHR, Yavuz et al (7) found that, in spite of a quite similar patient selection, there is neither a significant association of AHR with wheezing nor with nocturnal cough.…”

Validation of a small cough detector

“…The main limitation of such approaches is that recording with consistent quality can only be guaranteed under well-defined circumstances (mobile phone openly placed on table or nightstand next to the user) and during certain times of day (at home or in other silent environments). For conditions where, e.g., the nightly cough burden can be used as a surrogate marker for the general patient state, these approaches may be a cost-effective alternative to monitor disease progression (20)(21)(22).…”