Many of you may already have a vocal steamer, but maybe not have heard of a vocal nebuliser.
Unfortunately, a nebuliser isn’t a form of intergalactic travel. Nevertheless, it is pretty space age as far as singing paraphernalia goes. Aside from having a nice blue light and spooky mist coming out of it, it’s actually a really good investment for anyone who takes their vocal hygiene seriously! That probably includes all voice professionals out there and a good many regular singers. Let’s delve into why you could consider adding a nebuliser to your vocal preparation routine!
A wet larynx is a happy larynx
This statement is pretty much universally accepted in the world of singing. Very rarely has the advice been “don’t bother” when talking about regularly drinking water and keeping hydrated for singing. That’s because singers for the last few hundred years have all reported the negative effects and raised effort connected with singing on a dry voice. It just feels crappy.
There’s also no shortage of research out there that reinforces the point. Scientist pretty much all arrive at the same point… respiratory effort to sing (measured by nifty lab instrumentation) and perceived effort to sing (reported by the singer subjects) all went up considerably when vocal folds were dehydrated.
Along with raised respiratory effort comes a higher lung pressure needed to create sound. In other words, when you’re dry you’re highly likely to have to push more air to sing. That can lead to all forms of vocal fatigue and injury in the long term, which is obviously NOT something we want to be at risk of.
Interestingly, for anyone who sings in or above their break/passaggio, the studies showed that the biggest changes in effort were associated with higher pitches. Speaking pitch and low singing weren’t as uncomfortable, which means you’ll really feel the dryness if you tend to sing with a bigger range. You might not spot that you’re dehydrated until you go up there either, at which time it might be too late to do anything about it!
Looking at the hydrated singers, they all skipped around (figuratively, of course) singing with less perceived effort, less actual effort, and were able to produce a richer, more resonant voice. Job done.
That’s fine… I’ll just drink water
Drinking water is a must. If you’re a singer, or any earth-based organism, and you DON’T drink water every day, you’re literally insane. You absolutely need it to be fully operational, and singers should be especially careful to drink enough each day for the reasons in the last section.
Before drinking water can hydrate your vocal folds, it needs to be processed by the body and delivered to the dry tissues in your larynx. Depending on many factors, that could be anywhere between one hour and three hours. After you’ve downed a big glass, occasionally you need to speed things up a little! Sometimes you may also live in a dry air environment, or have a dry voice from using it a lot. Out comes the vocal steamer!
Alright then… I’ll steam
Steam is water, obviously. Boiling water transforms it into tiny droplets, and you breath those droplets in when you use a steamer. The idea behind this is to make the air moist so that the moisture rests on your vocal folds and hydrates them.
There’s a couple of potential pitfalls with this. In discussions with voice researchers and doctors over the years it seems that steam particles are much bigger than those that a nebuliser creates. That means the chance of the steam droplets condensing on the walls of the mouth and throat is much greater. In turn, that means less makes it to the vocal fold level to wet them.
Steam is also ruddy hot and steaming is usually recommended in limited amounts. Sometimes a bit too hot, which can scald you if you use a vocal steamer too soon after pouring in the water. According to friend of the podcast and consultant laryngologist, Dr. Reena Gupta:
“forcing high heat air (steam) in without allowing for the body’s natural inclination to cool it to body temperature would exacerbate edema (inflammation) – not useful!”
Especially if your voice is already inflamed due to overuse or an acute illness.
In any case, there’s very little actual evidence to suggest that steaming greatly improves voice production. Nebulisers, on the other hand, do.
The case for the fancy cool mist
If you need a celeb endorsement, Madonna has been papped with a nebuliser several times. Despite the papers speculating that she must be ill, she clarified on Brazilian TV that it’s to keep her voice moist.
Another bolster for the case is that nebuliser particles are smaller. Hence, they have a much better chance of making it down to your larynx without condensing on your airway. That means better hydration right away!
Using saline (instead of water) is also a key ingredient to why a nebuliser is awesome. I’ll explain that more below, but it simply hydrates you better. If you use boiling hot saline in a vocal steamer, the salt will be left behind in the evaporation process! Good for your dinner, but not for your voice.
You can’t use any old saline though. It has to be 0.9% isotonic saline.
Why would your voice need salty water? Let’s go geeky…
Saline is what’s known as isotonic. An isotonic substance matches the fluid properties in our body’s cells, and is a better option for hydration all round. Just think of those foul tasting rehydration sports sachets; salt and fruit. Yuck! But perfect for the job because they’re also isotonic and the body can use them very easily.
