Dr Laurie Slovarp Outlines the Benefits of Behavioral Cough Suppression Therapy

Behavioral cough suppression therapy can be used to help patients with chronic cough manage their cough, prevent a cough, and even trigger their cough less often, explained Laurie Slovarp, PhD, CCC-SLP, associate professor in the School of Speech, Language, Hearing, and Occupational Sciences at University of Montana.

Transcript

How can patients manage their chronic cough to reduce its interference in their everyday lives?

So, as a speech therapist, we provide what we call behavioral therapy, or I call it behavioral cough suppression therapy. And the main thing that we do is we teach patients how to do different breathing strategies, and a couple of other ways that they can suppress their cough.

So, these patients usually feel a sensation in their throat, that the cough is coming. Some people describe it as a tickle or an itch. And we teach them how to suppress that sensation. It's kind of like a mosquito itch, and if you don't itch it long enough, that sensation will go away. We teach them some pretty basic breathing strategies to get them through that sensation.

Without any FDA-approved drugs on the market to treat chronic cough, what therapies can patients use?

So, the therapy that I do, which is this cough suppression therapy, involves helping them find strategies that allow them to suppress their cough. Now, the goal of the therapy is not to make them good at suppressing cough—even though that can be helpful in a pinch, to be able to suppress a cough and send it off for a while or maybe even make the urge goes away. But ultimately, what we're trying to do is for their hypersensitivity to be reduced.

And what we find is that, particularly patients who are pretty effective at suppressing their cough, within sometimes even just a few days, they're being triggered less often. And some research has shown that after effective behavioral cough suppression therapy, that their cough sensory thresholds drop. Actually, the thresholds go up, but that's a drop in sensitivity. So the goal of the therapy is to stimulate their own nervous system to change and to become less sensitive, so that they're not being triggered to cough so often.

Now, the other thing that we do in treatment, though, is about 50% of these patients also have a problem with their voice. Now, sometimes the problem with the voice is because of all the coughing, and so that causes inflammation. And you would think that would always be the case, but actually what's more common is what we call a functional voice disorder, called muscle tension dysphonia. And coughing is really tense. So, it causes a lot of muscle tension, and it causes them to have a strain voice. Sometimes it's so subtle that patients don't even know they have it. And we know that those 2 are highly correlated, the chronic cough and this tension in the voice. So, we also in therapy address the tension in the voice, because that also tends to calm down the problem with the cough.