Stumbling over words, also known as dysfluency, is common for many people from time to time. However, when it becomes more frequent or severe, it can indicate an underlying issue. In this article, we will explore some of the most common reasons for sudden increased dysfluency and provide tips for managing symptoms.
What causes sudden increased dysfluency?
There are several potential causes of sudden increased stumbling over words:
Stress and anxiety
Feeling stressed or anxious can directly impact speech and language capabilities. During times of high stress or anxiety, changes occur in breathing patterns and muscle tension that can disrupt normal speech production. Stress hormones like cortisol also interfere with parts of the brain responsible for language.
Fatigue
When tired or fatigued, both physical and cognitive resources are depleted. This makes it more challenging to focus and coordinate the mouth muscles and vocal cords necessary for clear speech. Insufficient sleep, in particular, has been linked to increased dysfluency.
Medications
Some prescription medications list dysfluency or slurred speech as potential side effects. This includes medications that act on the brain like antidepressants, anti-anxiety medications, stimulants for ADHD, and certain pain medications.
Head injury
Traumatic brain injuries, even mild concussions, can impact speech and language abilities. Areas of the brain like the frontal lobe that control motor planning and language production are vulnerable to injury. Damage leads to difficulty coordinating muscles for clear speech.
Neurological conditions
Disorders that affect the nervous system and brain function often have dysfluency as a symptom. Examples include stroke, Parkinson’s disease, multiple sclerosis, and Alzheimer’s disease. These conditions disrupt pathways between language and speech centers of the brain.
Respiratory infections
When respiratory infections like colds, bronchitis, or sinus infections cause inflammation in the vocal cords and nasal passages, this directly impacts the ability to produce clear speech. Swollen vocal cords disrupt their vibration, leading to voice changes and dysfluencies.
| Cause | Explanation |
|---|---|
| Stress and anxiety | Changes in breathing, muscle tension, and stress hormones impair speech production |
| Fatigue | Depleted cognitive and physical resources make coordinating speech more difficult |
| Medications | Side effects like dysfluency more common with brain-active prescription medications |
| Head injury | Damage to frontal lobe impairs motor planning and language production |
| Neurological conditions | Disorders like stroke and Parkinson’s disrupt brain pathways for language and speech |
| Respiratory infections | Inflammation causes voice changes, impaired vocal cord vibration, and dysfluencies |
When to see a doctor
In many cases, mild or temporary increased dysfluency is not a major cause for concern. However, it is important to make an appointment with your doctor if you experience:
- Sudden, unexplained changes in speech or voice
- Frequent or worsening stuttering
- Slurred or garbled speech
- Loss of train of thought or trouble finding words
- Associated symptoms like muscle weakness, dizziness, headache, or confusion
- Dysfluency after head injury
- No improvement after treating potential causes like respiratory infection or stress
Your doctor can check for underlying conditions that may be contributing to speech changes. Based on your symptoms, they may recommend imaging tests like an MRI to visualize the brain or refer you to a neurologist or speech language pathologist for further evaluation. Identifying any treatable causes is key to improve dysfluency symptoms.
Tips for managing sudden increased dysfluency
If your symptoms do not indicate a serious underlying condition, there are techniques you can try at home to manage increased stuttering or slurring:
Reduce stress
Practice relaxation techniques like deep breathing, meditation, yoga, or mindfulness. Make time for hobbies you enjoy. Get regular exercise to manage anxiety and boost endorphins. Consider stress-reducing supplements like lemon balm oil.
Improve sleep habits
Ensure you get 7-9 hours of sleep per night. Maintain a consistent bedtime routine. Limit electronics before bed, keep your room cool and dark, reduce caffeine intake, and use white noise if needed. Treat any conditions like sleep apnea.
Speak slowly and take pauses
Slow your rate of speech and allow gentle pauses between phrases or thoughts. This provides more time to coordinate the muscles needed for clear speech. Avoid feeling rushed.
Over-articulate words
Focus on carefully pronouncing each syllable and sound. Overemphasize your lip, tongue, and jaw movements. Imagine you are teaching someone how to say a new word.
