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Treatment of Chronic Cough in Adults

Habit cough can be cured by watching a video.

Key points

  • Chronic cough that does not produce phlegm and stops with sleep may be caused by habit.
  • Therapy with suggestion helps resolve habit cough in children.
  • The chronic cough of some adults also has improved with suggestion therapy.
  • Suggestion therapy can be accomplished through viewing a video at home.
Stockbakery/Shutterstock
Source: Stockbakery/Shutterstock

Are you an adult suffering from a long-standing cough that does not produce phlegm and stops as soon as you fall asleep? Has your cough failed to improve despite being treated with different medications? Has your health care provider told you that the cause of your cough is unknown, even after a physical examination, chest x-ray, blood testing, and breathing tests?

In many cases of adults with such coughs, the diagnosis might be “habit cough,” which can resolve nearly immediately with the right therapy.

Such a cough has been well-documented in the medical literature about children. Habit cough is thought to be triggered by irritation of the airways that is caused by prolonged coughing. In other words, this is a catch-22 situation in which the cough can perpetuate itself. Habit cough does not respond to treatment with medication.

Treatment of Habit Cough in Children

Fortunately, among children, it has been well-recognized that psychological therapy involving suggestion can lead to rapid resolution of the cough (e.g., as quickly as within a few minutes), even after it has persisted for many years (Anbar & Hall, 2004).

For instance, in the 1970’s it was suggested to children that their cough could improve by wrapping a bed sheet around their mid-section, and that whenever they have an urge to cough, they can tighten the sheet to support their abdominal musculature instead of coughing. While giving this suggestion made no physiological sense, many children’s cough thereafter resolved (Cohlan & Stone, 1984).

In the 1980’s, “suggestion therapy” was shown to be highly effective in achieving rapid resolution of habit cough by explaining to children that they can control their cough through ignoring the tickle in their throat, and instead sipping some water (Weinberger & Hoegger, 2016).

In the early 2000’s suggestions given through hypnosis were shown to be equally effective in resolving habit cough (Anbar, 2021).

In 2019, suggestion therapy was provided by Dr. Miles Weinberger through video conferencing to a 12-year-old girl with habit cough. As was the case when suggestion therapy was provided in-person, this girl’s cough resolved during the single therapy session.

This 26-minute video encounter was recorded by the patient’s father, and posted on-line. The video can be viewed through the link provided at the end of this blog. Importantly, since this video’s posting, more than 100 parents contacted Weinberger to let him know that their children’s habit cough resolved when they viewed the video and followed the given suggestions.

A Surprise in Adults

Unexpectedly, more than 40 adults have also contacted Weinberger to let him know that their chronic cough also resolved during or soon after viewing the video, even after some of them had dealt with their cough for decades (Weinberger & Buettner, 2023).

When it became clear that some adults with chronic cough can also respond to viewing a video of suggestion therapy (termed suggestion therapy by proxy) it was proposed that habit cough might exist in adults, who can benefit from therapy involved with suggestion, just like children (Weinberger et al., 2023).

In most current adult medical literature, habit cough does not even appear on the list of possible causes of chronic cough. For instance, in a 2024 review of chronic cough in adults, Peters et al. list asthma, gastroesophageal reflux, upper airway cough syndrome, and neuropathic cough as potential causes of cough.

Peters et al. recognize that physicians are unable to find a diagnosis that can explain chronic cough in many adults, nor identify a treatment that can help this population. Thus, it is unfortunate that to date, outside of Dr. Weinberger’s work, there have been no reports in the medical literature of adoption of suggestion therapy trials in adults.

Weinberger’s experience with adults who contacted him to report of their cough resolution has been dismissed as “anecdotal,” which means they might have just improved by chance, and he has been criticized for not having subjected suggestion therapy to a randomized scientific study (Weinberger et al., 2023). Many physicians have even stated they do not believe habit cough exists in adults.

To conduct a randomized study documenting the effectiveness of suggestion therapy by proxy for adults with chronic cough will take years and will require the interest and participation of physicians who treat adults. In the meantime, the good news is that if you are suffering from symptoms suggestive of habit cough you can conduct your own trial of therapy by viewing the video.

Takeaway

The medical field tends to be conservative by nature, in part because of the dictum that we should first do no harm. Thus, before a new therapy is adopted many physicians want to ensure that it works, rather than prescribing a treatment that might cause side-effects, waste time or money, or work less effectively than other types of treatments.

In the case of chronic cough in adults that does not produce phlegm and stops with sleep, many times we do not have a treatment that works at present. Watching a video at home is about as safe a treatment that can be offered. For this reason, as a pulmonologist, I fully endorse a trial of watching the suggestion therapy video that could help cure a troublesome long-term cough.

References

Anbar RD. (2021). Changing Children’s Lives with Hypnosis. Lanham, MD: Rowman & Littlefield.

Anbar RD & Hall HR. (2004). Childhood habit cough treated with self-hypnosis. J Pediatr, 144:213- 217.

Cohlan SQ & Stone SM. (1984). The cough and the bedsheet. Pediatrics, 74:11-15.

Peters AT, Altman KW, Dicpinigaitis P, Drake MG, Satia I, & Patel GB. (2024). Therapeutic and mechanistic advances in chronic cough. Ann Allergy Asthma Immunol, 23:S1081-1206(24)01758-7. Epub ahead of print.

Weinberger M, & Buettner D. (2023). Habit cough is a cause of chronic cough in adults. Ann Allergy Asthma Immunol, 130:808-809.

Weinberger M, Buettner D, & Anbar RD. (2023). A review, update, and commentary for the cough without a cause: Facts and factoids of the habit cough. J Clin Med, 12:1970.

Weinberger M & Hoegger M. (2016). The cough without a cause: the habit cough syndrome. J Allergy Clin Immuno, 137:930-931.

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