{"id":20785,"date":"2022-04-11T18:43:25","date_gmt":"2022-04-11T22:43:25","guid":{"rendered":"https:\/\/world.dan.org\/?post_type=dan_alert_diver&#038;p=20785"},"modified":"2023-05-31T16:18:29","modified_gmt":"2023-05-31T20:18:29","slug":"laryngospasm-and-anxiety","status":"publish","type":"dan_alert_diver","link":"https:\/\/world.dan.org\/fr\/alert-diver\/article\/laryngospasm-and-anxiety\/","title":{"rendered":"Laryngospasme et anxi\u00e9t\u00e9"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img decoding=\"async\" src=\"https:\/\/dan.org\/wp-content\/uploads\/2022\/03\/laryn-Q1_139.Medline.jpg\" alt=\"larynx\" class=\"wp-image-30828\"\/><figcaption class=\"wp-element-caption\">Image par Yodiyim\/ISTOCK<\/figcaption><\/figure>\n<\/div>\n\n\n<p class=\"has-dan-blue-200-color has-text-color\"><strong>Q :<\/strong>&nbsp;<strong>During dive training in the pool, I couldn\u2019t breathe after clearing my mask <span style=\"color:#005274\" class=\"color\">with my regulator in my mouth.\u00a0After surfacing, I took six to eight wheezing breaths and then could breathe normally again.\u00a0It\u2019s possible I inhaled water during the exercise, but my instructor and I could not recall when or how that would have happened. Someone at the training center suggested that something might be wrong with my epiglottis. Is there a way to inspect the epiglottis to ensure it is functioning properly? What causes it to relax and open back up?<\/span><\/strong><\/p>\n\n\n\n<p><strong>A :<\/strong>&nbsp;It is not uncommon for new divers to have some anxiety when fully removing their mask underwater. When you expose your nose to the water, it\u2019s natural to feel uncomfortable if water enters the nasopharynx. Our bodies are trained not to take a breath while underwater, but it is possible if you can relax and focus on breathing through your regulator.<\/p>\n\n\n\n<p>&nbsp;If water entered the larynx, the epiglottis\u2019 natural response would be to close the airways to prevent aspiration. The larynx would reflexively trigger coughing to expel the fluid, or you would try to remove the fluid through exhalation.\u00a0Even a small amount of fluid can induce laryngospasm, which will stimulate this powerful reflex. &nbsp;<\/p>\n\n\n\n<p>This passage from Marieb and Hoehn\u2019s&nbsp;<em>Anatomie et physiologie humaines<\/em>&nbsp;is a good overview of how the epiglottis works: \u201cWhen only air is flowing into the larynx, the inlet to the larynx is wide open and the free edge of the epiglottis projects upward. During swallowing, the larynx is pulled superiorly and the epiglottis tips to cover the laryngeal inlet. Because this action keeps food out of the lower respiratory passages, the epiglottis has been called the guardian of the airways. Anything other than air entering the larynx initiates the cough reflex to expel<br>the substance.\u201d<\/p>\n\n\n\n<p>Another possibility is that you had an anxiety-induced laryngospasm, which can be triggered by discomfort, panic, or high anxiety. Some physicians think this spasm is part of the body\u2019s natural defense against accidental drowning or suffocation and may be part of the body\u2019s response to fluid in the larynx.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Your breathing problem may be an issue with your comfort level and experience, but it\u2019s possible there are other complications we cannot identify based on the information you provided. Discuss these concerns with your physician, and request a fitness-to-dive evaluation to ensure that you have no physical contraindications to dive activity. Your physician may refer you to an ENT for further investigation, if needed.<\/p>\n\n\n\n<p>Si votre m\u00e9decin vous autorise \u00e0 plonger, nous vous recommandons de passer plus de temps en piscine pour travailler vos comp\u00e9tences avec votre instructeur avant d'aller plus loin dans votre formation.