A laryngospasm is a sudden, involuntary clamping of your vocal cords that blocks your airway, typically lasting about 20 seconds before releasing on its own. Those seconds feel much longer when you can’t breathe or speak, but specific physical techniques can help break the spasm faster, and treating the underlying cause can prevent episodes from coming back.
What to Do During an Episode
The most important thing during a laryngospasm is to avoid panicking, which is easier said than done when your airway closes. Panic triggers your body to gasp harder, which can make the spasm worse. Instead, focus on slow, controlled breathing through your nose if any air is getting through. Breathing out through pursed lips (as if blowing through a straw) creates back-pressure in your airway that helps push the vocal cords apart. This works because the positive pressure acts as a physical force against the muscles holding your vocal cords shut.
If you can’t get air through at all, try swallowing repeatedly. Some people find that bearing down gently (the same motion as straining during a bowel movement) can interrupt the reflex. Tilting your chin up slightly to extend your neck may also help open the airway.
The Larson Maneuver
A well-established technique called the Larson maneuver involves applying firm pressure with your fingertips to the soft spot just behind both earlobes, in the notch between the jawbone and the base of the skull. You press inward firmly while simultaneously pushing your jaw forward (a jaw thrust). This stimulates a nerve response that can release the spasm. It was originally developed for anesthesiologists managing patients in the operating room, but the finger-pressure component can be done on yourself or by someone nearby during a waking episode.
Why Most Episodes Are Linked to Acid Reflux
If you’re having repeated laryngospasms outside of surgery, acid reflux is overwhelmingly the most likely cause. Studies consistently find that 80% to 94% of people with recurrent laryngospasm have gastroesophageal reflux disease (GERD). Stomach acid creeping up to the throat irritates the tissues around the vocal cords, triggering the protective spasm reflex even when there’s nothing to protect against.
The encouraging news is that treating the reflux reliably stops the episodes. In one study of 35 patients with recurrent laryngospasm, 94% were found to have reflux, and every single patient’s laryngospasm was completely prevented within six weeks of starting acid-reducing medication and making lifestyle changes. Another study of 12 patients found that all responded to reflux treatment, with laryngospasm stopping entirely after dietary and lifestyle adjustments. A third study reported complete remission in about half the patients and partial improvement in most of the rest.
If you’re experiencing repeated episodes, especially ones that wake you from sleep or happen after meals, untreated reflux is the place to start investigating. Many people with reflux-triggered laryngospasm don’t have classic heartburn, so the connection isn’t always obvious. A doctor can evaluate you with upper endoscopy or pH monitoring to confirm the diagnosis.
Other Triggers Worth Knowing
Low calcium levels can trigger laryngospasm, though this is much more common in infants than adults. In adults, it typically shows up alongside other signs of calcium deficiency like muscle cramps, tingling in the hands and feet, or more severe muscle spasms. One documented case involved a patient whose blood calcium had dropped to less than half the normal range. If you have a condition that affects calcium absorption (such as a parathyroid disorder) or have had thyroid surgery, this is worth discussing with your doctor.
Upper respiratory infections, strong chemical fumes, smoke, and cold air can also provoke episodes. People with a history of laryngospasm often notice that their episodes cluster around colds or exposure to airborne irritants. Vocal cord dysfunction, a related condition where the vocal cords close inappropriately during breathing, shares many of the same triggers: exercise, psychological stress, irritants, sinus problems, and reflux. The key difference is that laryngospasm is typically a brief, intense event lasting seconds, while vocal cord dysfunction tends to cause longer episodes of breathing difficulty with audible stridor (a high-pitched sound when inhaling).
Laryngospasm During or After Surgery
Laryngospasm is one of the more common complications of general anesthesia, particularly in children. About 60% of anesthesia-related laryngospasms happen during the emergence phase, when the patient is waking up. Key risk factors include having an active upper respiratory infection (which nearly triples the risk), excess secretions in the throat, and being at an inadequate depth of anesthesia during airway management. Children with airway abnormalities face the highest risk.
If you or your child has a history of laryngospasm during anesthesia, or if your child has an active cold before a scheduled surgery, let the anesthesia team know. In most surgical cases, the spasm resolves with supplemental oxygen and gentle positive airway pressure. Only a small percentage of cases require medication to break the spasm.
When a Laryngospasm Becomes Dangerous
Most laryngospasms resolve on their own within seconds. But in rare cases, a prolonged spasm can drop oxygen levels dangerously low, cause loss of consciousness, or trigger a dangerously slow heart rate. One documented emergency case involved a patient whose oxygen saturation fell to 76% (normal is 95% or above) with a respiratory rate nearly three times normal. She required emergency medication to break the spasm.
Signs that an episode needs emergency care include turning blue around the lips or fingertips, losing consciousness, a spasm lasting longer than a minute or two, or episodes that keep recurring within a short period. If someone near you has a laryngospasm and passes out, call emergency services immediately. Loss of consciousness sometimes allows the vocal cords to relax and the airway to reopen, but this is not something to count on.
Long-Term Prevention Strategies
For most people with recurrent laryngospasm, prevention means treating the root cause. If reflux is the driver, acid-reducing medications combined with lifestyle changes (elevating the head of your bed, avoiding eating within three hours of lying down, reducing acidic and fatty foods) have proven highly effective in clinical studies. Some patients who don’t fully respond to one medication improve when a second type is added.
Reducing exposure to known irritants helps if environmental triggers are involved. This includes avoiding strong fumes, wearing a scarf over your nose and mouth in very cold air, and managing sinus conditions or allergies that increase throat secretions. For people whose episodes are linked to stress or anxiety, breathing retraining with a speech-language pathologist can teach techniques to consciously relax the throat muscles and interrupt the spasm reflex before it fully takes hold.
Keeping a log of when your episodes happen, what you were doing, what you ate beforehand, and how long they lasted gives your doctor useful information for identifying your specific pattern and tailoring treatment accordingly.