Etiological factors of chronic cough in children: Don’t ignore obstructive sleep apnea

Background: Chronic cough in children is a clinical condition requiring proper intervention. Objectives: This pragmatic real-life study aimed to evaluate children with chronic cough using a standardized clinical algorithm and call attention on obstructive sleep apnea (OSA) as a causative factor. Methods: Children referred for chronic cough between January 2016-January 2017 were assessed and classified according to etiologies. Presence of OSA was evaluated using a pediatric sleep questionnaire (PSQ) and polysomnography was handled in patients with scores ≥8. Results: A total of 251 patients with a median age of 5,88 years (0,28-17,89) were enrolled. The most frequent etiologies were asthma (n=80) (31,8%), protracted bacterial bronchitis (PBB) (n=79) (31,5%) and adenotonsillary hypertrophy (n=19) (7,6%) (Figure 1). We identified 14 patients with OSA (adenotonsillary hypertrophy (n=11), gastroesophageal reflux (n=1), obesity (n=1) and no identifiable cause (n=1)). All patients were cough free after treatment of OSA. Conclusions: As compatible with previous research, we recognized asthma and PBB as the most frequent causes of chronic cough. We believe that implementation of a standardized algorithm including investigation of OSA as an etiological factor of chronic cough in children may improve clinical outcomes. Figure-1: Etiologies of patients (n=251) *: Three patients were diagnosed as astma and gastroesophageal reflux