&nbsp;<\/p>\n\n\n\n<p><em>- Ben Strelnick, NREMT, W-EMT<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img decoding=\"async\" src=\"https:\/\/dan.org\/wp-content\/uploads\/2022\/03\/laryn-Q1_140.Medline-copy.jpg\" alt=\"plongeur avec tortue de mer\" class=\"wp-image-30830\"\/><figcaption class=\"wp-element-caption\">Photo de Stephen Frink<\/figcaption><\/figure>\n<\/div>\n\n\n<p class=\"has-dan-blue-200-color has-text-color\"><strong>Q :<\/strong>&nbsp;<strong>Une personne souffrant d'hypertension pulmonaire peut-elle devenir plongeur ?<\/strong><\/p>\n\n\n\n<p><strong>A :<\/strong>&nbsp;L'hypertension pulmonaire est consid\u00e9r\u00e9e comme une affection \u00e0 risque grave et la plong\u00e9e est d\u00e9conseill\u00e9e aux personnes qui en sont atteintes. Les disciplines d'endurance telles que la plong\u00e9e, qui sont susceptibles de poser les exigences h\u00e9modynamiques les plus \u00e9lev\u00e9es et requi\u00e8rent un niveau de forme physique \u00e9lev\u00e9, sont difficiles pour les personnes souffrant d'hypertension pulmonaire. Le stress que la plong\u00e9e fait subir aux poumons et au c\u00f4t\u00e9 droit du c\u0153ur peut \u00eatre trop important pour ces personnes. Les risques d'insuffisance cardiaque congestive ou d'\u0153d\u00e8me pulmonaire induit par l'immersion ne sont que deux facteurs de risque importants.<\/p>\n\n\n\n<p>A person\u2019s preexisting condition and exercise intolerance will affect the heart and lungs\u2019 ability to perform underwater.\u00a0Various factors while underwater lead to intravascular volume shifts to the central circulation involving the heart, coronary vessels, and lungs.\u00a0In a healthy state, this increase in fluid usually causes no problem, but a person with pulmonary hypertension will struggle, sometimes even at rest, to keep up with the right ventricle\u2019s increased workload as it tries to overcome the elevated pressure within the pulmonary vessels.&nbsp;&nbsp;<\/p>\n\n\n\n<p><em>\u2014 Shannon Sunset, NCPT, NREMT<\/em><\/p>\n\n\n\n<p class=\"has-dan-blue-200-color has-text-color\"><strong>Q :<\/strong>&nbsp;<strong>J'ai subi une commotion c\u00e9r\u00e9brale il y a quelques semaines. Quand pourrai-je reprendre la plong\u00e9e ?<\/strong><\/p>\n\n\n\n<p><strong>A :<\/strong>&nbsp;Given that your injury occurred a few weeks ago, it is still too early in your recovery to give specific return-to-dive recommendations. Diving may be possible for you, but whether it\u2019s safe is not a quick and easy answer because there are many additional factors to consider regarding a concussion. If you experienced a loss of consciousness (LOC) that caused you to fall or that otherwise led to your concussion, however, you should seek further evaluation to determine the cause of that LOC and if that condition is compatible with diving.<\/p>\n\n\n\n<p>&nbsp;Le risque de crises d'\u00e9pilepsie est l'une des principales pr\u00e9occupations pour d\u00e9terminer l'aptitude \u00e0 plonger apr\u00e8s un traumatisme cr\u00e2nien. La p\u00e9riode d'attente recommand\u00e9e avant de reprendre la plong\u00e9e varie en fonction de la gravit\u00e9 de la blessure, de la p\u00e9riode de r\u00e9cup\u00e9ration et du risque de crise. La reprise de la plong\u00e9e d\u00e9pend de l'absence de sympt\u00f4mes et de l'\u00e9valuation de l'\u00e9quipe m\u00e9dicale.<\/p>\n\n\n\n<p>La meilleure recommandation est de vous concentrer sur votre r\u00e9tablissement et de ne pas reprendre la plong\u00e9e pendant cette p\u00e9riode. Il est n\u00e9cessaire de d\u00e9terminer votre risque de crise apr\u00e8s votre traumatisme cr\u00e2nien avant d'envisager de reprendre la plong\u00e9e. Une fois que vous \u00eates compl\u00e8tement gu\u00e9ri et que votre \u00e9quipe m\u00e9dicale vous a autoris\u00e9 \u00e0 pratiquer une activit\u00e9 compl\u00e8te et sans restriction, faites \u00e9valuer votre aptitude \u00e0 la plong\u00e9e par un m\u00e9decin sp\u00e9cialis\u00e9 en m\u00e9decine de plong\u00e9e avant d'essayer de plonger.