Efficacy of Behavioral Therapy for Chronic Refractory Cough

Inclusion Criteria: * Eligible participants are adults aged ≥18 years i.e. normal chest radiograph. * participants with chronic cough persisting for more than eight weeks that is refractory to standard medical treatment for common causes of chronic cough, including asthma, gastroesophageal reflux disease . * Participants are required to exhibit clinical features suggestive of laryngeal hyperresponsiveness, such as cough triggered by phonation, laughter, cold air, or irritant exposure, with associated laryngeal symptoms including throat irritation, dysphonia, or frequent throat clearing. Exclusion Criteria: * Patients are excluded if they are current smokers or had ceased smoking within six months * patients have evidence of active pulmonary or cardiac disease, recent respiratory tract infection, recent angiotensin-converting enzyme inhibitor use. * significant structural laryngeal pathology, neurological disorders affecting cough reflex control, or inability to comply with study procedures. * Head \&neck pathology e.g sinusitis, glottal insufficiency or primary muscle tension dysphonia