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Struggling to Breathe? It Could Be Vocal Cord Dysfunction – Here’s What You Need to Know

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A woman uses both hands to touch her neck. She looks worried.

Struggling to breathe can be frightening, but that's what people with vocal cord dysfunction, or VCD, face on a regular basis. VCD can also impact the quality of your voice, making communication more difficult. If severe, these episodes may land a patient in the emergency room, which can be deeply alarming for both the patient and their loved ones.

“Imagine your vocal cords are two small doors,” said Katelyn Swiader, CCC-SLP, speech pathologist at Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University Ear, Nose & Throat Surgeons. “When you breathe normally, your vocal cords act like tiny doors that open wide to let air flow into your lungs. These doors stay open when you breathe out too.”

However, when these doors – your vocal cords – close unexpectedly during an inhalation, what results is Vocal Cord Dysfunction, or VCD. This is unlike asthma, which affects breathing due to narrowed airways.

“This closure during inhalation may cause you to have a gasping sound known as inspiratory stridor,” said Swiader. “It's not a physical problem with the vocal cords themselves, but rather a learned reflex where they become overly sensitive to irritants like dust, smoke, strong smells, acid reflux (GERD), or even emotional stress.”

Your vocal cords come to closure or midline when you talk, sing, swallow, cough, or lift something heavy. The amount of closure depends on what your ideal vocal task is. Sensitivity to these irritants triggers them to close too tightly, making breathing difficult.

Common symptoms of vocal cord dysfunction include:

  • Difficulty inhaling, often with a gasping sound from the throat.
  • Wheezing, especially during exercise, cold weather, or exposure to irritants.
  • Feeling like you can't catch your breath.
  • Hoarseness or changes in voice quality.

While VCD can affect anyone exposed to triggers, people in these groups are more susceptible:

  • Singers or teachers – people who rely heavily on their voice due to vocal strain
  • Athletes, especially those exposed to cold air or chlorine
  • People exposed to strong chemicals or dust at work
  • Individuals who've experienced emotional trauma
  • World Trade Center responders

The good news is, VCD is treatable. Identifying and avoiding triggers like dust or strong smells is helpful, as well as managing stress and practicing good vocal hygiene by staying hydrated. The most effective way patients can manage symptoms is to learn how to identify it and to make the physical adjustments through training with a skilled speech-language pathologist who specializes in voice and upper airway disorders.

“With speech and breathing therapy,” said Swiader, “we help retrain your vocal cords to open and close properly, reducing the false alarms and learned habits that trigger the tight closure.”

If you have had difficulty finding an answer to your breathing issues, a diagnosis of VCD often comes after a thorough process of elimination and can take time before receiving the diagnosis.

Make an appointment with Swiader or one of her colleagues at Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University Ear, Nose & Throat Surgeons by calling 757-388-6200.