Mental Health and Sleep Outcomes Among Patients Diagnosed with Chronic Cough

Introduction: Chronic cough is a multi-factorial condition that can often be difficult to effectively treat. Past studies have associated chronic cough with a degraded quality of life, namely related to psychological and sleep outcomes. We investigated the association between chronic cough and later diagnosis with mental health and sleep disorders using a large database.

Methods: We conducted a retrospective cohort analysis using the TriNetX research database. Patients aged ≥18 years with chronic cough diagnosed from 2008-2018 and no recent history of mental health or sleep disorders were included and compared to a control cohort. Primary outcomes were five-year diagnoses with sleep disorders, depression, and anxiety. Secondary outcomes included rates of interaction with the healthcare system, other mental health diagnoses, and usage of psychological medications and sleep devices.

Results: Of 60,709 patients with chronic cough meeting our inclusion criteria, the mean age was 55.1 ± 15.2 and patients were 59% female, 71% white, and 77% not Hispanic/Latino. Patients with chronic cough had significantly higher rates of nicotine dependence, obesity, asthma, and GERD. Patients were at significantly higher risks of developing any sleep disorder (RR 10.67, p< 0.01), depression (RR 7.22, p< 0.01), and anxiety (RR 6.55, p< 0.01) and were more likely to receive antidepressant or antianxiety medications (RR 3.34, p< 0.01) in the five years following diagnosis with chronic cough. Patients with chronic cough diagnosis also had significantly increased interactions with the health system (RR 1.90, p< 0.01).

Conclusions: Chronic cough is associated with increased risk of development of anxiety, depression, and disordered sleep, as well as increased interaction with the health system. This is the largest study to date examining the burden of chronic cough and its associated outcomes. Further study will investigate these associations further and promote awareness leading to better educational and emotional support for patients with chronic cough.