The effect of mindfulness meditation on cough reflex sensitivity
- E C Young1,
- C Brammer2,
- E Owen2,
- N Brown2,
- J Lowe2,
- C Johnson2,
- R Calam3,
- S Jones3,
- A Woodcock1,
- J A Smith1
- 1Respiratory Research Group, University of Manchester, Manchester, UK
- 2University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
- 3Division of Clinical Psychology, University of Manchester, Manchester, UK
- Correspondence to Dr E Young, North West Lung Research Centre, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester M23 9LT, UK;
- Received 21 March 2009
- Accepted 21 July 2009
- Published Online First 12 August 2009
Background: Chronic cough is common, and medical treatment can be ineffective. Mindfulness is a psychological intervention that aims to teach moment-to-moment non-judgemental awareness of thoughts, feelings and sensations.
Method: 30 healthy subjects and 30 patients with chronic cough were studied in two sequential trials. For both studies, cough reflex sensitivity to citric acid (C5) was measured on two occasions, with urge to cough rated following each inhalation; between challenges subjects were randomised to (1) no intervention, (2) mindfulness or (3) no intervention but modified cough challenge (subjects suppress coughing). For the healthy volunteers, measures were 1 h apart and mindfulness was practised for 15 min. For the patients with chronic cough measures were 1 week apart and mindfulness was practised daily for 30 min.
Results: In healthy volunteers, median change (interquartile range (IQR)) in cough reflex sensitivity (logC5) for no intervention, mindfulness and suppression was +1.0 (0.0 to +1.3), +2.0 (+1.0 to +3.0) and +3.0 (+2.8 to +3.0) doubling concentrations (p = 0.003); there were significant reductions for both mindfulness (p = 0.043) and suppression (p = 0.002) over no intervention. In patients with cough, median change (IQR) in logC5 for no intervention, mindfulness training and voluntary suppression was 0.0 (−1.0 to +1.0), +1.0 (−0.3 to +1.0) and +1.0 (+1.0 to +2.0) doubling concentrations (p = 0.046); there was a significant reduction for suppression (p = 0.02) but not mindfulness (p = 0.35). Urge to cough did not change after mindfulness compared with control in either healthy subjects (p = 0.33) or those with chronic cough (p = 0.47).
Conclusion: Compared with control, mindfulness decreased cough reflex sensitivity in healthy volunteers, but did not alter cough threshold in patients with chronic cough. Both groups were able to suppress cough responses to citric acid inhalation.
▸ Instructions for the participants and an additional figure are published online only at http://thorax.bmj.com/content/vol64/issue11
Funding North West Lung Centre Endowment Fund.
Competing interests None.
Ethics approval Ethics approval was obtained from Tameside and Glossop Local Research Ethics Committee.
Provenance and Peer review Not commissioned; externally peer reviewed.