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What Causes Severe Cough Upon Waking Up?

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Posted on Mon, 17 Oct 2016
Question: Large airways

So large airways are what helps push the air to the vocal cords to make vibrations and sounds?

The constriction of small airways limits? deep breaths, exhaling completely, what all does the small airways do with breathing besides supply oxygen to the aveoli.

Oh not sure if its exhaustion but I have been sleeping till 3, then fall asleep till wife gets up.

I have been forcing self to do a walk at night after work but before dinner. Temperature has been changing getting ready for winter and is getting cooler. Not sure how i feel about winter. might have to find a treadmill.

Current wife is on the crossfit exercise program, not something i can do.l
doctor
Answered by Dr. Kaushal Bhavsar (1 hour later)
Brief Answer:
Larger airways starts after vocal cords.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Honestly speaking, you are too much thinking about airways, large, small etc.
Sorry if I hurt you.
Lower airways starts after vocal cords.
Lower airways divide in two. Larger and smaller.
Larger airways are mainly conducting air. They don't take part in gas exchange.
Smaller airways do both things, conducting air two alveoli and also cause gas exchange.
Air from larger airways help in vibration of vocal cords and producing sounds.
Hope this is clear to you.
Is it?
So all are important.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (1 minute later)
Good to know, thanks
doctor
Answered by Dr. Kaushal Bhavsar (2 minutes later)
Brief Answer:
You are sounding like I hurt you.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Oh man. You are sounding like I hurt you.
Is it so?
If yes then sorry for this.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (3 hours later)
You think you hurt me, that is not ever the case. I know I drive you crazy with questions that are repeated or have little bearing on things. but when I hear or read a comment on something like large airways affect the vibrations in voice, I then want to know more. I am a very curious person.
doctor
Answered by Dr. Kaushal Bhavsar (27 minutes later)
Brief Answer:
You are my favorite.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
You are my favorite.
I thought you might get hurt.
And you didn't reply for long so I thought you hurt for sure.
Yes, you are a curious person.
But I like you the way you are.
You are my favorite.
Happy?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (18 hours later)
It's morning. Yuk. I've noticed over that past few months I get a coughing spell in the morning after I get up. After coughing on and off for about 15 minutes with nothing but throat clearing happens and then it's done for day. Is that night irritants I breathed in while sleeping?
doctor
Answered by Dr. Kaushal Bhavsar (13 minutes later)
Brief Answer:
Do you expectorate anything?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, possibility of throat cleaning due to overnight accumulating secretion is more.
But please let me know
1. Do you expectorate anything?
2. After doing this, do you feel better?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (8 minutes later)
I cough and cough and cough until I feel as if I have the dry heaves. Then at the conclusion i may get a little spit. nothing much. Then i get to clear my throat for a few minutes.

Yes I feel better, mostly because the coughing is over.
doctor
Answered by Dr. Kaushal Bhavsar (2 minutes later)
Brief Answer:
It is mostly due to irritation from dryness in throat due to snoring.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
It is mostly due to irritation from dryness of throat due to snoring.
You must be still snoring. Are you?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (2 minutes later)
Not sure, I sleep on side so not to snore or to lessen snore.

Can I ask you a question about total lung volume on pft and volume amount inspired when breathing
doctor
Answered by Dr. Kaushal Bhavsar (1 minute later)
Brief Answer:
Yes, you have all rights to ask any question.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Oh, yes man.
You have all rights to ask any questions about anything you want to know.
Go ahead and ask. I am waiting.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (10 minutes later)
Using my pft for example, if the lung volume is normal, what is the cause of only partial volume entering my lungs if
a. I have no RV or Air Tapping
B I only have mild hyper inflation
c. I have great total volume that is normal, my fev1 is basically normal.
but i get only a small inspiration. Is this the airways inflammed or airways suddenly closing when I try to breath or breath quickly.

OH. I heard something of FEV3 and Fef 3 where does that fit in regards to the FEV1 and FEF 25/75
doctor
Answered by Dr. Kaushal Bhavsar (4 minutes later)
Brief Answer:
FEV3 means forced expiratory volume in three seconds.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Sorry to say but I don't understand initial part of your question.
So please made me understand.
FEV3 is forced expiratory volume in first 3 seconds. This means amount of air you are expiring in first three seconds.
It is of not good clinical importance.
More important parameter is FEV1 which is forced expiratory volume in 1st second.
I don't know from where you got to know about this term FEV3.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (5 minutes later)
I had a message come through the XXXXXXX lung association regarding using FEV3 and a new FEF level instead of FEV1

TRy the other question in a new form. My lung volume on the pft shows normal lung volumes.

