Surreal illustration of a person listening to a cough constellation in the night sky.

Decoding Nighttime Cough: What It Means for Cystic Fibrosis and Ciliary Dyskinesia

Lena Kashyap in Health & Wellness December 2025 • 5 min read.

"A new study uncovers how nighttime cough patterns differ in patients with cystic fibrosis and ciliary dyskinesia, offering potential clues for better diagnosis and treatment."

Coughing, a common reflex, plays a vital role in clearing our airways and protecting our lungs. But what happens when cough becomes a persistent nighttime companion? For individuals with chronic respiratory conditions such as cystic fibrosis (CF) and primary ciliary dyskinesia (PCD), nighttime cough can be more than just an annoyance; it can be a significant indicator of disease progression and overall health. Cystic fibrosis is a genetic disorder that causes the body to produce thick and sticky mucus that can clog the lungs and obstruct the pancreas. Primary ciliary dyskinesia (PCD) is a rare genetic condition that affects the function of cilia, tiny hair-like structures that line the airways and help to clear mucus.

While doctors often rely on patient reports and standard lung function tests, these methods have limitations. Patient accounts of cough can be subjective and may not always align with objective measurements. Traditional lung function tests might not be suitable for all age groups, and questionnaires can introduce biases. This is why researchers are increasingly interested in finding reliable and easily assessable markers—surrogates—that reflect the true severity of these conditions. Cough frequency, measured objectively, has emerged as a potential candidate.

Recognizing the need for more precise methods, a team of researchers set out to explore the nuances of nighttime cough in individuals with CF and PCD. Their study, a prospective observational analysis, aimed to determine if cough patterns are related to disease severity and if there are notable differences between CF and PCD patients. By using advanced sound monitoring technology, the researchers hoped to uncover valuable insights that could lead to improved diagnostic and therapeutic strategies.

Unlocking the Secrets of Nighttime Cough: What the Study Revealed

Surreal illustration of a person listening to a cough constellation in the night sky.

In this study, researchers used the LEOSound® Monitor, a sophisticated microphone-based system, to track and analyze cough patterns in three groups: healthy subjects (HS), patients with cystic fibrosis (CF), and patients with primary ciliary dyskinesia (PCD). Each group consisted of 25 participants, and their coughs were monitored over two consecutive nights in their home environments. The goal was to count and compare the number of coughs and cough epochs (a series of coughs occurring close together) during the night.

The results provided some fascinating insights:

Cough Frequency: Healthy subjects coughed very little at night, with a median of 0.0 coughs per hour. In contrast, CF patients had a median of 1.3 to 2.3 coughs per hour, while PCD patients had a median of 0.2 to 0.5 coughs per hour.
Group Differences: CF and PCD patients coughed significantly more than healthy subjects. Additionally, CF patients coughed more than PCD patients.
Key Risk Factor: A multivariable analysis identified forced expiratory volume in one second (FEV1) as an independent risk factor for increased cough frequency. FEV1 is a measure of how much air a person can exhale in one second, and lower values indicate poorer lung function.
Reliability: The reliability of repeated measurements was higher for cough epochs per hour compared to coughs per hour, suggesting that cough epochs might be a more consistent measure.

These findings highlight that nighttime cough is indeed more prevalent in individuals with CF and PCD compared to healthy individuals. The fact that CF patients coughed more than PCD patients suggests that there are underlying differences in the mechanisms driving cough in these two conditions. The identification of FEV1 as a key risk factor underscores the link between lung function and cough frequency. Ultimately, the LEOSound® Monitor proved to be well-tolerated by patients and showed no side effects during the study.

The Implications for Diagnosis and Treatment

This study offers a fresh perspective on how we understand and manage cough in CF and PCD. By demonstrating that nighttime cough patterns are linked to disease severity, it opens the door for more objective and personalized approaches to treatment. Monitoring nighttime cough frequency could potentially serve as a valuable endpoint in clinical trials, helping researchers to assess the effectiveness of new therapies. The use of cough epochs per hour, rather than just counting individual coughs, may provide a more reliable and consistent measure for tracking changes in cough patterns. Further research is needed to fully explore the potential of cough monitoring as a tool for improving the lives of individuals with CF and PCD.

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Everything You Need To Know

Why is nighttime cough so important to study in conditions like cystic fibrosis and primary ciliary dyskinesia?

Nighttime cough is a significant indicator of disease progression and overall health in individuals with chronic respiratory conditions like cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). Unlike occasional coughs that healthy individuals experience, persistent nighttime cough in CF and PCD patients can reflect the severity of their condition and how well their lungs are functioning. Understanding these cough patterns can lead to improved diagnostic and therapeutic strategies, offering a more objective way to assess the effectiveness of treatments.

How does the new study measure cough differently in patients with cystic fibrosis and primary ciliary dyskinesia, and why is this important?

The study uses the LEOSound® Monitor, a microphone-based system, to objectively track and analyze cough patterns, counting both the number of coughs and cough epochs (series of coughs close together) during the night. This is important because traditional methods rely on subjective patient reports and standard lung function tests which can be biased or unsuitable for all age groups. Objective measurements, like those provided by the LEOSound® Monitor, offer a more reliable and consistent way to assess cough frequency and its relationship to disease severity in cystic fibrosis and primary ciliary dyskinesia.

What were the key findings of the study comparing nighttime cough in healthy subjects, cystic fibrosis patients, and primary ciliary dyskinesia patients?

The key findings revealed that healthy subjects coughed very little at night, while cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) patients coughed significantly more. CF patients coughed more than PCD patients. A critical risk factor identified was FEV1 (forced expiratory volume in one second), where lower values (indicating poorer lung function) correlated with increased cough frequency. The reliability of repeated measurements was higher for cough epochs per hour compared to individual coughs per hour. This suggests that cough epochs might be a more consistent measure, pointing to underlying differences in cough mechanisms between CF and PCD.

What does it mean that FEV1 (forced expiratory volume in one second) was identified as an independent risk factor for increased cough frequency in cystic fibrosis and primary ciliary dyskinesia?

The identification of FEV1 as an independent risk factor means that a patient's lung function, specifically how much air they can exhale in one second, is directly related to how much they cough at night, regardless of other factors. Lower FEV1 values, indicating poorer lung function, are associated with more frequent coughing. This finding emphasizes the link between airway obstruction and cough and suggests that treatments aimed at improving lung function could potentially reduce nighttime cough in patients with cystic fibrosis and primary ciliary dyskinesia.

What are the potential implications of using nighttime cough monitoring, particularly cough epochs, as a tool in clinical trials for cystic fibrosis and primary ciliary dyskinesia?

Monitoring nighttime cough frequency, especially using cough epochs per hour, could serve as a valuable and objective endpoint in clinical trials. It provides a more reliable and consistent measure for tracking changes in cough patterns than simply counting individual coughs. By using nighttime cough monitoring, researchers can more accurately assess the effectiveness of new therapies aimed at improving airway clearance and reducing cough in individuals with cystic fibrosis and primary ciliary dyskinesia. This could lead to more personalized and effective treatment strategies.