Coughing is an essential defense mechanism that aids in clearing excessive lower respiratory tract secretions while also helping to protect the lungs from potentially toxic and hazardous foreign chemicals. However, it can also be a sign of a serious condition. This is where knowing and understanding types of cough is very helpful.

In this article, we will go through the key terms that doctors use to categorize coughs, explain and describe all cough types, as well as their meaning. 

Cough Identification Based on Characteristics

We can identify cough types based on their intrinsic characteristics such as productivity, time of day when they happen, sound, and duration. We often see more than one name for a single type of cough. The next section aims to cover all the types as well as their names so you can more easily and clearly communicate your cough type to your doctor.

Cough Types Based on Productivity

Cough productivity refers to the production of mucus or phlegm when coughing. Depending on whether there is mucus or phlegm, coughs are generally classified into dry (unproductive) or wet (productive).

Dry Cough

This is the type of cough that mostly produces dry air; it is also known as non-productive cough. Dry coughs frequently result from irritated or inflamed airways. As your body tries to remove the pathogen from your airways during the first few days of a respiratory infection, you could suffer from a dry cough.

There are numerous potential underlying reasons for dry coughs, including exposure to allergens, toxins, respiratory infections, and specific medications.

Tickly Cough

A tickly cough is a type of dry cough. It comes on as an irritating, ticklish feeling at the back of the throat that causes relentless coughing. Other symptoms that may accompany a tickly cough include:

• Throat pain
• Coughing that causes chest or abdominal muscles to hurt
• Clogged nose
• Sensitivity to other irritants 
• sneezing

They typically result from viral diseases like the flu or the common cold or from environmental factors like pollution or climate. Even if you don't have mucus in your lungs, the bronchial tubes can be inflamed, which generates a tickling sensation that makes you cough. 

Hacking Cough

A hacking cough is a severe type of dry cough that makes a loud rough sound. One of its characteristics is that you continuously cough and feel as though something is stuck in your throat. You may experience a dry, hacking cough after inhaling some irritants, such as dust, smoke, or powder.

A hacking cough is most frequently caused by viral infections of the nose and throat, a disorder, such as an allergy, or an infectious condition, like viral laryngitis. 

Wet Cough/Chesty Cough/Phlegmy Cough

Wet cough is one that produces mucus or phlegm. It is also known as a productive cough. Wet coughs are caused by infections from microorganisms such as bacteria or viruses such as those that cause a cold or flu.

The most common symptom of wet coughs is mucus production. The mucus produced can be clear, white, yellow, green, or brown. Additionally, your chest may feel tight or produce a rattling sound when you breathe. Other symptoms that may accompany a wet cough include:

• a sore throat
• a runny nose
• headaches
• shortness of breath or difficulty breathing
• Wheezing
• fever
• chills
• muscle pains/body aches
• fatigue

Cough Types Based on When You Cough

Determining what causes someone to cough can help a healthcare provider identify an illness that requires treatment. The time of day you cough or coughing after an activity can be an indication of a pattern. 

Daytime Cough

A daytime cough as the name suggests typically occurs any time of day; morning, afternoon, or evening. A morning cough can occur for a variety of reasons, but not all of them are a cause for alarm.

Some of the causes of daytime coughs include:

• Cold air or activities
• Common cold
• Respiratory conditions such as: GERD, LPR, postnasal drip, asthma, etc.

Nighttime Cough

On the other hand, a nighttime cough occurs during the night hours. While a cough at night is frequently brought on by the same factors that make you cough during the day there are reasons why some people mainly cough at night. These include:

• Poor indoor air quality
• Exposure to allergens such as dust, pollen, and mites from the bedding
• The posture one takes when sleeping
• Conditions affecting the upper airways, lower airways, gastrointestinal tract, or cardiovascular system. 

Additionally, due to the fact that at night the airways are more sensitive and irritable, some conditions such as asthma can also elicit nightly coughing. 