My pft shows no air trapping and slight hyper inflation so why do I only have a reduced amount of air coming into lungs than what is capable from with normal Volume

doctor
Answered by Dr. Kaushal Bhavsar (7 minutes later)
Brief Answer:
Can you send me that message?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Oh. This is interesting.
Can you send me that message which you got from XXXXXXX lung association? I want to read in detail.
About your PFT query, possibility of stress related small Airway inflammation which gives you feeling of inadequate air entry and lung feeling.
This is just your perception. All PFT reports can not be wrong. So no need to think too much that why I don't have abnormal lung volumes on PFT despite of symptoms.
Is this clear?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (3 minutes later)
Small Airway Disease

COPDGene was an observational study that enrolled more than 10,000 cigarette users with and without chronic obstructive pulmonary disease (COPD).[1] The study was designed to explore genetic associations with COPD and to refine our understanding of COPD phenotypes. All patients had expiratory and inspiratory CT of the chest. The resulting dataset has provided insights into COPD physiology and genetics.

I have been writing a lot recently about small airway disease (SAD)—its measurement and significance in the setting of asthma or COPD. The CHEST journal just published more data from COPDGene that evaluated markers for SAD.[2] The study is important for several reasons. First, the investigators compared measures of SAD using more than one modality. They also expanded on what we already know about the forced expiratory volume in 3 seconds (FEV3). Perhaps of greatest importance, they correlated small airway dysfunction with functional outcomes.

For the past 40 years it has been dogma that SAD can affect respiratory function.[3] It has also been acknowledged that these patients are hard to assess, and that standard spirometric measures won't detect SAD until it has progressed. For a long time, the forced expiratory flow at mid-expiration (FEF25%-75%) was considered a surrogate for SAD, but this measure shows wide variability and overlap between normal and abnormal values.[4] Impulse oscillometry (iOS), plethysmography, FEV3, and CT imaging with air-trapping/mosaicism have all been used to establish SAD. Unfortunately, little in the way of comparative research between modalities has been done, and little correlation with clinical outcomes has been found.

FEV3, the SAD Measure of Choice

Enter the most recent installment from the COPDGene study published in CHEST.[2] The investigators compared FEV3 with CT and established good correlation. It's reassuring that the two modalities are measuring the same phenomenon. In addition to what we already know about FEV3 and SAD,[5,6] they found that FEV3/FVC6 was superior to FEV3/FVC for predicting clinical outcomes in patients with COPD. Among patients with otherwise normal spirometry, the 15.4% with a low FEV3/FVC6 had increased symptoms (St George's Respiratory Questionnaire and modified Medical Research Council [mMRC] dyspnea score) and BODE index score,[7] as well as shorter 6-minute walk distance compared with those with normal FEV3/FVC6. The importance of the relationship with functional status and symptoms cannot be overstated. All of the modalities used to measure SAD are short on clinical outcomes data; without those data, how do we know whether the deficits we believe we are identifying are clinically relevant?

This is more evidence that SAD is clinically relevant and supports using FEV3 as the small airway measure of choice. It's easy; it has already been reported with spirometry and, in my opinion, is backed by the best data.[2,4,7] There is no radiation risk and it doesn't require advanced equipment like iOS or plethysmography. For all you pulmonologists out there, start looking at the FEV3 when you get spirometry on your tobacco users and patients with unexplained dyspnea.

http://www.medscape.com/viewarticle/868507?src=wnl_edit_tpal&uac=187613FK


I found it on XXXXXXX lung but i see its from medscape
doctor
Answered by Dr. Kaushal Bhavsar (24 minutes later)
Brief Answer:
This is something interesting.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I have gone through the material you have provided.
This is something interesting.
Medicine is ever changing field. It is great to see learn new things from patients. Thanks buddy.
Have you checked for FEV3 values in your spirometry report?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (26 minutes later)
My report does not include that number
doctor
Answered by Dr. Kaushal Bhavsar (7 minutes later)
Brief Answer:
Can you send me PFT graphs?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can calculate this value if I have the graph of PFT.
Can you send me graph of your PFT?
I can tell you the value.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14979 Questions

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What Causes Severe Cough Upon Waking Up?

Brief Answer: Larger airways starts after vocal cords. Detailed Answer: Thanks for your question on Healthcare Magic. I can understand your concern. Honestly speaking, you are too much thinking about airways, large, small etc. Sorry if I hurt you. Lower airways starts after vocal cords. Lower airways divide in two. Larger and smaller. Larger airways are mainly conducting air. They don't take part in gas exchange. Smaller airways do both things, conducting air two alveoli and also cause gas exchange. Air from larger airways help in vibration of vocal cords and producing sounds. Hope this is clear to you. Is it? So all are important.