Throat Muscle Contraction
A spasm is any involuntary contraction of a muscle. If you have read much of this web site you will have seen terms like cricopharyngeal spasm or Adductor spasmodic dysphonia. The throat area has a number of muscles all of which have the potential to spasm. If laryngospasm is your condition, then the following should apply. Please be sure a physician verifies that this is your condition.
The symptoms are very characteristic.
* Abrupt, sudden onset
* May occur anytime, but often noticable when eating and talking simultaneously and something feels like it went down the wrong way
* May be awakened in the middle of the night unable to breath.
* I personally have had it happen while camping, when a tiny bug flew down my throat.
* Feels like you are going to die or never breathe again
* Yet typically, it lasts less than 30 or 60 seconds.
* Very noisy and difficult “breathing in”
* Rather easy breathing out, still able to cough.
* Faster “breathing in” makes it worse.
This syndrome results from a spasm in the adductor muscles - the muscles closing or bringing the vocal folds together. From a technical standpoint, my observation is that the lateral cricoarytenoid is the main muscle activated, but possibly the thyroarytenoid as well. As soon as your voice box or the area of the windpipe below the voicebox detect the entry of water or other substance, the vocal folds spasm shut. Evolutionarily speaking, this works very well to keep water out of the lungs - if you start to drown or a bug flies down your throat while you were starting to inhale, or you inhale that glass of water, then the vocal cords very immediately and very effectively close.
That closure is a benefit to protect the airway, but it makes “breathing in”, very difficult. It can happen even when only the sensation is present of something other than air entering the windpipe.
A management program
An exam of the neck and throat is extemely important to eliminate serious problems. Your physician may consider asthma or a narrowing of the windpipe or even heart conditions as possible causes of shortness of breath. The symptoms of laryngospasm are extremely characteristic, but, one should never assume anything without a history and physical exam.
1. Knowing what the condition is and its short duration helps patients deal with the episodes more confidently
2. The Bernoulli principle - the one you may have learned about in high school physics that keeps airplanes in the air - is the reason laryngospasm worsens with stronger attempts at breathing in. The faster the air flow through a narrow area, the lower the pressure. The voice box is the narrowest part of the windpipe so it has the lowest pressure during rapid breathing. And, in fact, laryngospasm might not be a spasm at all. It may be an inhibition or lack of ability for the opening muscles of the voice box to operate momentarily. Then, the rapid airflow through the voice box, in effect, more easily sucks the vocal folds tighter together.
3. With the Bernoulli principle in mind, one can see that slower breathing in will effectively get more air into the lungs than rapid breathing in. In fact, we spend most of our life breathing out, as in talking, then we take a quick breath in and spend more time talking. When one has an episode of laryngospasm, one can reverse this usual trend and take most of your time to breath in slowly and then a quick breath out can be followed by another slow breath in. This can be repeated until the spasm stops.
4. An observation was made by a person with the condition that if they tilted their head backwards during an episode, it made the slow breathing in easier. I certainly think that is plausible as I find it more difficult to oppose my own vocal cords with my neck extended backwards. By stretching the neck, it effectively lowers the voicebox in the neck and that may prevent some of the clamping down by the vocal cord muscles.
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