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Ear, Nose, and Throat Disorders

Is it a laryngospasm?

01/02/2001

Question:

Hello,Hello, Three nights ago, I woke up from sleep with a cough and couldn`t get my breath. My throat seemed to be closed, appeared to be in spasms and I couldn`t get a breath in. I had to hold my breath for a few seconds then slowly inhale by pursing my lips and do the same while exhaling. I could feel my throat in spasms and just a tiny bit of air could pass. After what seemed like forever, but was most likely a minute or less, I was able to breathe, careful that I didn`t cough and trigger the spasm again. It was a very squeeky sound initially until the spasms or whatever stopped. This is the 5th time this has happened in 15 years. It has also happened when I choked on my saliva while driving and other times after a harsh one time only cough. Is this some type of laryngospasms or bronchospasm? How can I prevent this and what other way can I deal with this? The only way to breathe again is to remain calm, hold my breath and slowly let the tiniest bit of air out before I can let the tiniest bit of air in. My medical history only includes myofascial trigger points of the chest muscles and pelvic muscles which are controlled and treated with PT and home exercises. Also, I have benign PVC`s and had a reaction to Keflex. I am only 38 years old, only 20 lbs overweight (depends on which chart you refer to), have three children (2 pregnancies---twins). I have no known allergies other than what I assume are environmental in the spring and fall (I feel mucousy with post nasal drip and phlegm). What is causing this frightnening problem? I am afraid that one time I will not be able to breathe again! thank you for your time

Answer:

Your problem is not that uncommon. The severity and the presentation are concerning. You say that you have post nasal drip and mucus accumulation in your throat. I would want to know if you need to clear your throat a lot. Do you occasionally get hoarse? Do you have soreness of your throat, sometimes bad enough that you get treated with antibiotics? Do you believe or have you been told that you have bad breath? Do you get heartburn or indigestion? If you answer yes to some of these questions, you probably have acid reflux causing laryngospasm. This problem is usually brought on by two problems. The first is acid reflux. The second problem is stress or anxiety. The good news about laryngospasm is that it will probably not kill you. Usually when you can`t breathe, you pass out. Once you pass out, your vocal cords will open up and you will start to breathe again. There are a couple of ways of treating this problem. When I treat patients with this problem I always put them on medication(s) to neutralize the stomach acid, even if they don`t complain of heartburn or indigestion. (Most patients with this problem do not complain of heartburn or indigestion.) The medications require a presciption. They usually take about 2-3 months to achieve maximal benefit. They are relatively safe medications and can be used for long term management of this problem. The second part of this treatment plan is to have the patient make some dietary and lifestyle changes. If there are foods that upset your system after eating them, they need to be eliminated. I usually discourage patients from eating within 3 hours of bedtime. Also, do not lay down for 3 hours after eating a meal. Cigarettes and caffeine products need to be eliminated. The third part of this treatment plan is used for those patients who go into laryngospasm. I strongly recommend some sort of relaxation activity like meditation, Yoga, Tai Chi, regular massage therapy, etc. You must do something to reduce your anxiety and stress levels. The other benefit of these activities hopefully will be the understanding that you are in control of your life and you can overcome whatever is triggering these episodes. If you have not seen an Ear, Nose and Throat specialist, I strongly recommend that you do. You voice box should be inspected to rule out other causes of cough and laryngospasm. I wish you luck in dealing with this troubling problem.

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Response by:

Keith M Wilson, MD Keith M Wilson, MD
Associate Professor of Otolaryngology, Director of Head and Neck Division
College of Medicine
University of Cincinnati