6 Vocal Hygiene Tips You Need To Know!

Background Information, General, Tips, Guides & Practice, Voice Kevin Dorman February 19, 2018

In order to breathe easily and produce voice with the least amount of effort, one needs to establish a foundation of healthy habits to promote vocal hygiene. At Prismatic Speech Services, both transgender vocal training and rehabilitative voice therapy clients begin with learning the basics of proper vocal hygiene. Oftentimes, underlying vocal hygiene issues can be the cause of unnecessary strain and, over time, develop into a voice disorder, or an injury to the vocal mechanism.

From our lungs to our lips, our airway's walls are made of mucosal tissue; a lining designed to keep the airway humid. When one's water intake is low, the tract can dry out, making producing voice much more difficult. Take a look at this video of healthy vocal fold function:

The rippling, vibratory motion of the epithelial layer (or the outer layer of the vocal folds) is dependent on proper bodily hydration and a moist environment. When the mucosal tissue gets dry it becomes prone to irritation, which can cause a coughing fit, which in turn causes more irritation to the mucosal tissue.

The #1 way to take care of your body is to listen to the signals it's sending you. What does your body feel like when you don't drink water throughout the day? What about when you drink more water? Does your throat feel tired, or even sore, throughout the day, and if so, are there any trends you can establish as to the cause, time of day, how stressed you are, etc? These signs and signals can vary from person to person, so asking these questions are crucial for developing a deeper understanding of your unique physiology and how your body needs to be taken care of!

Making sure you drink enough water is one of the best things you can do for your body. Without proper hydration throughout the day, many bodily functions have a much more difficult time working properly, and the respiratory tract is no different.

Nailing down how much water you, as an individual, should drink is tricky; everyone's body is different and has different needs. The best gauge of your hydration is your urine. If your urine is clear or light yellow, you're doing well! If your urine is dark yellow, you should increase your water intake.

Track Your Intake!

Unsure of how much water you're consuming each day? Try keeping a record of your intake for a week using a journal or app of your choice! An app I'd recommend is Plant Nanny, available for free on iOS and Android. This app encourages you to keep drinking throughout the day by giving you a cute cartoon plant to take care of–whenever you drink a glass of water, you water your virtual plant. Doing so will keep your plant healthy and growing until it reaches its adult form; and believe me, you'll want to keep that little guy happy. Forgetting to drink water (and water your plant) will cause it to shrivel up and become unhappy.

But the game doesn't leave you to the whims of your memory; it also sends you small reminders to drink water if you haven't watered your plant in a certain time period. Using this app really helped me increase my water intake, and it was incredible how much better my body felt when it was receiving the amount of water it needs!

Compensate for Dehydrating Agents

There are a number of different factors in our environment and personal habits which can result in dehydration, where one's body is losing more water than it's taking in. These agents will not affect every person the same way; some are more sensitive to dehydration than others. As discussed below in the treatments for acid reflux, monitoring your diet and keeping track of any substances you ingest or activities you partake in which cause a great deal of dehydration is a great first step towards learning your individual body's needs. Below are some common dehydrating agents:

When one speaks at excessively higher intensities to make one's voice louder, a couple different things happen physically. Instead of the vocal folds coming together in perfect synchronicity with air being provided (as seen in the video above), the vocal folds are slammed together tightly, causing a hard impact and requiring more air to be provided from below to push them apart.
This harsh, high-impact usage can cause damage to the delicate membranes and muscles of the larynx. Over time, (non-cancerous) lesions such as nodules, polyps, or cysts may develop. These growths interfere with the vocal folds' abilities to function properly, resulting in an atypical voice quality. Vocal hemorrhaging (or bleeding) can also occur from this phonotraumatic use. If an injury to your vocal mechanism is suspected, you are encouraged to cease vocalizing for the time being and seek an assessment as soon as possible.

