Better Me

Understanding Laryngospasm: Causes, Symptoms, and Management

Laryngospasm is a condition where your vocal cords – which are in your throat – tighten and close. Symptoms of laryngospasm can come on suddenly, and they can be quite scary. People of all ages and genders can develop laryngospasm.

“It is a condition where the vocal cords are irritated, and they come together. That effectively closes off the airway,” said Helena Yip, MD, an ear, nose and throat (ENT) specialist with Banner – University Medicine.

With laryngospasm, you may gasp for breath, feel like you’re choking and have a desperate need for air. Your voice may sound hoarse or strained. “Oftentimes, you may lose your voice during these episodes,” said Dr. Yip. “You may feel as if you cannot breathe, but it is not a life-threatening condition. In the worst-case scenario, you may pass out and then the spasm will stop.”

What can cause laryngospasm?

Certain triggers can irritate the vocal cords and cause laryngospasm. Recognizing and managing these triggers can help you avoid repeat episodes.

  • Gastroesophageal reflux disease (GERD): With this digestive problem, stomach acid can flow back into the esophagus, irritate the throat and trigger laryngospasm. 
  • Allergies: Allergic reactions can be triggers. 
  • Respiratory infections: Colds, flu or bronchitis can lead to long-lasting throat irritation. 
  • Chronic cough: “Sometimes, a severe coughing spell could be so bad that your vocal cords end up spasming and coming together,” Dr. Yip said.
  • Anxiety or stress: “This used to be thought of as a common cause, especially in young elite female athletes,” said Dr. Yip. “But anxiety or stress are more likely to be the result of not being able to breathe, rather than the cause.” 
  • Irritants: Inhaling smoke, chemical fumes, pollen, dust or strong odors can irritate the throat. 
  • Strenuous physical activity: Exercise can trigger laryngospasm in some people. 

What to do if you have a laryngospasm episode

It’s common to feel distressed. Try to stay calm, since panicking can make your symptoms worse. Here are some steps to try:

  1. Purse your lips or make “kissy face” lips and exhale slowly. Pursed lips help put the vocal cords in a relaxed position.
  2. Take two short sniffs through your nose.
  3. Repeat until breathing improves.

When you start to feel better, you can take steps to help keep your vocal cords from being irritated:

  • Avoid irritants: If you know that something like smoking, strong odors or allergens triggered your episode, steer clear of them in the future. Treat acid reflux and reduce stress.
  • See a speech pathologist: You can learn breathing retraining exercises.

When to get medical care

“If you are experiencing laryngospasm episodes, seek treatment,” said Dr. Yip. A pulmonologist or allergist can evaluate your symptoms. If you have asthma and have laryngospasm symptoms even though you’re taking asthma medications, it’s a good idea to also see an ENT doctor.

Dr. Yip warned that sometimes, people are overtreated for laryngospasm symptoms in the emergency room (ER). They may receive steroids or intubation. 

“If you have been healthy, don’t have a history of asthma and you suddenly develop breathing difficulties that goes away without any lip swelling, then you should suspect laryngospasm,” she said. “It is an underdiagnosed condition and can often be overtreated as an anaphylactic (life-threatening allergy) condition. So it’s important to mention laryngospasm to your health care provider as a possibility.”

Diagnosing laryngospasm

“Laryngospasm is often misdiagnosed as asthma or allergies,” said Dr. Yip. If you’re being treated for allergies or asthma and you aren’t getting better, you may want to see an ENT specialist.  

“Usually, laryngospasm is a diagnosis of exclusion, meaning you have already seen a pulmonologist or allergist, done tests and tried treatments for allergies or asthma before seeing an ENT,” Dr. Yip said. 

An ENT will often diagnose laryngospasm based on your symptoms since your examination can be completely normal.  

How speech therapy and treatment can help

A speech therapist can teach you techniques that may reduce your laryngospasm risk. It’s a good idea to see a speech therapist with experience in vocal cord dysfunction. “Specific breathing exercises called respiratory retraining exercises can break the closing of the vocal cords,” Dr. Yip said.

In stubborn cases, you can have Botox injections to the voice box to inhibit the vocal cords from coming together temporarily. “The injection will effectively reset the voice box. When the Botox wears off, then the voice box is not so overly sensitive,” said Dr. Yip.

Connect with education and support  

Laryngospasm is underrecognized, often misdiagnosed and can be unpredictable. Once you learn the breathing techniques to undo it, you’ll feel less anxious, and you can educate your close family, friends and colleagues. You may want to share a signal to let them know laryngospasm is starting.

You may also want to carry a card or note that explains your condition in case you have an episode in a public place. 

The bottom line

Laryngospasm is a condition where your vocal cords contract and block your airway when you are inhaling or exhaling. Gasping and choking can be scary symptoms. 

“Know that laryngospasm is not life-threatening, and it can be broken with breathing techniques,” Dr. Yip said.  

An ENT specialist can evaluate your symptoms and help refer you to speech therapy. Reach out to Banner Health to connect with an expert

Other useful articles

Ear, Nose and Throat