FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Choosing One Comfortable Cough Substitute

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Original entry 3: Gentle nasal sniff or clinician-selected substitute. This page expands the original list rather than adding a new intervention. [Professional consensus; individual assessment required]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For the Person With FND

There is no single trick that suits every cough or throat sensation. A speech and language therapist may teach a small nasal sniff, a comfortable dry swallow, a gentle pursed-lip exhale or another response after checking what your airway and breathing are doing. You only need the response that fits your assessment.

Trying it with your care team

Ask your clinician to demonstrate the chosen response and watch you try it while comfortable. Agree a short cue you can remember. Use that one response at an early familiar urge, then let breathing settle naturally and return to what you were doing. Ask for a written or visual reminder if remembering instructions during symptoms is difficult.

Making room for difficult days

A sniff should not become a series of forceful gasps. A dry swallow should not become repeated throat checking. If the selected action causes strain, dizziness, more coughing or difficulty breathing, stop and ask for a different approach. Do not cycle through every example on this page to find a rescue treatment for an unexplained episode.

For a familiar, mild bout, use your agreed plan and reduce the activity demand if needed. Once comfortable, return gradually to something ordinary. You do not need to make up missed practice. If the approach repeatedly makes things harder or offers little help, ask for review; continuing support should not depend on quick improvement.

When this page is not the right response

Do not use cough suppression to manage choking, serious breathlessness or a new unexplained breathing pattern. Seek emergency help for severe difficulty breathing, blue or grey colour, inability to speak because of breathlessness, collapse or suspected airway obstruction. Chest pain or coughing blood needs urgent medical assessment. New noisy breathing, fever, weight loss, repeated chest infections or a changed persistent cough warrants reassessment. Follow prescribed respiratory treatment and your individual emergency plan.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Family, Friends, and Other Supporters

Use the person’s agreed cue, if invited, rather than adding your own breathing instructions. Several people coaching at once can be overwhelming. Give them room to use their plan and keep prescribed respiratory treatment available.

Agree beforehand how the person wants help during a familiar bout. A changed or severe episode calls for the medical plan rather than more coaching. Coughing can be exhausting even after the visible bout has ended; leave room for recovery and practical help.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Select according to cough, laryngeal, nasal, swallowing and respiratory findings. Demonstrate the exact response and check teach-back. Distinguish assessed inducible laryngeal obstruction from FND and asthma; they can coexist, and their action plans must remain clear. These examples are options within therapy, not a validated sequence for all patients.

These pages concern assessed presentations. Chronic cough, cough hypersensitivity, tic cough, somatic cough syndrome and inducible laryngeal obstruction are not interchangeable diagnoses, and upper-airway symptoms are not automatically FND. Use the paired diagnostic page and coordinate an individualized plan. Agree a review point, meaningful participation goals and access adaptations rather than prescribing an arbitrary exercise dose.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

The practical explanation adapts professional consensus into everyday language. It is not a tested standalone protocol. Evidence from broader cough-management programmes or other airway diagnoses does not establish the efficacy of this single component in FND. Illustrative situations are teaching examples, not patient quotations or outcome claims.

  • FND-CIT-0025: Baker J, Barnett C, Cavalli L, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. JNNP. 2021;92(10):1112–1125. DOI. FND-related speech and language therapy consensus; component-specific evidence is limited.

  • FND-CIT-0147: Haines J, Esposito K, Slinger C, et al. UK consensus statement on the diagnosis of inducible laryngeal obstruction in light of the COVID-19 pandemic. Clinical & Experimental Allergy. 2020;50(12):1287–1293. DOI. Supports specialist diagnostic assessment; pandemic access arrangements are historical, not a general reason to omit laryngoscopy.

Source review: September 20, 2026 · Human review pending

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —