Sleep-related laryngospasm

Abstract

The term "sleep-related laryngospasm" refers to episodic, abrupt interruption of sleep accompanied by feelings of acute suffocation followed by stridor. The condition is included in the diagnostic and coding manual of the American Sleep Disorders Association (ASDA), but there are few references in the peerreviewed literature.Our description of the distinct clinical picture associated with this condition is based on an analysis of the histories of a series of 10 patients. The patients and their families gave precise, uniform accounts of the dramatic attacks. Diagnostic work-up included pulmonary and gastroenterological assessment.All patients reported sudden awakening from sleep due to feelings of acute suffocation, accompanied by intense fear. Apnoea lasting 5-45 s was followed by stridor. Breathing returned to normal within minutes. Patients were left exhausted by the attacks. Nine of our 10 patients had evidence of gastro-oesophageal reflux and six responded to antireflux therapy.We conclude that the nocturnal choking attacks (and the occasional daytime attacks experienced by some of the patients) are caused by laryngospasm. The pathogenesis of the apparent underlying laryngeal irritability is unknown. The condition may be related to a gastro-oesophageal reflux. Eur Respir J 1997; 10: 2084-2086 The anaesthesiological, laryngological and pneumological literature contains reports of laryngospasm occurring secondary to procedures involving manipulation of the larynx. However, very little has been published on the subject of spontaneous laryngospasm during sleep and its devastating effects on sleep quality and patients' overall quality of life.In 1987, a patient referred to us for assessment of suspected obstructive sleep apnoea syndrome (OSAS) reported suffering repeated, brief, nocturnal choking attacks. In the years that followed, we encountered several more patients who complained of sleep disturbance due to the same cause. Their distressing experiences all followed the same pattern, and the words and gestures they used to describe the attacks strongly suggested an aetiology involving mechanical obstruction of the upper airway.On the basis of a case series, we describe the clinical characteristics of this by no means rare disorder, for which the designation "sleep-related laryngospasm" is used, and present arguments supporting the conclusion that spontaneous laryngospasm is indeed the triggering factor.

Laryngospasm: An underdiagnosed symptom of X-linked spinobulbar muscular atrophy

“…Laryngospasm has been reported in patients in the initial phase of ALS, 6 and we found laryngospasm in only 2% of a large cohort of patients with ALS in early disease stages. 4 The frequency varied from daily episodes to once-yearly episodes. 7 Compared with ALS, laryngospasm in KD seems to be a frequent phenomenon because we observed this symptom in 47% of our cohort of patients with KD.…”

Parasomnias associated with sleep-disordered breathing and its therapy, including sexsomnia as a recently recognized parasomnia

“…Sleep related esophageal acid reflux promotes sleep disruption with clinical consequences involving insomnia [36], and also paroxysmal sleep related laryngospasm that may be accompanied by parasomnia-like symptoms involving abruptly sitting up in bed with intense fear, jumping out of bed, and running to the bedroom window or bathroom in an agitated state, at times with profuse diaphoresis [37][38][39]. Paroxysmal sleep related laryngospasm is characterized by abrupt awakenings from sleep.…”

Non–Rapid Eye Movement Sleep Parasomnias

“…Gastroesophageal reflux may result in prolonged laryngospasm [252][253][254] or stridor [254]. Gastroesophageal reflux may exacerbate bronchial asthma or result in pulmonary aspiration [255].…”