<\/p>\n\n\n\n<p><em>\u2014 Anne Strysniewicz, AEMT, DMT<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img decoding=\"async\" src=\"https:\/\/dan.org\/wp-content\/uploads\/2022\/03\/laryn-Q1_143.Medline-copy.jpg\" alt=\"Test du syndrome de Marfan\" class=\"wp-image-30832\"\/><figcaption class=\"wp-element-caption\">Photo par Hailshadow\/ISTOCK<\/figcaption><\/figure>\n<\/div>\n\n\n<p class=\"has-dan-blue-200-color has-text-color\"><strong>Q :<\/strong>&nbsp;<strong>Je suis atteint du syndrome de Marfan et j'aimerais obtenir des informations de la part d'un sp\u00e9cialiste de la plong\u00e9e et des risques qui y sont associ\u00e9s. Mon cardiologue m'a d\u00e9conseill\u00e9 de plonger, mais les personnes atteintes du syndrome de Marfan ont g\u00e9n\u00e9ralement une activit\u00e9 physique limit\u00e9e, ce qui ne m'a pas surpris. J'ai \u00e9t\u00e9 trait\u00e9 toute ma vie et je maintiens un mode de vie tr\u00e8s actif, notamment la natation, le water-polo, le basket-ball et le marathon, contrairement \u00e0 toutes les recommandations. Quels sont les risques encourus par une personne atteinte du syndrome de Marfan et puis-je faire quelque chose pour les att\u00e9nuer ?<\/strong><\/p>\n\n\n\n<p>Marfan syndrome has an extensive spectrum of presentation from mild to severe and requires your physician team\u2019s assessment. Many factors may have influenced your cardiologist\u2019s recommendation against diving despite the active physical activities that you describe.<\/p>\n\n\n\n<p>Les m\u00e9decins s\u00e9pareront soigneusement la liste des activit\u00e9s appropri\u00e9es. La plong\u00e9e affecte plusieurs syst\u00e8mes corporels, et la pression suppl\u00e9mentaire exerc\u00e9e sur ces syst\u00e8mes par le syndrome de Marfan est donc un \u00e9l\u00e9ment important \u00e0 prendre en compte. Voici quelques conditions sp\u00e9cifiques \u00e0 prendre en compte :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><span style=\"color: #005274;\" class=\"stk-highlight\">Dilatation et dissection de l'aorte :<\/span><\/strong>&nbsp;Les changements de fluides qui se produisent pendant la plong\u00e9e peuvent exercer une pression sur l'aorte.<\/li>\n\n\n\n<li><strong><span style=\"color: #005274;\" class=\"stk-highlight\">Affections cardiaques valvulaires, cardiomyopathie et dysrythmie :<\/span><\/strong>&nbsp;Ces probl\u00e8mes potentiels sont souvent plus importants s'ils se produisent sous l'eau.<\/li>\n\n\n\n<li><strong><span style=\"color: #005274;\" class=\"stk-highlight\">Pneumothorax :<\/span><\/strong>&nbsp;Marfan syndrome can have a higher association with pneumothorax. There can be a risk of spontaneous pneumothorax (collapsed lung) with little or no inciting event. Although problematic on land, it is life-threatening while diving. Pulmonary barotrauma can cause a collapse of anyone\u2019s lung. Upon ascent, trapped air expands and may cause a collapsed lung to develop into a tension pneumothorax, a medical emergency in which air cannot escape the pleural space around the affected lung, increasing<br>le risque de syndrome de surgonflage pulmonaire tel que l'embolie gazeuse art\u00e9rielle.<\/li>\n\n\n\n<li><strong><span style=\"color: #005274;\" class=\"stk-highlight\">Scoliose :<\/span><\/strong>&nbsp;La courbure de la colonne vert\u00e9brale a \u00e9t\u00e9 associ\u00e9e au syndrome de Marfan. Selon sa gravit\u00e9, la scoliose peut entra\u00eener une diminution de la tol\u00e9rance \u00e0 l'exercice, ce qui rend plus difficiles les activit\u00e9s de plong\u00e9e habituelles telles que le port du mat\u00e9riel, l'ascension d'une \u00e9chelle de bateau ou la nage \u00e0 contre-courant.