Cough Types Based on Cough Sound

Clinicians frequently regard a given cough's distinctive sound¹ as a helpful diagnostic trait. The auditory characteristics of respiratory sounds can be objectively evaluated via acoustic analysis to diagnose the underlying condition. Below are some types of cough sounds.

Wheezing Cough

Wheezing² is often described as a high-pitched sound with high-pitched whistling when breathing. Imagine the wind blowing through a tunnel or a dog’s squeaky toy sounds. The airways (narrowed due to inflammation) make musical or squeaky noises. Wheezing may be brought on by blockages or constricted airways.. The wheezing can often be heard without a stethoscope, but sometimes medical equipment is required. 

A wheezing cough is typically triggered by asthma, allergies, viral infection, and, in some cases, more severe health conditions such as heart failure. 

A wheezing cough can affect all ages, but it can be especially worrying when it occurs in infants. It is, therefore, essential to diagnose the underlying problem and treat the underlying cause.

Some common causes of a wheezing cough in adults include:

• Viral or bacterial infections 
• Asthma 
• COPD (chronic obstructive pulmonary disease)
• GERD (gastroesophageal reflux disease)
• Allergies 
• Heart disease 

Some common causes of a wheezing cough in infants include:

• Respiratory syncytial virus infection (RSV)
• Bronchiolitis
• Whooping cough
• Allergies
• Asthma
• Choking 

Croup Cough (Barking Cough)

Croup is an infection of the upper airways most often caused by a virus. Parainfluenza viruses (HPIVs) are the most common cause of croup, but influenza viruses, adenoviruses, enteroviruses, and the respiratory syncytial virus (RSV) can cause it as well.

The congestion brought on by the swelling of the upper airways produces the distinctive “barking” cough that sounds like a seal. Swelling in and around the voice box also causes a raspy voice and squeaky breathing noises. 

Croup coughs can begin abruptly, frequently in the middle of the night. Children, typically younger than five years old, are particularly susceptible to croup. Most children with croup will also experience stridor, which is a loud, agitated inhalation (breathing in).

Whooping Cough

Whooping cough is also referred to as pertussis which is a very contagious respiratory illness commonly caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia, which line a section of the upper respiratory system and resemble tiny hairs. Toxins released by the bacteria damage the cilia and enlarge the airways.

The second stage of whooping cough, about two weeks³ into the beginning of the infection, is characterized by paroxysmal coughing. This violent and rapid coughing happens until the lungs are empty of air. At this point, you have to inhale, gulping air with the “whooping” sound that gives this condition its common name. These coughing fits can cause you to be very tired and lead to vomiting.

If you have a less severe or lesser condition, the "whoop" may not always be there. 

Infants and young children whose immunities are still adjusting to their surroundings are frequently affected by whooping cough. Additionally, those who have never gotten pertussis immunization are more vulnerable. Teenagers and adults, especially those who have had the pertussis vaccine, typically experience a milder infection.

Cough Types Based on Duration of Cough

Your doctor will want to determine how long your cough has lasted. The three common descriptions of cough duration⁴ are acute, subacute, and chronic.

Acute Cough

When a cough lasts three weeks or less, it is considered acute.⁵ Most frequently, a viral infection of the upper respiratory system (e.g., the common cold) or lower respiratory system (e.g., acute bronchitis) is the culprit. As described above, coughing like this can either be productive (produces mucus) or nonproductive (dry, no mucus). The flu, pneumonia, and COVID-19 can also cause an acute cough.

Subacute Cough

Subacute coughs typically last between three and eight weeks before the cough eventually resolves, usually on its own.

The most common cause of a subacute cough is postinfectious cough.⁶ The causes of postinfectious cough are:

• Persistent inflammation of the nose and paranasal sinuses, leading to an upper airway cough syndrome (UACS; also referred to as postnasal drip syndrome, PNDS)⁷
• GERD, which may be a complication of the vigorous coughing
• Asthma⁸

If a subacute cough⁹ has a known cause, treating this is the best way of getting rid of the cough. If the reason for the cough is unknown and it persists, it is treated as a chronic condition.