As the fluid in our vocal folds cells are also made up of 0.9% saline, using the equivalent saline concentration in a nebuliser will allow the most effective lubrication of the larynx surface, if it needs it. It also won’t disturb the delicate hydration balance of the rest of your airway in the process. All you need to do is remember:
POINT – NINE – PERCENT
Say it over and over again.
The current thinking
There have been studies on singers specifically using nebulisers. During the studies, they measured the lung pressure needed to sing and the perceived effort of the singer. Pure water didn’t reduce pressure and effort nearly as much as 0.9% saline did. In fact, it performed fairly badly. In the study in question, it was said that:
“The results from this study indicate that nebulized isotonic saline has the potential
to reverse the perceived adverse effects associated with laryngeal
dryness in singers, whereas nebulized sterile water was inadequate in addressing these effects”
Nebulized Isotonic Saline Versus Water Following a Laryngeal Desiccation Challenge in Classically Trained Sopranos (Tanner/Roy et al 2010)
And, wonderfully, the effects of the saline nebuliser helped the vocal folds to stay flexible and easier to use for nearly two hours. Just enough time to allow a bottle of Volvic to get round your digestive system to hydrate your cells.
There are quite a few on the market from many different manufacturers. Although I use my faithful Beurer IH-50, I’ve been reliably informed by fellow voice professionals, researchers and laryngologists that the Omron MicroAIR U100 Pocket Nebuliser is the one that ticks all the boxes AND lasts a really long time! It’s also the brand that was used in the studies I mentioned. US singers, click here for an equivalent product available in your country.
You can use it with the AC adapter or with batteries, so it’s truly portable. You also don’t need to boil a flippin’ kettle to get some moisture, which ticks the convenience box massively compared to a conventional steamer.
For the sterile isotonic saline I buy these 20ml Irripods in a box from Amazon. They are isotonic, 0.9% sterile saline in handy little tubes, and you can get them in any pharmacy too. As far as how much you should use in your nebuliser, the studies I look at used between 2-9ML/CC per application. I would recommend highly against mixing your own saline because it’s not sterile. That means you could inhale nasty bacteria, which we definitely don’t want!
There’s no substitute for drinking water
A nebuliser is certainly a valuable addition to a pro’s vocal hygiene regime. It helps keep a hard working voice tip-top if it’s being used a lot everyday or is often in a dry environment (like on an aeroplane, or in air conditioned hotel rooms). It’s also a god send as part of a vocal warm up and can be used as a kick start for hydration if you need to sing early in the day.
BUT, drinking water is still king to avoid dehydration of the vocal folds. Topical dehydration is the dryness you experience on the surface of your vocal folds from the air you breath, especially if you’re a mouth breather. You can help that a lot with a nebuliser.
Systemic dehydration, on the other hand, is dehydration from the inside. That comes from not drinking enough water. One study I came across during my reading was on how well vocal fold tissue was able to return to normal after being systemically dehydrated. Turns out, there’s a chance that when systemic dehydration was high enough, bathing the vocal folds in isotonic saline didn’t reverse the short term effects in many cases.
The lesson we can learn here is to drink plenty and avoid very dry environments as a baseline. Topically hydrating with a nebuliser and 0.9% saline, according to the current research, can put the cherry on top. Then you’ll have a doubly great chance of keeping your healthy, rich and flexible voice throughout a busy schedule and the many challenging environments that singers find themselves in. In the meantime, I’ll keep an eye out for new findings on steaming and nebulisers as there’s clearly more that needs to be done!
Please do comment below or contact us if you have any more questions about this article. I’ll be here to answer them!
- Dependence of Phonatory Effort on Hydration Level (Verdolini et al 1994)
- An Evaluation of the Effects of Three Laryngeal Lubricants on Phonation Threshold Pressure (PTP) (Roy et al 2003)
- Ex vivo canine vocal fold lamina propria rehydration after varying dehydration levels (Hanson et al 2011)
- Nebulized Isotonic Saline Versus Water Following a Laryngeal Desiccation Challenge in Classically Trained Sopranos (Tanner/Roy et al 2010)
- The Effects of Laryngeal Desiccation and Nebulized Isotonic Saline in Trained Male Singers (Fujuki 2014)
- The role of hydration in vocal fold physiology (Sivasankar/Leydon 2010)
- The Effects of Three Nebulized Osmotic Agents in the Dry Larynx (Tanner/Roy 2007)NOTE: We receive a small commission from any products bought via the links in this post.
Chris is also a writer for iSing Magazine, a founder/presenter of The Naked Vocalist podcast, a voting member of Pan American Vocology Association, and a teacher trainer/vocal coach with the Vocology In Practice network.
All that aside, he's a pure and true music fan with a penchant for Donny Hathaway and songs about heartbreak.
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