title: The effect of mindfulness meditation on cough reflex sensitivity.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Respiratory Research Group, University of Manchester, Manchester, UK. emma.young@manchester.ac.uk
authors.forename: E C
authors.initials: EC
authors.lastname: Young
authors.forename: C
authors.initials: C
authors.lastname: Brammer
authors.forename: E
authors.initials: E
authors.lastname: Owen
authors.forename: N
authors.initials: N
authors.lastname: Brown
authors.forename: J
authors.initials: J
authors.lastname: Lowe
authors.forename: C
authors.initials: C
authors.lastname: Johnson
authors.forename: R
authors.initials: R
authors.lastname: Calam
authors.forename: S
authors.initials: S
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Woodcock
authors.forename: J A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D001985:Bronchial Provocation Tests; D002908:Chronic Disease; D019343:Citric Acid; D003371:Cough / Q000139:chemically induced / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation / Q000523:psychology; D008875:Middle Aged; D012018:Reflex / Q000187:drug effects / Q000502:physiology*; D012064:Relaxation Therapy; D012680:Sensitivity and Specificity
chemical_list: D019343:Citric Acid