The man was 60 years old and almost morbidly obese. Although he had a history of health problems—including diagnoses of coronary artery disease and diabetes—those issues weren’t what brought him to the office of Dr. Lourdes DelRosso.
“He was referred for evaluation of possible obstructive sleep apnea,” recalls DelRosso, who at the time was a sleep doctor at the Louisiana State University School of Medicine. (He has since moved on to the University of Washington). “I remember I could barely understand him because of the persistent hiccups every couple of words.” She found out that the man had been hiccupping more or less incessantly for the past year—including while he slept—and was, understandably, desperate for relief.
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DelRosso and her colleagues eventually got the hiccups under control using a combination of anti-reflux drugs and a form of airway ventilation therapy known as CPAP (continuous positive airway pressure). But the case stuck with her. “I was shocked to learn that hiccups can persist in all stages of sleep,” she says.
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What exactly is a hiccup? It’s an involuntary reflex—sort of like the one that makes your leg kick when a doctor thwacks the soft spot just below your knee. This reflex causes the diaphragm—the main respiration muscle that causes your chest to rise and fall as you breathe—to forcefully contract, DelRosso explains. The contraction leads to a rapid drop in the throat’s air pressure, which in turn closes the gap between the vocal cords, known as the glottis. It’s the closing of the glottis that causes the “hic” sound you make when you have the hiccups, she says.
What triggers the reflex? There are two theories: First, hiccups may help pull trapped air out of the stomach and into the throat. It could also help move stuck food from the upper part of the esophagus—the tube connecting your throat to your stomach—to the lower part.
DelRosso says any medical condition that affects the pathways involved in the hiccup reflex—including gastroesophageal reflux disease (GERD), hiatal hernia, meningitis, and stroke—could lead to persistent hiccups. But when it comes to run-of-the-mill bouts of hiccups that last just a few minutes, she says swallowing too much air may be to blame. Eating or drinking quickly, slurping a lot of carbonated beverages, and chewing gum are all potential triggers.
Thankfully, there are evidence-backed ways to relieve most normal, short-term bouts of hiccups. If you’re issue is more persistent, research suggests these home remedies won’t do you much good, and DelRosso says you should see a doctor for an evaluation. For everyone else, here’s what the science says about a few of the most common techniques.
Holding Your Breath
“Since the mechanism of hiccups includes a drop in intrathoracic pressure, a mechanism to relieve them involves an increase in intrathoracic pressure,” DelRosso says. What increases intrathoracic pressure? Holding your breath. This actually mimics the effect of CPAP therapy in some ways, DelRosso says.
Being Frightened
Anything that can “interrupt” the hiccup reflex can potentially shut it off, DelRosso says. A good scare qualifies. We’re talking the kind of that makes you jump—and suck a big, sudden gasp of air into your chest.
Popping Your Ears
Popping your ears—that is, plugging your nose, closing your mouth, and trying to force out trapped air—is formally known as the “Valsalva maneuver.” And while you’ve probably been told you’re not supposed to do this, it’s actually not a big deal, says Brett Comer, an ear, nose, and throat doctor and surgeon at the University of Kentucky. There’s also some evidence that, like a good scare, this maneuver can interrupt the hiccup reflex. Just don’t do it too forcefully, and don’t keep doing it if it doesn’t work, Comer says.
Drinking a Glass of Water
There are a dozen variations of this remedy—like, the water has to be ice cold, or you have to drink it upside down, etc. But drinking water (however you want to do it) can help interrupt the hiccup reflex, and so can provide some relief, finds a 2016 study in the British Journal of General Practice.
Breathe into a Paper Bag
Yes, even this method of hiccup relief can work too, DelRosso says. The “rebreathing” technique can raise the amount of CO2 in the air you’re inhaling, which in turn can change the pressure in your airway, interrupting the hiccup reflex.
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