My voice goes hoarse after talking all day. Why?
When you talk all day, the two small bands of tissue in your voice box that make sound, the vocal folds, do a great deal of work. The US National Institute on Deafness and Other Communication Disorders (NIDCD) explains that they snap together and vibrate each time you speak, and lists teachers, sales people and others who talk for work as making great demands on their voices. In a 2007 study that recorded teachers for two weeks, their voice was in use 23% of the time at work. Talking loudly over noise, a dry throat and few breaks add to the load. A 2018 US clinical guideline says the voice box should be checked if hoarseness lasts 4 weeks without going away or getting better.
What happens in my throat when I talk all day?
Your voice starts in the larynx, or voice box, which sits between the base of the tongue and the top of the windpipe.
How the voice is made
NIDCD explains that when you are not speaking, the vocal folds stay open so you can breathe. When you speak, they snap together while air from the lungs blows past, making them vibrate. The vibrations become sound, which the throat, nose and mouth shape into your voice. Each sentence means the folds coming together and parting again and again.
How much a working voice is used
Researchers in the United States have measured this with small devices that record how often a person's voice is in use.
| Study | Who was measured | What they found |
|---|---|---|
| Titze, Hunter and Švec, 2007 | 31 teachers, all waking hours for 2 weeks | Voice in use 23% of the time at work, 13% after work and 12% at weekends; about 1,800 starts and stops of voicing an hour at work and 1,200 outside work |
| Hunter and Titze, 2010 | 57 teachers, 2 weeks each | Voicing at work more than twice that outside work, around 30% per hour on average; loudness at work about 1 dB higher and steady through the day; pitch higher at work and rising through the day |
In the 2010 study by Eric Hunter and Ingo Titze, the authors pointed out that talking after work is added to a voice that has already been working hard all day. Both studies involved small groups of US teachers, so they show a pattern rather than a figure for every job.
Pushing, dryness and noise
MedlinePlus, from the US National Library of Medicine, says that talking too much, screaming, constantly clearing your throat or smoking can make you hoarse. The voice-care leaflet from the Department of Communication Sciences and Disorders at Ramathibodi Hospital, Mahidol University, lists overusing the voice among the reasons, says it is often seen in people who use their voice for work, and describes habits such as shouting, talking over loud noise, forcing the voice, talking at a pitch that is too high or too low for a long time, tensing the neck and shoulders, and breathing in through the mouth while talking, which brings dry air and dust into the throat.
Dryness matters too. A 2010 review by Mahalakshmi Sivasankar and Ciara Leydon found that when the body or the surface of the vocal folds is dried out, aerodynamic and acoustic measures of speakers' voice production go up. The same review says that strong evidence on how well hydration measures work is still lacking.
Who gets a tired, hoarse voice most often?
People who talk for a living, and women more than men, according to several surveys.
What the surveys found
| Study | Who was asked | Finding |
|---|---|---|
| Roy and colleagues, 2004 | 2,531 adults in Iowa and Utah, USA (1,243 teachers) | A voice problem at the time: 11.0% of teachers, 6.2% of others. Ever in their life: 57.7% of teachers, 28.8% of others |
| Hunter and Banks, 2017 | 640 US teachers (518 women, 122 men) | Compared with adults without voice problems, about 3 times as likely to report a tired voice or avoiding talking, and more than 3 times as likely to report physical discomfort when talking |
| Banks, Bottalico and Hunter, 2017 | 506 US women teachers | The number of students a classroom held affected how much vocal tiredness teachers reported; the age effect was largest at around 40 to 45 |
In the 2004 survey by Nelson Roy and colleagues, women had had voice problems more often than men over their lifetime (46.3% compared with 36.9%), and being aged 40 to 59 was also linked with having had one. The survey by Hunter and Banks found women teachers reported more vocal tiredness than men. The 2018 US guideline says hoarseness affects nearly one-third of people at some point in their life.
What these numbers can and cannot tell you
All three surveys asked people to describe their own voice, and all were done in the United States. They show that a tired voice is common among people who talk for work. They cannot tell you the reason for your own hoarseness; only an examination can.
Which everyday habits strain the voice?
Many jobs in Thailand ask a lot of the voice: teaching, selling at a market or shop counter, tour guiding, call centres, coaching and leading meetings. The habits below come from NIDCD and Ramathibodi Hospital's advice.
Habits that add strain
| Habit | Why it matters, according to the source | Where it happens in Thai working life |
|---|---|---|
| Talking over noise | NIDCD says trying to talk above noise strains the voice | Classrooms with fans running, markets, restaurants, construction sites |
| Talking for hours without a break | Ramathibodi advises against talking for many hours in a row | Back-to-back classes, all-day sales shifts |
| Shouting or whispering | NIDCD says talking too loudly and too softly can both stress the voice | Calling across a school field, whispering in the library |
| Talking from the throat without breath support | NIDCD says this puts great strain on the voice | Long sentences until you run out of breath, which Ramathibodi also advises against |
| Breathing in through the mouth in cold, dry rooms | Ramathibodi says this brings dry air into the throat | Air-conditioned offices, malls and classrooms |
| Clearing the throat often | MedlinePlus lists constant throat clearing as a cause of hoarseness | A habit during long meetings or calls |
| Cradling the phone between head and shoulder | NIDCD lists this among things to avoid | Long calls at a desk or shop counter |
How can I look after my voice during a long day of talking?