Chronic Cough (Persistent Cough)

Everyone periodically coughs, but one sort of cough that frequently raises concern is a chronic cough – a persistent cough that lingers. In adults, a cough is considered chronic if it lasts longer than eight weeks; in children, the limit is four weeks. For many people with a persistent cough, it can last for months or even years. For others, it can return seasonally or it can happen in specific circumstances, such as chronic cough in pregnancy.

Cough Identification Based on Causes

Coughing is often caused by another condition. When this is the case, we identify cough by what is causing it. The next section will explore some common causes of cough.

Upper Airway Cough Syndrome (UACS)

A nagging cough isn’t always a sign of something severe. It could be upper airway cough syndrome (UACS, formerly known as postnasal drip syndrome/PNDS),¹⁰ one of the most common causes of chronic cough¹¹ in adults.

Broadly speaking, UACS is a chronic cough¹² featuring odd sensations in the upper airway. It is a chronic upper respiratory tract irritation that comes with hypersensitive cough receptors.

Some definitions of UACS, describe a tickly cough with milder symptoms during the day, that worsen in the mornings and at night. Some reports describe a feeling of something in the throat or the presence of mucus. Regardless, a strange sensation in the throat is pivotal to the diagnosis.

Symptoms include:

• Persistent cough 
• Abnormal or unpleasant sensations in the throat
• Frequent throat clearing
• Postnasal drip
• Cobblestone appearance of the inside of the throat

Several glands in your airways are constantly creating mucus. The main function of this mucus is to lubricate the airway and filter out extraneous objects that would otherwise find their way into the respiratory tract. 

This includes allergens. Some examples of common allergens and irritants are:

• Dust mites
• Pet dander
• Pollen
• Perfume
• Cleaning products
• Mold

The majority of the time, the amount of mucus produced is small and it is unconsciously swallowed.

However, occasionally, the mucus production is excessive and slowly trickles down your throat from your nostrils, building up and irritating you. This drip of abundant mucus causes ongoing irritation, and a persistent cough develops.

While it’s usually not dangerous, it can be an annoyance.

Gastroesophageal Reflux Disease (GERD) Cough

GERD happens when stomach acid backs up in your throat (in your esophagus, to be exact). This condition can happen occasionally or persistently, depending on the severity of the disease. Having acid in your esophagus can lead to heartburn and other symptoms, as well as tissue damage if it persists. 

Even though it’s normal to have acid reflux from time to time, GERD is diagnosed through an esophageal pH test to measure the pH or amount of acid that flows into the esophagus from the stomach during a 24-hour period.

There are many causes of GERD, and most of them are related to people’s eating habits although in some cases, it is caused due to a faulty digestive system. 

GERD often afflicts those who are experiencing one or more of the following conditions: 

• Pregnancy, causing increased pressure on their abdomen
• Obesity or being overweight
• Smoking, or long-term exposure to secondhand smoke
• Taking particular medications such as sedatives, antidepressants, or asthma medication

There are various symptoms of GERD, but the most common one is heartburn. Heartburn is usually described as the discomfort or burning sensation in your chest. It tends to worsen when you bend over, lie down, or after eating food. 

However, not everyone with GERD experiences heartburn. There are also other symptoms such as: 

• Bad breath 
• Tooth decay
• Vomiting or nausea
• Respiratory problems such as bronchial asthma, bronchitis, pneumonia, and interstitial fibrosis among others

Asthma Cough

While asthma commonly comes with coughing and a whistling or wheezing sound in the chest, there is a type of asthma referred to as Cough Variant Asthma (CVA) where the only symptom is chronic cough.

Asthma coughing can happen both during the day and at night (which can make it difficult to fall or remain asleep). Exercise-induced asthma is common in those with CVA, where exercising causes the cough to get worse. Additionally, coughing may worsen due to exposure to asthma triggers, allergen-inducing factors like dust, potent smells, or cold air.

