Laryngospasm: Causes, symptoms and treatments
Laryngospasm happens when the muscles of the vocal cords seize up, restricting the flow of air into the lungs.
This may happen during the night, with a person waking up unable to speak or breathe.
This condition is relatively rare. Although it can be frightening, it usually clears up after a few minutes.
Laryngospasm can be caused by allergic reactions, foreign bodies in the throat or infections, such as epiglottitis.
Laryngospasm can also be related to gastro-oesophageal reflux disease ( GORD). GORD is a condition that occurs when the ring-like muscle that normally closes to keep the stomach's contents from backing up doesn't work correctly. With GORD, harsh acids from the stomach rise up into the oesophagus and cause irritation.
Regular exposure to stomach acids can damage and inflame the delicate lining of the oesophagus. This damage can lead to momentary spasms of the vocal cords, which close the airway and prevent air and oxygen from getting into the lungs.
When stomach acids reach the larynx, the condition is called laryngopharyngeal reflux (LPR). The tissues of the larynx are even more delicate and prone to injury than the oesophagus. Coughs from a cold can push more acid into the larynx. So a recent or current upper respiratory infection may increase the likelihood of developing laryngospasm.
Laryngospasm may also be a complication of surgery. Anaesthesia used during the surgery can irritate the vocal cords, especially in children.
Laryngospasm caused by anaesthesia can be life-threatening.
What are the symptoms of laryngospasm?
When laryngospasm occurs people are unable to breathe or speak. Sometimes the episodes occur in the middle of the night. A person may suddenly awaken feeling as though he or she is suffocating. This condition is called sleep-related laryngospasm. It also is related to GORD. Some people will actually lose consciousness during these episodes.
As the airways slowly open, the person will make a high-pitched breathing sound (called stridor). The entire episode lasts only a minute or two before breathing returns to normal. But the experience can be terrifying.
In addition to experiencing laryngospasm episodes, people with this condition will typically have symptoms of GORD, which include:
How is laryngospasm treated?
If GORD is the problem, treating the condition can help manage laryngospasm. Doctors often prescribe proton-pump inhibitors that reduce the production of stomach acids to make the fluids from the stomach that do back up into the oesophagus less corrosive. Another option is “prokinetic agents”. These stimulate movement in the digestive tract to reduce the amount of acid available.
Patients who don't respond to these treatments may need a surgical procedure called fundoplication. This is a procedure that wraps the upper part of the stomach (fundus) around the oesophagus to prevent acids backing up.
You can also relieve GORD and LPR, and help prevent laryngospasm, by following these lifestyle tips:
- Avoid common heartburn triggers such as fruit and fruit juices, caffeine, fatty foods and peppermint.
- Eat smaller meals, and stop eating at least three hours before bedtime.
- If you smoke, stop. Also limit alcohol consumption.
- Raise the head of your bed 15cm (6in) by putting wood blocks under the bedpost.
In children who develop laryngospasm as a complication of anaesthesia during surgery, treatment usually involves moving the head and neck to open the airway. It also involves using a machine (continuous positive airway pressure, or CPAP) to deliver air directly into the airway. Some children need to have a tube placed into the throat to assist with breathing.