23 Aug When To Use Steam vs. When To Use a Nebulizer

There is a massive amount of information out there about vocal health and caring for your voice as a singer. Some of it is good and some of it is not very helpful. Even the “good” information can feel unhelpful if it is applied ineffectively. With that in mind, I want to clarify and simplify two tools that singers frequently use to improve their vocal health and hydration.

Hydration is a significant part of keeping our voices/bodies healthy. The vocal folds themselves are covered in delicate tissue called epithelium and the tissue needs to hydrated in order function well and protect the underlying tissues. If you feel the inside of your cheek with your tongue, that gives you a rough idea of the feel and delicate nature of this tissue. If the epithelium is dehydrated (and all the tissues within the larynx), we are more susceptible to vocal injury.

So how do we stay hydrated?

1. Drink water! There’s no way around this answer. We must consume enough water in small, consistent amounts throughout the day that our urine is a pale yellow. Only when we wake up in the morning, and we’ve been fasting from water all night long, should the urine be a darker yellow. Staying sufficiently hydrated helps all the tissues and functions of the body work properly, especially the structures of the voice.
2. Add electrolytes to that water. Electrolytes are minerals that carry electrical charge (ions) and help the body function at the most basic levels. They affect cell function (maintain electrical neutrality in the cell), generate and conduct action potential (contraction and release of muscles) and nerves, balance the amount of water in your body, balance pH levels in the body, move nutrients and waste, keep your heart rate and rhythm steady, keep your blood pressure stable and promote healthy bones and teeth. YOU NEED ELECTROLYTES. Here is a link to an electrolyte powder that I use everyday, because it has no artificial colors and no sugar (sweetened with Stevia) and it tastes great! It also has significantly more electrolytes compared to popular brands.
3. Avoid drying agents. Caffeine and alcohol both inhibit the Anti Diuretic Hormone (ADH). This hormone is important because it tells the kidney to reabsorb usable water in the body, which allows the body to be more efficient at staying hydrated. When ADH is inhibited by caffeine or alcohol, the kidneys release far more water from the body and we become dehydrated. The half-life of caffeine in the body varies widely (between 1.5 to 9.5 hours), but for the typical, healthy adult it is around 5 hours. So half the caffeine you consume is still in your body up to six hours after drinking a caffeinated beverage. Alcohol has a similar half-life, but it takes five half-lives to get rid of the alcohol completely. That means it takes about 25 hours for your body to clear all the alcohol. (see this article from the Cleveland Clinic ) This doesn’t mean you can’t live your life or enjoy a cup of coffee. However, you should definitely take into consideration how much you’re ingesting and if you have days coming up that are going to be vocally demanding. It would be wise to limit the amount of drying agents you ingest as you approach vocally demanding days.
4. Use a nebulizer. A nebulizer is a medical device that is designed to break down liquid into small enough particles that it will pass over the vocal folds and into the lungs. Asthmatic patients use the nebulizer to deliver medication to the lungs that opens the airways and allows more ease in breathing. As a singer, you are not going to use the medication in the nebulizer. You will use saline water (there’s those electrolytes again!) in the nebulizer. It will break down the saline water into small particles that will pass over the vocal folds and the tissues of the vocal folds will absorb that liquid, giving you an instant shot of hydration directly to the voice.

Notice what I didn’t mention in the hydration steps above? I didn’t mention steam. That’s because steam has a purpose in vocal health, but doesn’t provide vocal fold hydration. The particles of steam are too large to make it past the tissues of the vocal tract. That means that steam will hydrate your mouth, nasal cavities and skin, but it does not reach the vocal folds. There is no such thing as “steaming the vocal folds”. So I’ve told you what steam doesn’t do, but let me explain where steam’s superpower really shines!

Steam is a fantastic tool for releasing compacted mucous in the sinuses. For the management of cold and allergy symptoms, steam is a heavy hitter. You don’t need a fancy steamer either. Just heat up water in a pot on your stove, throw a towel over your head and breathe in deeply. That beautiful steam will loosen the mucus and you will need to blow your nose repeatedly. It’s a wonderful tool for clearing the sinuses that doesn’t require medication.

So to break this all down in the most simplistic way:

Hydration to the vocal folds —-> Nebulizer with saline

Stuffy sinuses —–> Steam and blow

These two great tools have very different purposes, so use them correctly for the benefits you seek!

As always, reach out if you have any questions!