Dr. Aakanksha Chawla

A cough that lasts more than three weeks is generally classified as a chronic cough. While most short-term coughs are caused by viral infections and resolve on their own, a persistent cough may indicate an underlying condition that needs clinical evaluation.

Common causes of chronic cough include: post-nasal drip from allergies or sinusitis, cough-variant asthma (where cough is the primary symptom rather than wheezing), gastroesophageal reflux disease (GERD), and chronic bronchitis. Less commonly, a persistent cough may be related to interstitial lung disease, infections like tuberculosis, or other serious conditions.

When to seek evaluation: If your cough has persisted beyond three weeks, produces blood-tinged sputum, is accompanied by shortness of breath or weight loss, or disrupts your sleep — it is reasonable to consult a pulmonologist for a structured assessment. Early evaluation can help identify the cause and guide appropriate treatment, rather than relying on repeated courses of empirical antibiotics or cough suppressants.

Obstructive sleep apnoea (OSA) is a condition where the upper airway repeatedly collapses during sleep, causing brief pauses in breathing. These pauses — often lasting 10 to 30 seconds — can occur dozens or even hundreds of times per night, leading to fragmented sleep and reduced oxygen levels.

Key symptoms to watch for: loud, habitual snoring; witnessed pauses in breathing during sleep; waking up gasping or choking; excessive daytime sleepiness despite adequate sleep hours; morning headaches; difficulty concentrating or irritability.

Untreated OSA is associated with increased cardiovascular risk, including hypertension, heart disease, and stroke. It can also impair daytime alertness and cognitive function. Diagnosis typically involves a sleep study (polysomnography or a home sleep test), and treatment options range from lifestyle modifications and positional therapy to CPAP devices and, in select cases, surgical intervention.

If you or your partner have noticed loud snoring combined with daytime fatigue, a clinical evaluation can help determine whether sleep apnoea is present and what steps are appropriate.

Asthma is a chronic condition characterised by airway inflammation and intermittent narrowing, leading to episodes of wheezing, cough, chest tightness, and breathlessness. While asthma cannot be cured, it can be well-controlled with appropriate management.

Common triggers include: allergens (dust mites, pollen, pet dander), air pollution, cold air, respiratory infections, exercise, strong odours, and emotional stress. Identifying and minimising exposure to your specific triggers is a key part of asthma management.

When asthma needs attention: If you find yourself using your reliever inhaler more than twice a week, waking at night due to cough or breathlessness, or if your symptoms are limiting your daily activities — your asthma may not be adequately controlled. A structured review with a pulmonologist can help assess your current treatment, adjust medications, check inhaler technique, and create an updated action plan.

Well-managed asthma should allow you to live an active, symptom-free life most of the time. If that is not the case, it is worth revisiting your management plan.

Snoring is extremely common and, in many cases, is a benign condition without significant health consequences. However, snoring can also be the most visible symptom of obstructive sleep apnoea — a condition with real cardiovascular and neurological risks.

Simple snoring vs. sleep apnoea: Simple snoring is typically positional (worse on the back), not associated with daytime sleepiness, and does not involve witnessed breathing pauses. When snoring is loud, habitual, and accompanied by excessive daytime tiredness, morning headaches, or observed apnoea episodes, it raises the possibility of OSA.

Who should consider evaluation: Individuals with loud snoring plus any combination of daytime sleepiness, witnessed apnoeas, high blood pressure, obesity, or a large neck circumference. A targeted clinical assessment and, if indicated, a sleep study can distinguish between benign snoring and a condition that requires treatment.

Most chest infections — including viral bronchitis and community-acquired pneumonia — resolve with appropriate treatment. However, some patients experience persistent respiratory symptoms weeks or even months after the acute infection has cleared.

Post-infection symptoms that warrant evaluation: A lingering cough that persists beyond 4–6 weeks after a respiratory infection; persistent breathlessness or reduced exercise tolerance; ongoing fatigue disproportionate to the infection severity; recurrent chest infections within a short time frame; abnormal findings on a follow-up chest X-ray.

This is particularly relevant for patients recovering from severe COVID-19, influenza pneumonia, or other significant respiratory infections. Post-infectious cough, reactive airway disease, and organising pneumonia are among the conditions that may develop after a chest infection and benefit from specialist evaluation.

If you have recovered from a chest infection but find that your breathing has not returned to normal, a pulmonary evaluation — including lung function testing and imaging review — can help identify any residual issues and guide rehabilitation.