Laryngospasm describes a sudden, involuntary contraction of the vocal cords, which causes them to clamp shut and temporarily block the flow of air into the lungs. This reflex is essentially a protective mechanism, designed to prevent foreign material like water or stomach contents from entering the windpipe and lungs. Though the sensation of being unable to breathe or speak can be frightening, these episodes are typically brief, lasting less than 60 seconds before the vocal cords relax and normal breathing resumes. Understanding both how to manage an acute episode and how to address the underlying cause can help reduce the frequency and severity of these alarming events.
Immediate Actions to Halt an Episode
The most immediate and effective step during a spasm is to resist the instinct to gasp or panic, as rapid, shallow breathing can worsen the vocal cord constriction. Instead, focus on a controlled, intentional shift in breathing mechanics to encourage the vocal cords to open. One of the most successful techniques involves forcing air out through a small opening to create back pressure in the airway.
Try to hold your breath for approximately five seconds, then exhale slowly and forcefully through tightly pursed lips, as if blowing through a narrow straw. This maneuver creates positive pressure below the larynx, which can act to push the vocal cords open and interrupt the reflex arc that is keeping them closed. If possible, repeat this sequence of holding and slow, controlled exhalation until the spasm begins to release.
A physical technique known as the “laryngospasm notch maneuver” can also be attempted to disrupt the muscular reflex. This involves applying forceful, sustained pressure bilaterally on the soft area just behind the earlobes and slightly above the jawbone. The intense pressure in this area, sometimes called Larson’s point, can trigger a neurological response that forces the laryngeal muscles to relax. If assisting someone else, instruct them to sit up and focus on controlled breathing while applying pressure inward and forward towards the base of the skull.
Understanding and Pinpointing Common Triggers
Laryngospasms are rarely random events; they are typically a symptom of an underlying condition that sensitizes the laryngeal nerves. One of the most common precursors is irritation caused by stomach contents, known as Gastroesophageal Reflux Disease (GERD) or Laryngopharyngeal Reflux (LPR). When stomach acid or digestive enzymes back up and touch the sensitive tissue of the voice box, it immediately provokes the protective closure reflex. This type of spasm often occurs at night, waking a person from sleep, or after a large meal.
Stress and anxiety are also frequent activators, as intense emotional responses can cause muscle tension throughout the body, including the laryngeal muscles. In these cases, the spasm is often classified as psychogenic. Environmental factors, such as inhaling fumes, dust, smoke, or even cold, dry air, can directly irritate the vocal cords and provoke the spasm reflex.
People with conditions that cause airway hypersensitivity, like asthma or chronic allergies, are more susceptible to these spasms. The inflammation present in the respiratory system makes the laryngeal tissues more reactive to minimal stimuli. Laryngospasm is also a known, though rare, complication during the administration of general anesthesia, particularly when the patient is lightly anesthetized or during the removal of the breathing tube after surgery.
Proactive Strategies for Recurrence Prevention
Preventing future episodes involves identifying and managing specific triggers. For spasms linked to acid reflux, dietary and positional changes are necessary. Avoid lying down for at least three hours after eating, and elevate the head of the bed by six to eight inches using blocks or a wedge pillow. Limiting common reflux-triggering foods and beverages, such as caffeine, alcohol, chocolate, mint, and fatty or spicy items, can also significantly decrease the frequency of events.
If anxiety or stress is determined to be the primary cause, incorporating relaxation and stress-reduction practices into the daily routine is beneficial. Techniques like diaphragmatic breathing, meditation, or progressive muscle relaxation can help lower overall muscle tension and reduce the nervous system’s reactivity. Consulting with a speech-language pathologist is also highly recommended, as they specialize in breathing retraining exercises that promote a healthy, less reactive breathing pattern.
For individuals sensitive to environmental stimuli, minimizing exposure to airborne irritants can reduce laryngeal nerve stimulation. This involves using high-efficiency particulate air (HEPA) filters in the home, avoiding smoking or second-hand smoke, and wearing a scarf over the mouth and nose in cold air. Adequate hydration is also an effective strategy, as it helps thin the protective mucus layer in the throat, making it a more resilient barrier against irritation.
When Laryngospasm Requires Medical Intervention
While most episodes of laryngospasm are brief and resolve spontaneously, persistent or recurrent instances warrant consultation with a healthcare professional. Seek an evaluation if the spasms become more frequent, last longer than a few minutes, or are accompanied by a bluish tint to the skin or lips, which indicates oxygen deprivation. Spasms occurring after surgery or anesthesia always require immediate medical attention.
A physician, often an otolaryngologist, can conduct diagnostic procedures such as a laryngoscopy to visually inspect the vocal cords for irritation or abnormalities. They may also order specialized tests to confirm the presence of GERD or LPR. Treatment might involve prescribed medications to suppress stomach acid production or anti-anxiety agents to reduce nervous system over-reactivity. In rare, severe cases refractory to other treatments, a physician may consider a Botulinum Toxin injection into the laryngeal muscles to temporarily relax the vocal cords.