dry cough at 4am only

[littlemil]

My 2 1/2 year old boy has been suffering from a dry cough that we can't seem to shake off. It started last year during the winter months and then got better during the summer months only to come back with a vengeance in the last month or so. We have tried pretty much everything that we can try. GP originally diagnosed with post-viral cough, then gradually started to think more down the asthma route but they can't diagnose officially until child is able to do spirometry tests (so until they are about 4 years old). We tried inhalers but did not make any difference. Other things we have tried: vapourizers (not sure if helped), piriton (some help from that), controlling dustmites levels in his room (not sure if that helped), temperature and heating modality in his room (not sure if that helped). He had an ENT review but consultant said his cough is not an ENT issue. Gp practice we are registered with (we always see locums) not interested in persuing this any further and 'he will grow out of it eventually'. Currently we are up everynight at 4am (like clockwork) with a bout of cough which lasts between 1 hour and 1 1/2 half. Once the bout of cough starts there is nothing I can do to soothe it, we just have to ride it out until it comes to an end. I know it's not a life-threatening problem but it's very disruptive for the whole family, particularly when it happens everynight for months in row. Not sure what to do next. If anybody has had something similar please can you share your experiences? Many thanks

I sympathise as we have a similar problem with our three year old but it started when he was around 9 months old. You could often set your watch by the episodes of coughing. It often causes him to vomit with the effort of coughing and happens once a night for around two hours from September through to April. It has got worse as he's got older with him struggling with viruses/high temperatures every couple of weeks and this persistent dry night cough. We have done everything to try and manage it - humidifier, bed head raised, Vicks, nitrogen, ventolin (after pestering the GP for something to help), opening windows, cooling his room down and when that didn't work, warming it up.

We're lucky to have private medical insurance so managed to get some tests done including a chest x-Ray and some allergy tests but it's all been inconclusive. This winter has been worse than ever with coughing every night from the end of September and we've been back to see our consultant who has him on a regime of drugs, which finally seem to be helping. He's been on nasal drops for seven days and another daily spray, he's on daily montelukast and two doses of anti-histamine a day. We've also been advised by the consultant to go dairy free for a month to see if that helps. The consultant believes it is upper airway inflammation and all the drugs are to try and reduce the inflammation. For me it's about getting to the bottom of the inflammation to try and resolve it so we are planning to see a paediatric allergy specialist to rule out an obvious allergy. I truly sympathise as the sleeplessness brings everyone to their knees coupled with the worry of not knowing why it happens and being unable to do anything to help or prevent it. I've always been worried that he's going to have a full on asthma attack one night and with no idea of how to treat it or choke on his vomit and us not hear him.

I'm not sure if it's linked but he also has eczema and had two horrible ear infections when he was very tiny so we're also wondering if it's a ENT problem. Funnily enough the eczema has improved since he's been on the new regime.

We have had similar in the past and it was asthma. What worked (after much trial and error) was a preventer inhaler and Singulair which is for allergy related asthma. 10 years on ds rarely needs inhalers now except in hay fever season.

Good luck, I know how exhausting it is sitting up in the night with a poorly child.

Sounds like asthma. Ask GP for a referral.