NIDCD and Ramathibodi Hospital both give practical advice for people who use their voice a lot. These are everyday habits for anyone who talks a lot.
During the working day
- Take vocal naps. NIDCD suggests resting your voice throughout the day. Short quiet breaks between classes, calls or customers count.
- Sip water. NIDCD advises drinking plenty of water, and Ramathibodi suggests sipping water often when your throat feels dry.
- Let the equipment do the work. NIDCD suggests a lightweight microphone and speaker in classrooms, exhibit areas and exercise rooms.
- Move closer instead of louder. Ramathibodi advises standing close to the person you are talking to so you do not need to shout.
- Breathe from the chest. NIDCD says to support your voice with deep breaths rather than relying on your throat alone.
- Stop when your throat feels dry. Ramathibodi advises that people who use their voice a lot should stop talking for a while when their throat feels dry.
After work and at home
| Situation | What NIDCD and Ramathibodi suggest |
|---|---|
| Your voice already feels hoarse or tired | Avoid speaking or singing while it is hoarse or tired (NIDCD) |
| A noisy room, TV or hairdryer in the background | Avoid talking over the noise (NIDCD, Ramathibodi) |
| Air-conditioned or dry rooms | NIDCD suggests a humidifier at home, with about 30% humidity |
| Coffee, tea, alcohol or fizzy drinks | NIDCD: balance caffeinated drinks and alcohol with plenty of water; Ramathibodi lists them among things to avoid for the voice |
| Smoke | Avoid smoking and second-hand smoke (NIDCD, Ramathibodi) |
| Tiredness | NIDCD says physical tiredness has a negative effect on the voice, so get enough rest |
NIDCD also suggests not using alcohol-based mouthwash and asking your doctor which medicines may dry out the vocal folds if you have voice problems. If your throat is also sore, see Sore throat: what should I eat, and what should I skip?
When should I get my hoarse voice checked?
Hoarseness after a long day that settles with rest is common. Hoarseness that stays is a reason to have the voice box looked at.
What the US guideline says
The 2018 clinical guideline by Stachler and colleagues, written for doctors, says the voice box should be examined, usually with a small camera, if hoarseness lasts 4 weeks without going away or getting better. It lists situations where it should be checked sooner:
- a lump in the neck
- difficulty breathing or noisy breathing
- recent surgery on the head, neck or chest
- a recent breathing tube
- a history of smoking
- relying on your voice for work, which the guideline lists as a group that may need to be seen sooner
Who can help
NIDCD says an ear, nose and throat (ENT) doctor can find the cause of a voice problem and may refer you to a speech-language pathologist, who can help you use your voice in a healthy way. In Thailand, hospital ENT departments examine the voice box, and Ramathibodi Hospital's leaflet notes that speech therapists assess the voice by listening and with instruments.
Do not wait if breathing is hard
If you are struggling to breathe, or your breathing has become very noisy, get medical help straight away rather than waiting to see whether it settles.
What to tell the doctor
- how long your voice has been hoarse, and whether it gets better after a weekend or holiday
- how many hours a day you talk for work, and in what kind of noise
- whether you smoke
- any medicines you take regularly
Frequently asked questions
Why does my voice go hoarse after talking all day?
How much do teachers actually use their voice?
Are teachers more likely to have voice problems?
What can I do during a long day of talking?
Is whispering better for a tired voice?
When should I see a doctor about a hoarse voice?
- NIDCD (US National Institutes of Health): Taking Care of Your Voice ↗
- MedlinePlus (US National Library of Medicine): Voice ↗
- Ramathibodi Hospital, Mahidol University: Hoarse voice (เสียงแหบ) ↗
- Stachler RJ, et al. Otolaryngol Head Neck Surg. 2018 (PubMed) ↗
- Roy N, et al. J Speech Lang Hear Res. 2004 (PubMed) ↗
- Titze IR, et al. Voicing and silence periods in daily and weekly vocalizations of teachers. J Acoust Soc Am 2007 (PubMed) ↗
- Hunter EJ, Titze IR. Variations in intensity, fundamental frequency, and voicing for teachers in occupational versus nonoccupational settings. J Speech Lang Hear Res 2010 (PubMed) ↗
- Hunter EJ, Banks RE. Gender Differences in the Reporting of Vocal Fatigue in Teachers as Quantified by the Vocal Fatigue Index. Ann Otol Rhinol Laryngol 2017 (PubMed) ↗
- Banks RE, et al. The Effect of Classroom Capacity on Vocal Fatigue as Quantified by the Vocal Fatigue Index. Folia Phoniatr Logop 2017 (PubMed) ↗
- Sivasankar M, Leydon C. The role of hydration in vocal fold physiology. Curr Opin Otolaryngol Head Neck Surg 2010 (PubMed) ↗
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