There was no significant relationship between cough frequency and sex, consistent with another study.21 This may seem surprising, since women are more likely to seek medical attention for cough, have a more heightened cough reflex, and report a greater impairment in cough-specific quality of life.22‐24 Faruqi et al19 and Kelsall et al,22 however, have reported higher cough frequency in female patients with cough. The reason for inconsistent findings regarding the relationship between cough frequency and sex is unclear. It is possible that the lack of sex difference in cough frequency in our study may be due to differences in the performance of the cough detection software between sexes; this needs further investigation. Our findings raise the possibility that the differences in quality of life and the need to seek medical attention in women may be related to factors other than cough frequency, such as cough intensity or the presence of adverse cough-related symptoms, such as urinary incontinence. It is not known if other cough sound characteristics, such as bandwidth and energy, could yield diagnostic information; this needs further investigation. As reported previously, there was a moderate relationship between cough frequency and self-reported cough symptom severity and health-related quality of life.12,19,20 This supports the possibility that cough severity may be influenced by unaccounted factors, such as cough intensity, urge to cough, personality traits, and the presence of adverse symptoms related to cough.25,26 Little is known about cough intensity, since it is difficult to measure, and the gold standard has not been established. Cough sound recorders may be an alternative to physiologic measurement of cough intensity and deserve further study. The lack of a strong relationship between subjective cough severity and objective measures of cough frequency suggests that a combination of assessment tools should be used to assess cough comprehensively.19,27 The optimal combination of cough severity measures needs to be determined.