Cough-variant asthma can develop at any point in life, although it's most frequent in young children with childhood asthma. Cough-variant asthma may then cause "classic" asthma to develop. 

Neurogenic Cough

Neurogenic means originating from the nervous system. A neurogenic cough is a persistent cough that develops after an infection that has damaged the nerves that supply the larynx. This can lead to the nerves becoming overactive or oversensitive¹³ after recovery from the infection.

Clinical examination of neurogenic cough is difficult since it is a sensory phenomenon and hence subjective. Therefore, it is typically a diagnosis of exclusion¹⁴ where other causes of cough must first be investigated before diagnosing a chronic cough as neurogenic. 

Patients with neurogenic cough may be more sensitive to chemical, thermal, mechanical, and other stimuli because of their nerves’ hyperreactive state. Other common triggers of a sensory neuropathic cough¹⁵ include:

• Laughing loudly
• Singing
• Swallowing
• Yawning
• Talking
• Changing position
• Inhaling cold air

It is possible for a cough to be accompanied by other symptoms like globus (the feeling of something in your throat), throat pain, throat clearing, dysphonia (hoarse, raspy, or strained voice), dyspnea (shortness of breath), choking, and/or stridor (loud inhalation).

Smoker’s Cough

It’s no surprise that smokers cough more¹⁶ than non-smokers. The longer you smoke, the more likely you are to develop a persistent, raspy cough. 

Tiny hair-like cells called cilia line our airways and catch any toxins we inhale. These cells then push the harmful substances away from the lungs towards the mouth so we can expel them.

But if you smoke, your cilia won’t function correctly because the chemicals in cigarettes slow them down,¹⁷ damage them, or destroy them.¹⁸

Therefore you have to work harder to filter toxins if you smoke. This inhibits your lungs’ ability to remove harmful substances, which then settle in the lungs, causing inflammation and triggering coughing as the body tries to clear the lungs. Smokers’ coughs are also less effective¹⁹ at removing irritants than those of non-smokers.

Chronic cough has been linked to cumulative smoke exposure and its evidence is overwhelming, for example in a  34-year longitudinal study²⁰ smoking cigarettes was substantially linked to coronary heart disease in males aged 45 to 64, but not in women or older men. 

The chemical irritation²¹ from smoking is one of the leading causes of cough, along with potentially being a sign of a severe underlying condition such as pneumonia,²² emphysema,

²³ or cancer.²⁴

Smokers’ cough symptoms are case-by-case, and how it affects any individual varies. But in general, the main symptoms are a nagging cough that tends to be worse in the morning and lessons during the day.

Symptoms progress the longer one smokes. During the early stages, the cough is mostly dry, but it may produce sputum later on. Additionally, the phlegm may be colorless, speckled with blood, yellow-green, or brown.

While these aren’t the only symptoms, they are the most common. Other symptoms include:

• Wheezing or a crackling sound when breathing
• Shortness of breath
• Chest pain
• Sore throat 

Iatrogenic Drug-Induced Cough

In some cases, your doctor might suspect a cough has been brought on as a side-effect of taking a particular medicine. This is very unlikely if you have a persistent cough or one that lasts longer than eight weeks.

The most prevalent drugs with chronic cough as a side effect²⁵ are angiotensin-converting enzyme inhibitors²⁶ (ACE-I). They are widely used to reduce blood pressure in people with cardiovascular conditions such as myocardia. Other medications reported to cause a chronic cough include:

• Omeprazole: used to treat conditions where there is too much acid in the stomach²⁷
• Some beta-blockers: used to treat blood pressure²⁸
• Leflunomide: used to treat rheumatoid arthritis²⁹

Therefore, a crucial step in the diagnosis and treatment of chronic cough is checking out your history regarding any medications that can cause chronic cough. You can check your medication on Drugs.com, and must talk to your PCP before stopping any medication that you think is causing a cough.