Some examples of high intensity usage which may result in an injury include:

Loud or Extensive Talking
Talking in Noisy Situations (see: Lombard Effect)
Prolonged Whispering
Yelling, Screaming
Excessive Throat Clearing, Coughing, or Sneezing

This is pretty common knowledge at this point, but smoke isn't great for one's laryngeal, lung, and oral health! Evidence shows that inhaling smoke can alter the structure of your vocal folds, and is directly related to developing laryngeal cancer. Smoking also inhibits your body's ability to clean carcinogens from the airway and lungs, and weakens your immune system. Inhaling smoke frequently irritates the airway's mucous membranes, resulting in frequent coughing or throat-clearing (the negative effects of which are discussed above).

Both allergens and allergy medications can have serious effects on one's respiratory system. Allergies can irritate the mucous membranes of the airway. This can lead to infection of the sinus cavities, swelling, and excess mucus production. The excess mucus, in turn, can drip down the back of the throat, irritating and stiffening the vocal folds. The thicker mucus production can also result in more frequent throat-clearing and coughing behaviors, and know how damaging those can be.

On the other side of the coin, allergy medications can cause the mucous membranes to dry out to an extreme degree, also resulting in irritation and potential damage. The importance of working with a primary care physician to find the medication that works for you can never be overstated.

Acid reflux refers to when stomach acid escapes out of the stomach and travels up the esophagus. When this happens multiple times a week, it's referred to as Gastroesophageal Reflux Disease (GERD). If you suspect you might be experiencing GERD, you are encouraged to see your primary care physician as soon as possible. The tissue lining the esophagus is not structured to be exposed to the caustic acid; thus, over multiple instances of acid exposure, serious damage may occur. Depending on how far the acid goes up the esophagus, it can reach the vocal folds and cause damage to your vocal mechanism (referred to as Laryngopharyngeal Reflux or LPR). This can result in a number of complications, from mild hoarseness and a sore throat to physically altering the structures if treatment is not administered at an early enough stage.

Lifestyle Changes

There are a number of factors in one's life which could predispose one to GERD. Stress is a large factor in many people's lives, and can heavily affect digestion. Smoking can also cause irritation, and nicotine relaxes the top opening of the stomach (the Lower Esophageal Sphincter, or LES). Look into these potential lifestyle changes which may lower your recurrence of acid reflux:

Reduce Stress
Avoid Wearing Tight or Compressive Clothing
Reduce Smoking
Reduce Coughing
Eat Smaller, More Frequent Meals
Avoid Exercising Immediately Following Eating

Sleep Suggestions

Many people who experience GERD experience acid reflux while they sleep, although they may not know it. Due to the body's supine position while resting, gravity is no longer helping keep acid down in your stomach, and if your LES is relaxed, acid can travel up the throat much eaasier. It's very difficult to know if this is happening until symptoms are observed. However, there are several changes to your sleeping positioning to decrease the likelihood of nighttime acid reflux:

Elevate Your Chest/Head Several Inches
Don't Eat Two Hours Before Resting
Avoid Sleeping On Your Stomach/Back
Sleep on Your Left Side

Medicinal Management

In addition to the treatment options previously listed, there are also several types of medicine which can help with indigestion. Some of these are available over-the-counter, and some require a prescription. If you find that you are frequently taking over-the-counter medication to alleviate acid reflux, consult your primary care physician to find a more effective method of treatment. Here are some possible medicinal treatments you may discuss:

Over-the-Counter Antacids: Short-Term Relief
H2 Blockers: Reduce Stomach Acid Production
Proton Pump Inhibitors: Greatly Reduce Acid Production
Prokinetics: Cause the Stomach to Empty Faster
Antibiotics: Treatment of Possible Infection

Above is a condensed .pdf version of the vocal hygiene guidelines outlined in this article. It is freely available and is intended to be a general guide for anybody who can use the information. I hope you find the information outlined in this article useful! Once one is living with vocally hygienic habits, they can begin exploring efficient ways of producing voice. If you're interested in these topics, I'd highly recommend you read my articles on respiration and producing voice. Let me know if you have any ideas for improving this resource as well!

Take care,

(1 Comment)

Barbara Wilder March 26, 2018

Thanks, Kevin! This looks great! I am working with adult voice therapy Pt on an outpatient basis and I was just looking for something like this! Also, I haven’t had a chance yet to join one of your transgender voice training conversations but I look forward to doing it in the near future!