Anthony F. Jahn, M.D.
   
 

Articles and Tips

That Morning Voice

 

You’ve had a big night out, either singing or just socializing, and you wake up the next morning with “no voice.” While most singers need to warm up the voice in the morning, on occasion the huskiness is dramatic—and more than usual. This is not just a bit of phlegm: you went to bed as Pamina and wake up as Sarastro. You have an 11 a.m. audition. What happened? And what to do?

There are many factors that can impact the voice you wake up with. Let’s look at a few of the ways you can minimize the effects of the night before on the morning after.

First, let’s agree that singers are generally not morning people. While rehearsals are beyond your control and are often scheduled for the morning, it is better, if possible, to postpone any major auditions to the afternoon, or a time of day when you know your voice is at its best. Morning definitely does not become Elektra—or Brünnhilde, for that matter. (And I apologize both to you and to Eugene O’Neill for that execrable pun.)

While the problem of morning voice (or, more correctly, morning no-voice) affects non-classical singers more—likely because of the kind of singing and the lifestyle that goes with pop or rock performance—classical singers can also be affected. Although they are more careful with their singing, they are still prone to morning hoarseness. While the degree of hoarseness is less, the classical voice is held to a more exacting standard than the voice of a rock singer, so the issue is relevant.

Let’s begin with the night before. Excessive vocal strain, either singing or speaking, is a major factor. When I examine a singer’s larynx in the morning, even after a normal and uneventful concert, I commonly see some redness and mild swelling of the vocal folds. If that performance was long, loud, or followed by a vocally taxing social event—a party or dinner in a noisy restaurant—the vocal folds can be even more swollen and the voice more hoarse.

To look at why, remember the Lombard effect: this is a law in psychoacoustics that states that when we speak, we will unwittingly raise our voice to be about 35 decibels above the background noise. So if your evening ends in a noisy restaurant or bar with an ambient noise level of 60-70 decibels, you will be normally using your voice at over 100 decibels, which is pretty loud and stressful to the vocal folds. The culprit may not be the performance itself but what happens after the performance. Solution: Make your post-concert celebration brief, hold it at a quieter venue, and try not to schedule any singing for the following day.

The best treatment for vocal strain is simple: vocal rest. In the non-classical singing community, there are voice therapists who suggest that after excessive voice use, you should “warm down” the larynx, similar to walking after a run, to get rid of any lactic acid in your muscles. I personally don’t think this approach is relevant to classical singers, and I mention it only in case you may have heard about it. The truth is, your vocal folds are moving all the time, even when you are not phonating. They gently swing to and fro with each breath (even breathing through your nose), they close with every swallow, and they close and open with coughing and straining. So there is a normal “warming down” that takes place even while you sleep, through no conscious effort on your part.

But back to the “night before.” What about that 11 p.m. post-performance Chinese food takeout? This is a sure-fire prescription for night-time acid reflux. Scheduling meals around performances is always a problem: you can’t support with a full stomach, so the meal before the performance is a small one, but you are hungry and still energized after the show. I would suggest that you avoid food you know causes reflux for you (such as tomatoes and spicy foods), and concentrate more on carbs, which naturally tend to make you sleepy. And consider topping off your meal with some antacid as you go to bed.

And what about that champagne toast (or two)? Alcohol is drying, disinhibits, and may add to the reflux. So, by the end of the evening, your vocal folds are dry and rubbing against each other—and you are still the life of the party! Drink alcohol in moderation, and end your evening with a big glass of water. And keep some water next to your bed so you can rehydrate through the night.

With all of the above considerations under control, some singers still wake up somewhat hoarse in the morning. If this is you, consider vocalizing in the shower. Inhaling steam while performing some vocal exercises is therapeutic—the warmth and the moisture will quickly bring your larynx back to life. You should probably start with that restorative shower before any significant vocal effort is undertaken (including long and stressful phone calls or yelling down the hall to your roommate).

The steam also loosens any thick mucus in the vocal tract, and morning mucus is often an issue. This is due in part to the fact that the cilia in your mucus membranes also “go to sleep” at night and don’t clear mucus as vigorously as when you are awake. To optimally get rid of mucus, start with a big glass of water, use your neti pot, and take that long, steamy shower. When morning mucus doesn’t respond to these measures, consider that you might either be allergic to something in bed (feathers, dust, dust mites) or have silent nocturnal reflux that causes mucus to form.

If despite all of the above, you have prolonged morning hoarseness, you might want to get your larynx examined. One manifestation of small nodules is the need for longer and longer warm-up periods. Chronic throat clearing and the sensation of persistent mucus getting stuck to the vocal folds is one symptom of a small polyp or varicosed blood vessel that might be otherwise asymptomatic.


DISCLAIMER: Reprinted by Permission, Classical Singer Magazine. The suggestions given by Dr. Jahn in these columns are for general information only, and not to be construed as specific medical advice, or advocating specific treatment, which should be obtained only following a visit and consultation with your own physician.

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