Try relaxation techniques before speaking
Do breath work, repeat a mantra, or use muscle relaxation techniques right before speaking situations. Reducing physical tension can improve flow.
| Tip | Examples |
|---|---|
| Reduce stress | Deep breathing, meditation, yoga, exercise, hobbies, supplements |
| Improve sleep habits | Get 7-9 hours per night, maintain routine, limit electronics and caffeine |
| Speak slowly and pause | Reduce speech rate, allow gentle pauses between phrases |
| Over-articulate words | Carefully pronounce each sound, overemphasize mouth movements |
| Relaxation before speaking | Breath work, muscle relaxation, repeating a mantra |
When to see a speech therapist
Seeing a speech-language pathologist is advisable if dysfluency:
- Is frequent or severe enough to impede daily communication
- Causes social anxiety or avoidance of speaking situations
- Does not improve with self-help techniques
- Has an underlying cause like neurological disease or injury
A certified speech therapist can provide evaluations to identify contributing factors. They also offer treatment plans involving:
- Breathing, vocal, and articulation exercises
- Structured practice and feedback
- Desensitization to dysfluency triggers
- Changing how you think about and monitor speech
- Developing compensatory strategies
- Stress management and coping techniques
For conditions like stroke, Parkinson’s disease, or TBI, speech therapy is crucial for regaining communication skills.
When to consider medications
Medications may be appropriate in certain situations if stuttering or slurred speech:
- Occurs alongside an anxiety disorder or ADHD
- Stems from a neurological condition like Parkinson’s disease
- Severely impacts daily life and communication
Examples include:
- Antidepressants like SSRIs can reduce anxiety that exacerbates dysfluency
- Stimulants like Ritalin may improve ADHD-related speech issues
- Dopaminergic drugs help manage motor speech disorders in Parkinson’s
- Anti-anxiety medication can be used in the short term for severe speech-induced anxiety
However, medications come with side effects and risks. Non-drug approaches should be tried first. Work closely with your doctor to weigh the potential benefits vs. risks.
When to consider devices and aids
Those with permanent, severe dysfluency from neurological damage or conditions affecting speech muscles may benefit from devices that help produce clearer speech. Options include:
- Speech-assistive devices that play back recorded words and phrases
- Handheld devices that provide visual cues for timing breathing and speech
- Apps that monitor speech rate and provide real-time feedback
- Altered auditory feedback devices to enhance self-monitoring
A speech therapist can help determine if these types of tools could be useful. Proper training is required to use them effectively.
For muscle-related speech disorders, treatment may focus on improving coordination and strength. This could involve exercises, electrical stimulation, or medical devices to support muscles like the tongue.
When to consider speech therapy alternatives
Traditional speech therapy is not for everyone. Some alternatives to explore include:
- Support groups to share tips and experiences with others who stutter
- Online speech therapy for more affordable, accessible treatment
- Hypnosis and suggestions therapy to reframe thoughts about speech
- Acupuncture may relax muscles and reduce stress contributing to dysfluency
- Apps with speech exercises, monitoring, and positive reinforcement
Some people find these options help boost confidence and fluency alongside or instead of standard speech therapy.
When to focus on acceptance
For those with chronic, lifelong developmental stuttering, the most helpful approaches focus on acceptance, desensitization, and building confidence. Some tips include:
- Accept stuttering as part of your identity instead of fighting it
- Practice voluntary stuttering to reduce fear and shame
- Don’t avoid situations that trigger dysfluency; face your fears
- Educate peers to be patient and supportive when you stutter
- Work on self-esteem and recognizing positive qualities beyond speech
- Find a support community of others who stutter
The International Stuttering Association provides resources to help people accept chronic stuttering. Certain therapies aim to reduce shame rather than fluency.
Conclusion
Increased dysfluency can be alarming but often improves by addressing underlying causes like stress, poor sleep, respiratory infections, or certain medications. See a doctor if speech problems persist, worsen, or impede daily life. Be patient with yourself and try management techniques like speaking slowly, over-articulating, and practicing relaxation skills. Speech therapy is considered if difficulties continue. Severe, chronic issues may require medications, devices, or focusing on self-acceptance. With time and support, it is possible to regain fluent communication.