Can a speech therapist help with chronic cough?

Yes. Speech therapists are trained in laryngeal (voice box) function and upper airway management. When chronic cough is caused by a hypersensitive larynx rather than an underlying medical condition, speech therapy techniques can retrain the cough reflex. Research shows speech therapy reduces cough frequency and improves quality of life in most patients with refractory chronic cough.

How long does speech therapy for chronic cough take?

Most people with chronic cough need four to six sessions. Many notice a reduction in coughing within the first week of practising the techniques. Sessions are typically spaced 1-2 weeks apart, with exercises to practise between appointments.

What if my doctor hasn't found a cause for my cough?

This is actually common. Research published in The Lancet suggests up to 42% of chronic cough cases have no identifiable medical cause. These are often called 'unexplained' or 'refractory' chronic cough. When medical investigations come back normal, the cough is frequently being maintained by laryngeal hypersensitivity, which is exactly what speech therapy addresses.

Is speech therapy for cough available via telehealth?

Yes. Sona Speech offers chronic cough therapy via telehealth across New Zealand. The techniques translate well to video sessions, and telehealth removes the travel barrier that can make regular appointments difficult.

A Cough That Won't Go Away? It Might Not Be What You Think

You’ve been coughing for months. Maybe longer.

The tests are clear. The chest X-ray looks fine. The medication didn’t work, or it helped briefly and then stopped. Nobody can tell you why you’re still coughing.

You’ve done the rounds: GP, respiratory specialist, maybe an ENT. Everything comes back normal. But the cough persists. It’s there when you talk, when you laugh, when you eat. It wakes you at night. It’s exhausting, embarrassing, and it’s taken over your life.

Here’s what most people don’t know: when all the medical tests come back normal, the problem often isn’t in your lungs. It’s in your larynx.

Why the cough won’t stop

Your larynx (voice box) sits at the top of your airway. It’s designed to protect your lungs by triggering a cough when something harmful tries to get in. That’s a useful reflex.

But sometimes this reflex becomes hypersensitive. It starts firing at things that shouldn’t trigger a cough: cold air, talking, laughing, strong smells, eating, even just taking a deep breath. The larynx has essentially turned up its sensitivity dial and can’t turn it back down.

This is called cough hypersensitivity syndrome, and it’s far more common than most people realise.

Research published in The Lancet suggests up to 42% of chronic cough cases have no identifiable medical cause. That’s nearly half of all people with a persistent cough being told “we can’t find anything wrong” and sent home without a solution.

The gap in the system

Chronic cough falls into a gap between medical specialties. Respiratory physicians focus on the lungs. ENT specialists focus on the ear, nose, and throat structures. Gastroenterologists look at reflux. Each specialist examines their piece, finds nothing wrong, and refers you on.

Nobody owns the problem.

But the mechanism maintaining the cough, the hypersensitive larynx, sits in exactly the territory speech therapists know best. We work with the larynx and upper airway every day. We understand how it functions, how it malfunctions, and how to retrain it.

How speech therapy fixes it

Speech therapy for chronic cough targets the hypersensitive cough reflex directly. The approach combines education, breathing techniques, and laryngeal control exercises.

Understanding what’s happening. Most people feel enormous relief just learning there’s an explanation. Your cough has a mechanism. It’s not in your head. It’s not anxiety. Your larynx is genuinely hypersensitive, and that’s a treatable condition.

Cough suppression techniques. You’ll learn specific strategies to interrupt the urge to cough before it takes over. These are techniques you can use anywhere, any time you feel that tickle building.

Breathing retraining. Many people with chronic cough develop breathing patterns that actually feed the cycle. Mouth breathing, upper chest breathing, frequent throat clearing. Therapy addresses these patterns and replaces them with ones that calm the larynx rather than irritate it.

Laryngeal relaxation. Tension in and around the larynx maintains hypersensitivity. Targeted relaxation exercises reduce this tension, gradually lowering the sensitivity threshold back to normal.

Irritant management. Identifying and managing the specific triggers that set off your cough: cold air, certain foods, strong perfumes, dry environments. Not by avoiding them forever, but by building resilience.

The evidence

This isn’t alternative medicine. Speech therapy for chronic cough has a solid evidence base.

A landmark randomised controlled trial published in The Lancet (Vertigan et al., 2006) showed that speech pathology management reduced cough frequency by 41% compared to placebo. Patients also reported significant improvements in quality of life.

More recent research continues to confirm these findings. A 2020 systematic review in the European Respiratory Journal found consistent evidence that behavioural cough suppression therapy (delivered by speech therapists) reduces cough frequency, severity, and impact on daily life.

The British Thoracic Society guidelines now recommend speech therapy as a treatment for refractory chronic cough. International cough guidelines from the European Respiratory Society include speech therapy in their treatment algorithms.

This is mainstream, evidence-based treatment. It’s just not widely known yet.

Is this you?

You’ve had a cough for more than eight weeks and all the tests are normal. You’ve tried inhalers, reflux medication, antihistamines. Nothing sticks. Your GP is running out of ideas. You’ve started to wonder if this is just your life now. It doesn’t have to be.

You cough every time you talk, laugh, or eat. Social situations have become stressful. You avoid restaurants because you can’t stop coughing through meals. Phone calls are exhausting. You’ve stopped singing in the car. The cough has shrunk your world.

You’ve been coughing for years. Everyone has told you to “just drink water” or “try honey and lemon.” You’ve heard every suggestion. The cough has become part of your identity, something people know you for. But it doesn’t have to be permanent. Even coughs lasting years can respond to speech therapy.

What to expect

Most people with chronic cough need four to six sessions.

Your first appointment is an assessment. Sacha will take a detailed history of your cough: when it started, what triggers it, what you’ve tried, how it affects your daily life. She’ll observe your breathing patterns and assess your laryngeal function.

From there, you’ll learn the techniques across a series of sessions, typically spaced one to two weeks apart. You’ll practise between sessions, because the real progress happens when you apply the techniques in your everyday life.

Most people feel a difference within the first session. Not a cure, but a sense that they have some control over the cough for the first time. Over the following weeks, as the techniques become automatic, the coughing gradually reduces.

You don’t have to keep coughing

If you’ve had a chronic cough with normal medical investigations, speech therapy is likely the missing piece. It targets what medicine can’t reach: the hypersensitive reflex that’s maintaining the cough.

Sona Speech offers chronic cough therapy via telehealth across New Zealand. Most people are seen within a week of booking.

Book a speech assessment to get started.