Home Cough Monitoring Reveals Higher Nighttime Cough Burden in Children With Cystic Fibrosis Compared With Healthy Children

Rational Remote health‐monitoring technologies such as cough monitors can track longitudinal changes in health status in children with cystic fibrosis (cwCF). We assessed the feasibility of a bedside cough monitor and hypothesized that cwCF would have a higher baseline cough frequency compared to healthy controls (HC), which would increase during pulmonary exacerbations (PEx). Methods Cough monitors capturing continuous audio data during pre‐set sleep times were provided for 3 months. Data were analyzed over 3 s intervals using a proprietary algorithm (CurieAi, Santa Clara, CA) to identify cough events. Multivariable modeling was used to compare baseline cough frequency (coughs per night) between cwCF and HC. Results We enrolled 40 children (20 cwCF and 20 HC; median [range] age 11 years [2−18]) between February and August 2024. Most participants were White, 3 (7.5%) identified as Hispanic and/or Latino. CwCF were all treated with elexacaftor/tezacaftor/ivacaftor (ETI); baseline median (range) ppFEV 1 was 107% (86%−124%). Data were captured over 82% of nights in the study period (median of 75.5 nights per participant, range 4−106). CwCF were more likely to cough at least once during the night compared to HC (IRR = 0.279, p = 0.02), and cough at a higher, albeit non‐statistically significant rate (IRR = 1.805, p = 0.082). We could not determine whether cough frequency changed during PEx due to limited data collection surrounding reported PEx. Conclusions A passive cough monitor detected nighttime cough in cwCF and HC. CwCF with preserved lung function have more nights with cough than HC despite being on elexacator/tezacaftor/ivacaftor (ETI).