Habit cough: What its it?

The cough is typically a frequent and loud cough, which is disappearing when the child is asleep. If it is heard at night it may occur when the child had woken up or is going to the toilet. The cough can be as often as every minute. It may follow a simple respiratory infection and can be going on from only a few weeks to typically many months. It does not respond to any of the medicines tried. It is usually very disturbing for the entire environment such as family or school. The cough is best described as a honking or barking cough and comes from the throat (Weinberger, 2010).

Weinberger, M., 2010. The Habit Cough Syndrome, s.l.: Personal Communication.

Habit cough may start following an infection. Initially the coughing provides a temporary relief of a throat irritation. The cough itself may then cause ongoing irritation and inflammation of the throat, voice box or wind pipe, which causes an urge to cough even more. It eventually becomes a vicious cycle.

Yes, there are different types of ‘vocal tics’ which include sighing, clearing of the throat, yawning, grunting noises or something similar. These can be for either deep inspiratory sighing breaths,  a persistent clearing of the throat or just repetitive yawning. Some children feel the urge to make a grunting noise.

Habits or tics are very common in young children and even adults. These habits can manifest itself in very different ways. Some are associated with noises (vocal tics) others are muscular jerks or twitching of the eyes (motor tics). There is a very wide range of severity of these tics. Some can be quite disturbing, often more for the surrounding people.

Habit cough as such is overall less common but a very well recognised presentation to Respiratory Paediatricians.

Children with habit cough have often been on a whole variety of different medicines to try and make the cough go away. Medicines are not helpful for habit coughs. On the contrary, it is helpful to make sure no medications are taken to cause coughing or are unnecessary. The medicines used are typically asthma medications – they are only helpful to control asthma symptoms but not a habit cough.

In some severe tic disorders, other medications are used but these are usually drugs with a significant effect on the central nervous system.

Weinberger, M., 2010. The Habit Cough Syndrome, s.l.: Personal Communication.

Habits and tics are often best ignored. There are some effective cognitive behavioural therapy methods. In the case of a habit cough, sighing or throat clearing suggestion therapy can be very helpful (Weinberger 2010). These are short sessions teaching the child to suppress the urge until the vicious cycle is permanently broken  (Weinberger, 2007) (Anbar, 2004). Other interventions include ‘habit reversal therapy’, ‘comprehensive behavioural intervention for tics’ [CBiT] or ‘exposure with response prevention’ (NHS website). In my experience it can be difficult to find such a service in the NHS or private sector. I have used the ‘suggestion therapy’ for habit coughs successfully (www.habitcough.com).

Weinberger, M., 2010. The Habit Cough Syndrome, s.l.: Personal Communication.

Anbar, R., 2004. Childhood habit cough treated with self-hypnosis.. J Paediatrics, 02, 144(2), pp. 213-7.

Weinberger, M., 2007. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma.. Pediatrics, 10, 120(4), pp. 855-64.
https://www.nhs.uk/conditions/tics/
https://www.habitcough.com