Surreal illustration of a child's silhouette with sound waves representing cough patterns during sleep.

Unmasking Psychogenic Cough in Kids: How Objective Assessments Can Help

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

"Is your child's cough more than just a cold? Discover how a new evaluation method using nocturnal cough patterns offers insights into psychogenic cough and its effective management."

Chronic cough in children can be a source of worry for parents and frustration for healthcare providers. While many coughs stem from common ailments like colds or asthma, some cases defy easy explanation. One such condition is psychogenic cough, also known as habit cough or tic cough. This type of cough is characterized by a persistent, dry cough that isn't caused by a physical illness but rather by psychological or emotional factors.

Psychogenic cough often presents with unique characteristics, such as a barking or honking sound, and typically disappears when the child is asleep. However, diagnosing psychogenic cough can be challenging, as these features may overlap with other conditions. Traditional methods rely heavily on subjective assessments and clinical observations, which can be prone to bias and misinterpretation.

To address this diagnostic gap, researchers have been exploring objective methods for evaluating cough patterns in children. One promising approach involves using cough counters and sound analysis to quantify and characterize cough sounds during the day and night. By objectively measuring cough frequency, intensity, and patterns, healthcare professionals can gain valuable insights into the underlying causes of chronic cough and tailor treatment strategies accordingly.

Decoding the Sounds: How Cough Monitoring Works

Surreal illustration of a child's silhouette with sound waves representing cough patterns during sleep.

In a recent study published in "Respiratory Investigation", researchers investigated the use of an original cough counter to evaluate nocturnal cough count and patterns in two children diagnosed with psychogenic cough. The cough monitor consisted of a high-resolution microphone, a high-sensitivity accelerometer, and a recorder to simultaneously capture cough sounds and thoracoabdominal movement. The recorded data were then analyzed using specialized software to quantify cough frequency and characteristics.

Both patients in the study presented with chronic, barking coughs that had persisted for several weeks despite conventional medical treatments. Traditional methods like antimicrobial drugs and steroid inhalation proved ineffective, raising suspicion for psychogenic cough. To confirm the diagnosis and gain a deeper understanding of the cough patterns, the researchers employed the cough monitoring system during the patients' hospitalization.

Objective Cough Measurement: High-resolution microphone and accelerometer record cough sounds and body movements.
Data Analysis: Specialized software analyzes the data to quantify cough frequency, intensity, and patterns.
Nighttime Monitoring: Measurements initiated at bedtime to capture nocturnal cough patterns.

The results revealed a striking contrast between the patients' cough patterns when awake and asleep. While the number of coughs was extremely high during waking hours, it significantly decreased during sleep. This pattern mirrored the cough behavior observed in conditions like asthma exacerbation, where cough tends to worsen at night. Moreover, the properties of the cough sounds themselves differed between the awake and asleep states. During waking hours, the coughs exhibited a characteristic barking quality with prolonged explosive sounds. In contrast, the cough sounds during sleep were more typical of a regular cough with shorter explosive sounds.

From Diagnosis to Relief: The Role of Psychotherapy

The objective cough monitoring provided valuable insights that supported the diagnosis of psychogenic cough in both patients. Armed with this information, the healthcare team initiated psychotherapy for both children. In one case, the child psychiatrist identified borderline personality disorder and depression, leading to treatment with psychotherapy and oral medicine. Within weeks, the patient's coughing showed remarkable improvement. In the other case, psychotherapy alone led to the complete resolution of the coughing within six weeks. These positive outcomes highlight the importance of accurate diagnosis and tailored treatment strategies for children with psychogenic cough. By combining objective assessments with psychological interventions, healthcare professionals can effectively manage this challenging condition and improve the quality of life for affected children and their families.

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This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.resinv.2017.08.008, Alternate LINK

Title: An Objective Evaluation Of Nocturnal Cough Count And Cough Pattern In Children With Psychogenic Cough

Subject: Pulmonary and Respiratory Medicine

Journal: Respiratory Investigation

Publisher: Elsevier BV

Authors: Eri Imai, Kota Hirai, Yoshiko Mikami, Mariko Nukaga, Mayumi Enseki, Hideyuki Tabata, Masahiko Kato, Hiroyuki Mochizuki

Published: 2017-11-01

Everything You Need To Know

What exactly is psychogenic cough?

Psychogenic cough, also known as habit cough or tic cough, is a persistent, dry cough in children that is not caused by a physical illness but is triggered by psychological or emotional factors. This means the cough isn't due to a cold, asthma, or other physical conditions but rather stems from the child's emotional state. It often presents with specific characteristics, such as a barking or honking sound, and typically disappears when the child is asleep.

Why is objective cough monitoring important for diagnosing psychogenic cough?

Objective cough monitoring is important because traditional methods of diagnosing psychogenic cough rely on subjective assessments and observations. This can lead to misdiagnosis or delayed treatment. The use of a cough counter and sound analysis provides objective data on cough frequency, intensity, and patterns. This helps differentiate psychogenic cough from other conditions and leads to better, more targeted treatment strategies. Without objective methods, it's challenging to accurately identify and address this type of cough.

How does a cough monitoring system work?

The cough monitoring system uses a high-resolution microphone and a high-sensitivity accelerometer to record cough sounds and body movements. Simultaneously, the system uses a recorder to capture and record all data. Specialized software then analyzes the recorded data, quantifying cough frequency and characteristics. The key is to capture data during both waking and sleeping hours to identify differences in cough patterns. This process helps healthcare professionals gain valuable insights, such as contrasting cough patterns during wakefulness and sleep, which is a hallmark of psychogenic cough.

What specific cough patterns were observed in the study that helped diagnose psychogenic cough?

The study found that patients with psychogenic cough exhibited a significant decrease in coughing during sleep compared to their waking hours. The cough sounds themselves also changed. The waking coughs had a barking quality with prolonged explosive sounds, while the sleeping coughs were more like regular coughs with shorter explosive sounds. This contrast helped confirm the diagnosis of psychogenic cough by providing an objective way to differentiate the cough from other conditions such as asthma, where coughing often worsens at night.

Why is psychotherapy an essential treatment for psychogenic cough?

Psychotherapy is a crucial part of treating psychogenic cough because the cough is rooted in psychological or emotional factors. Once the cough is accurately diagnosed using objective assessments, such as cough monitoring, psychotherapy can address the underlying issues. In the study cases, psychotherapy, sometimes combined with medication, led to significant improvement or complete resolution of the cough. This highlights the importance of addressing the psychological aspects of the condition for effective management and improved quality of life for the child and their family.