<\/li>\n\n\n\n<li><span style=\"color: #005274;\" class=\"stk-highlight\"><strong>Dure-m\u00e8re<\/strong>:<\/span>&nbsp;There may be changes to the spine\u2019s dura that can result in pain and headache. These changes may have a confounding impact on the diagnosis of spinal decompression illness (DCI).<\/li>\n\n\n\n<li><strong><span style=\"color: #005274;\" class=\"stk-highlight\">R\u00e9gulation thermique :<\/span><\/strong>&nbsp;Le port d'une protection thermique peut retarder la chute de la temp\u00e9rature centrale due \u00e0 l'immersion dans l'eau, mais vous finirez par vous refroidir et l'autor\u00e9gulation peut s'av\u00e9rer difficile. Vous devriez revoir la r\u00e9gulation de la temp\u00e9rature avec votre m\u00e9decin.<\/li>\n<\/ul>\n\n\n\n<p>Medications and your baseline wellness are also worth reviewing. Some medications may have adverse reactions that may be a contraindication to diving. Your daily wellness is a necessary consideration, as are any regularly occurring pain or deficits that\u00a0 may make diagnosing DCI difficult. It\u2019s essential to have\u00a0 an open discussion with your treating physician and follow\u00a0 their recommendations.<\/p>\n\n\n\n<p><em>\u2014 Robert Soncini, NR-P, DMT<\/em><\/p>","protected":false},"excerpt":{"rendered":"<p>Q: During dive training in the pool, I couldn\u2019t breathe after clearing my mask with my regulator in my mouth. After surfacing, I took six to eight wheezing breaths and then could breathe normally again. It\u2019s possible I inhaled water during the exercise, but my instructor and I could not recall when or how that would have [\u2026]<\/p>\n","protected":false},"featured_media":20787,"template":"","dan_alert_diver_categories":[80],"dan_alert_diver_issues":[478],"class_list":["post-20785","dan_alert_diver","type-dan_alert_diver","status-publish","has-post-thumbnail","hentry","dan_alert_diver_categories-from-the-medical-line","dan_alert_diver_issues-q1-2022"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Laryngospasm and Anxiety - DAN World<\/title>\n<meta name=\"description\" content=\"It is not uncommon for new divers to have some anxiety when fully removing their mask underwater. 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Lorsque vous exposez votre nez \u00e0 l'eau, il est naturel de se sentir mal \u00e0 l'aise si de l'eau p\u00e9n\u00e8tre dans le nasopharynx.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/world.dan.org\/fr\/alert-diver\/article\/laryngospasm-and-anxiety\/","og_locale":"fr_CA","og_type":"article","og_title":"Laryngospasm and Anxiety","og_description":"It is not uncommon for new divers to have some anxiety when fully removing their mask underwater. 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When you expose your nose to the water, it\u2019s natural to feel uncomfortable if water enters the nasopharynx.","twitter_misc":{"Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/world.dan.org\/alert-diver\/article\/laryngospasm-and-anxiety\/","url":"https:\/\/world.dan.org\/alert-diver\/article\/laryngospasm-and-anxiety\/","name":"Laryngospasme et anxi\u00e9t\u00e9 - DAN World","isPartOf":{"@id":"https:\/\/world.dan.org\/es\/#website"},"primaryImageOfPage":{"@id":"https:\/\/world.dan.org\/alert-diver\/article\/laryngospasm-and-anxiety\/#primaryimage"},"image":{"@id":"https:\/\/world.dan.org\/alert-diver\/article\/laryngospasm-and-anxiety\/#primaryimage"},"thumbnailUrl":"https:\/\/world.dan.org\/wp-content\/uploads\/2022\/04\/laryn-q1_141.medline-copy-e1647618230710.jpg","datePublished":"2022-04-11T22:43:25+00:00","dateModified":"2023-05-31T20:18:29+00:00","description":"Il n'est pas rare que les nouveaux plongeurs \u00e9prouvent une certaine anxi\u00e9t\u00e9 lorsqu'ils retirent compl\u00e8tement leur masque sous l'eau. 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