Somatic cough syndrome (Habit cough, Psychogenic cough, Tic cough)

Habit cough also known as psychogenic cough, tic cough,³⁰ or somatic cough syndrome, is a diagnosis that can only be made after ruling out everything else. This is a cough that has no physical cause but is maintained subconsciously by the person’s psyche. This occurs when a person has a habit of clearing their throat by coughing, even when there is no phlegm or mucus present. 

The best way to identify³¹ a habit cough is by observing its total absence as soon as the cougher falls asleep. 

Psychogenic cough can cause interference with daily activities, such as the cougher avoiding social situations for fear of judgment, and a propensity for secondary problems, such as school absence. Psychogenic cough is most effectively treated through psychotherapy or other behavioral approaches and does not respond to medication.

COVID-19 Cough

COVID-19³² is caused by the virus named SARS-CoV-2. It is a member of the coronavirus family, which also includes other viruses that cause more serious (but less common) disorders including the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), and those that cause the common cold.

Coronaviruses, like many other respiratory viruses, spread quickly through droplets that are emitted from the mouth or nose during breathing, coughing, sneezing, or speaking.

According to CDC,³³ people with COVID-19³⁴ have reported experiencing a wide range of symptoms, from minor discomfort to serious sickness. Two to 14 days after virus contact, symptoms may start to show. Anyone can experience minor to major symptoms. People who exhibit the signs below may have COVID-19:

• Cough
• Fever or chills
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Long Covid Cough

Long COVID³⁵ is the term given to the long-term effects of COVID-19. It is also referred to in other contexts as long-term effects of COVID, long-haul COVID, post-acute sequelae of SARS CoV-2 infection (PASC), post-acute COVID-19, and chronic COVID.

Long COVID symptoms vary from person to person. People with post-COVID conditions experience a wide range of symptoms in diverse combinations that fluctuate over time. Most patients' symptoms gradually improve over time. However, for some people, post-COVID conditions can last months, if not years, after the initial COVID-19 illness and can lead to disability.

There are many other causes of cough, including:

• COPD
• NTM
• Filariasis (loefflers syndrome) 
• TB
• Congrestive heart faliure
• Lung cancer
• Cystic fibrosis
• Damage or inflamed airways (bronchiectasis or bronchiolitis)
• Sarcoidosis
• Hiatus hernia
• Chronic scarring of the lungs
• Food particles or foreign bodies (aspiration)
• Psychological disorders

When to Consult a Health Professional About Cough?

To decide if you should visit a doctor, consider the type of cough, how long it has persisted, your age, and your health. Consider consulting a healthcare professional if any of the following are present:

• A cough that persists for more than three weeks or worsens
• Coughing up thick greenish-yellow, red, brown, or black mucus/phlegm
• Coughing up blood
• Shortness of breath/breathing difficulties
• Shallow or rapid breathing
• Fever
• Unexplained weight loss
• Foreign object inhalation
• Swollen feet or ankles
• Vomiting or choking
• Becoming red after having a coughing fit
• Fatigue/lethargy
• Barking cough
• Chest pain
• Fainting

Cough Complications

Coughing complexities can be categorized as either acute or chronic. Acute complications of coughing include:

• Fainting episodes following coughing fits (cough syncope)³⁶
• Insomnia³⁷ brought on by nighttime coughing
• Vomiting from violent or uncontrollable coughing episodes
• Involuntary urination triggered by coughing spells
• Headaches³⁸

Chronic complications include:

• Chest wall inflammation (costochondritis)³⁹
• Hernias⁴⁰ in the abdomen and pelvis
• Fatigue⁴¹
• Rib fractures⁴² on the bottom

Cough Treatments and Remedies

While there are many cough treatments available, they will vary depending on the type of cough or the underlying cause. Your physician will prescribe treatment based on if the cough is a result of an infection, allergy, medical condition, etc.

If your symptoms last longer than a few weeks or your symptoms worsen, follow up with your doctor for diagnosis and treatment.

Final Thoughts 

It can be difficult to describe a cough with words. When describing the frequency, tone, volume, length, and other unseen characteristics of a cough, human language often falls short.

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